Non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) serves as a pivotal biomarker in clinical contexts, enabling the precise assessment of an individual's risk for atherosclerosis and the development of metabolic diseases, particularly diabetes mellitus. Dyslipidemia is strongly associated with the development of several psychiatric disorders. The aim of this study was to explore the association between NHHR and the risk of developing depression in a middle-aged and elderly population from a community in Beijing, China.

We conducted a cross-sectional study using data from 764 questionnaires collected in a community in Beijing, China in 2019. The CESD-10 questionnaire was used to evaluate depression. A multivariable logistic regression model and a restricted cubic spline (RCS) model were applied to investigate the association between NHHR and depression risk. Additionally, subgroup and sensitivity analyses were conducted to test the robustness of the results.

A total of 152 individuals were diagnosed with depression in this study. After adjusting for covariates, higher NHHR was significantly associated with an elevated risk of depression (odds ratio [OR]: 1.62, 95% confidence interval [CI]: 1.24~2.12, P<0.001). Compared with the reference group with the lowest NHHR, participants in the fourth quartile had a significantly increased risk of depression after full adjustments (OR: 1.84, 95%CI: 1.09–3.13, P=0.009). A linear dose-response relationship existed between NHHR and depression risk (P=0.157). The results were robust in subgroup and sensitivity analyses.

Higher NHHR (either as a continuous or categorical variable) is significantly associated with a higher risk of depression. Further research on dyslipidemia will aid in the diagnosis and treatment of depression.