Abstract

Background

Mental disorders in occupational populations pose significant health and economic burdens, but there exists a lack of practical and objective biomarkers for occupational mental health monitoring. Our study aims to explore the correlation between high-density lipoprotein (HDL)-related inflammatory markers and negative psychological symptoms in occupational populations. We also seek to evaluate the potential application effectiveness of these indicators as biomarkers for identifying the impact of mental health on occupational populations. Moreover, the indicators found in this study can be used as indicators for identifying high-risk groups prone to inflammatory responses caused by negative psychological symptoms.

Methods

Our study adopted a cross-sectional design with a combination of questionnaires and biochemical index tests for 1920 eligible occupational populations. The Depression Anxiety Stress Scales-21 (DASS-21) was used to measure participants' levels of anxiety, depression, and stress. Collect individual and occupational characteristics of survey respondents through self-administered questionnaires. Blood samples are also collected to measure high-density lipoprotein cholesterol levels and peripheral blood cell counts. We employed statistical analyses including correlation analysis, Receiver Operating Characteristic (ROC) curve analysis, and univariate and multivariate regression.

Results

The final sample size included in the analysis was 1,434. The results showed that stress, anxiety, and depressive symptoms were significantly correlated with all four HDL-related inflammatory indices ( < 0.05). Especially for MHR, compared to those without symptoms, individuals experiencing stress, anxiety, or depression had an OR of 2.75 (95% CI: 1.90, 3.99), 3.27 (95% CI: 2.25, 4.78), and 3.02 (95% CI: 2.08, 4.40) for abnormally high levels, respectively. In addition, subgroup analyses showed that lower monthly incomes, longer working hours and frequent night shifts might be promoting factors for elevated HDL-related inflammatory levels. Receiver Operating Characteristic (ROC) analysis further demonstrated that PHR and MHR exhibit good predictive ability for all three psychological symptoms, with AUC values exceeding 0.6. Notably, for individuals with over 30 years of work experience, the predictive performance AUC is even higher, reaching above 0.7.

Conclusion

The results of this study suggest that PHR and MHR are expected to be potential biomarkers for identifying health problems caused by negative psychological symptoms in occupational groups, providing valuable information for occupational mental health assessment. Preventive measures should be implemented for high-risk groups, including those with low income, long working hours, and frequent night shifts, to mitigate potential health impacts.

MeSH

Depression, Lipoproteins, Stress, Physiological, Income, Public Health, Lipoproteins, Hdl, Biomarkers, Signs And Symptoms, Work, Roc Curve, Mental Health

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• Association between the Alpha-1-acid glycoprotein concentrations and depression in US adult women: a cross-sectional study from NHANES 2021-2023. Front Psychiatry, 2025