Abstract
INTRODUCTION: Previous studies have found that depressive patients tend to have low levels of creatinine; however, the extent to which creatinine levels are associated with depression has been poorly investigated. Therefore, this study aimed to explore the relationship between creatinine levels and depression. METHODS: The participants and follow-up data from the China Health and Retirement Longitudinal Study (CHARLS), as well as metabolomics data from the Metabolite Network of Depression Database (MENDA), were collected. The 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) was used to assess the severity of depression. Spearman correlation analysis, spline regression, and binary logistic regression models were employed to explore the relationship between creatinine levels and depression. RESULTS: A total of 7,826 participants and 3,886 follow-up participants were included in the CHARLS 2011 and 2015 surveys. Of these, 37.9% (2,966/7,826) and 34.6% (13,44/3,886) of participants experienced depression in CHARLS 2011 and 2015, respectively. The creatinine level was negatively correlated with the total CESD-10 score and dimensions scores, showing an inverse dose-response relationship between creatinine levels and depression. Compared with participants with high creatinine levels, those with middle creatinine levels were associated with a higher risk of depression (OR = 1.22, 95% CI = 1.08-1.38), while participants with low creatinine levels had the highest risk of depression (OR = 1.30, 95% CI = 1.13-1.49) in the fully adjusted model. Similar results were observed in the follow-up data, and the MENDA metabolomics data validated the negative correlation between creatinine levels and the severity of depression. CONCLUSION: Lower levels of creatinine were closely associated with a higher risk of depression, and it could serve as a potential marker for identifying individuals at high risk of depression.