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. 2024 Dec 12;16(24):4300.
doi: 10.3390/nu16244300.

Association of TyG Index and TG/HDL-C Ratio with Trajectories of Depressive Symptoms: Evidence from China Health and Retirement Longitudinal Study

Tingting Guo  1 , Qing Zou  1 , Qi Wang  1 , Yi Zhang  1 , Xinyuan Zhong  1 , Hantong Lin  1 , Wenxuan Gong  1 , Yingbo Wang  1 , Kun Xie  1 , Kunpeng Wu  1 , Feng Chen  2 , Wen Chen  1   3
Affiliations

Association of TyG Index and TG/HDL-C Ratio with Trajectories of Depressive Symptoms: Evidence from China Health and Retirement Longitudinal Study

Tingting Guo et al. Nutrients. .

Abstract

Objectives: To explore whether the triglyceride-glucose (TyG) index and the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio are associated with the trajectories of depressive symptoms.

Methods: In this longitudinal study, 4215 participants aged 45 years and older were recruited from the China Health and Retirement Longitudinal Study from 2011 to 2018. The trajectories of depressive symptoms, measured by the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), were identified using group-based trajectory modeling. Multinomial logistic models and restricted cubic spline analysis were used to investigate the relationships between the TyG index and the TG/HDL-C ratio and the trajectories of depressive symptoms. Stratified analyses were conducted based on sex, age, place of residence, and body mass index (BMI).

Results: Five distinct trajectories of depressive symptoms characterized by stable low, stable moderate, decreasing, increasing, and stable high were identified during a follow-up of 7 years. The associations of the TyG index and the TG/HDL-C ratio with trajectories of depressive symptoms are not entirely consistent. After adjusting for covariates, a higher TyG index at baseline was associated with lower odds of being on the decreasing trajectory of depressive symptoms (ORad = 0.61, 95% CI: 0.40-0.92) compared to the stable low trajectory, and restricted cubic spline analysis revealed a negative linear relationship between the TyG index and the likelihood of a decreasing trajectory of depressive symptoms. However, the relationship between the TG/HDL-C ratio and the decreasing trajectory of depressive symptoms was no longer statistically significant when all confounders were controlled (ORad = 0.72, 95% CI: 0.50-1.04). Additionally, this negative association between the TyG index and decreasing trajectory of depressive symptoms was observed among 45-64-year-old individuals, female participants, those living in rural areas, and those with a normal BMI.

Limitations: This study was conducted in a middle-aged and elderly population in China, and extrapolation to other regions and populations requires further confirmation.

Conclusions: Compared to the TG/HDL-C ratio, the TyG index may be a better predictor for trajectories of depressive symptoms in middle-aged and older adults. Considering that the pathology of depression progresses long term, our findings may have utility for identifying available and reliable markers for the development of depression.

Keywords: TG/HDL-C ratio; depressive symptoms; longitudinal study; trajectory; triglyceride–glucose (TyG) index.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
The trajectories of depressive symptoms in the study participants from 2011 to 2018. The trajectories are shown as solid lines, and the 95% confidence intervals (CIs) are shown as the dashed line.
Figure 2
Figure 2
Descriptions of the baseline TyG index based on the trajectories of depressive symptoms. The dot and error bar represent the mean and standard deviation of the baseline triglyceride–glucose (TyG) index in the five trajectory groups, respectively.
Figure 3
Figure 3
Descriptions of the baseline TG/HDL-C ratio based on the trajectories of depressive symptoms. The dot and error bar represent the mean and standard deviation of the baseline triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio in the five trajectory groups, respectively.
Figure 4
Figure 4
The association between quartiles of the TyG index and the TG/HDL-C ratio and trajectories of depressive symptoms. Abbreviations: OR, odds ratio; CI, confidence interval; TyG, triglyceride–glucose; TG/HDL-C, triglyceride to high-density lipoprotein cholesterol. The demographic factors included age, sex, household income, marital status, educational level, and residence. Health behaviors consisted of smoking status, drinking status, and hours of sleep. Baseline health conditions included health status, disabilities, hypertension, dyslipidemia, cardiovascular disease (CVD), diabetes, and cognition scores. Clinical laboratory test data consisted of body mass index (BMI), systolic blood pressure, diastolic blood pressure, low-density lipoprotein cholesterol (LDL-C), glycated hemoglobin, C-reactive protein (CRP), and high-density lipoprotein cholesterol (HDL-C, only for analyzing the TyG index).
Figure 5
Figure 5
The restricted cubic spline curve for the association of the TyG index with the trajectory of decreasing depressive symptoms.
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