Page 82 - JCBP-3-1

Journal of Clinical and

Basic Psychosomatics

ORIGINAL RESEARCH ARTICLE
Association of high-density lipoprotein-related

inflammatory markers with suicidal ideation:
Data from the NHANES 2015 – 2023 survey

1
2
1
Zhonghua Sun 1 , Sen Chen , Yameng Xu , and Chen Qu *
1 Department of Geriatrics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing,
Jiangsu, China
2 Department of Epidemiology, School of Public Health of Nanjing Medical University, Nanjing,
Jiangsu, China

Abstract

Suicidal ideation (SI) is a strong predictor of suicide risk. High-density lipoprotein
(HDL)-related inflammatory indicators, which combine HDL cholesterol (HDL-C)
with other inflammation-related markers, provide a comprehensive assessment of
the body’s inflammatory, immune, and metabolic states. However, limited research
has examined the association between HDL-related inflammatory indicators and SI.
This study analyzed data from 14,554 participants, including 588 individuals with SI,
using information from the 2015 – 2023 National Health and Nutrition Examination
Survey. SI was evaluated using the ninth item of the Patient Health Questionnaire-9.
*Corresponding author: A weighted approach was applied to logistic regression, restricted cubic spline, and
Chen Qu
(quchen@njmu.edu.cn) subgroup analyses to explore the relationship between six HDL-related inflammatory
indicators and SI. In addition, weighted quantile sum regression was employed to
Citation: Sun Z, Chen S, Xu Y,
Qu C. Association of high-density account for the interactions among inflammatory markers and their influence on the
lipoprotein-related inflammatory outcomes. Among the various single-marker models, only high-sensitivity C-reactive
markers with suicidal ideation: Data protein/HDL-C (CHR) consistently demonstrated a significant linear association
from the NHANES 2015 – 2023
survey. J Clin Basic Psychosom. with SI. In Model 3 of the logistic regression analysis, the odds ratio with a 95%
2025;3(1):76-88. confidence interval was 1.11 (1.02, 1.21). Mixture analyses further identified CHR as
doi: 10.36922/jcbp.5084 the primary factor contributing to the increased prevalence of SI. This study provides
Received: October 8, 2024 the first epidemiological evidence linking multiple novel inflammatory markers to SI,
identifying CHR as the most critical factor. Further prospective studies are needed to
Revised: October 20, 2024
confirm this causal relationship.
Accepted: November 13, 2024
Published Online: December 17, Keywords: Suicidal ideation; Patient Health Questionnaire-9; High-density lipoprotein-
2024
related inflammatory indicators; National Health and Nutrition Examination Survey
Copyright: © 2024 Author(s).
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution, 1. Introduction
and reproduction in any medium,
provided the original work is Globally, suicide remains a major cause of death, with approximately 800,000 fatalities
properly cited. annually, accounting for 57% of all violent deaths. Although global suicide rates have
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Publisher’s Note: AccScience declined since 1990, suicide remains among the top 10 leading causes of age-standardized
Publishing remains neutral with years of life lost, including in the United States (U.S.). Suicidal ideation (SI) substantially
2
regard to jurisdictional claims in
published maps and institutional increases the risk of suicide across diverse populations and serves as a critical warning
3,4
affiliations. sign of suicide mortality. Numerous studies have demonstrated a strong association
Volume 3 Issue 1 (2025) 76 doi: 10.36922/jcbp.5084