U-shaped association between myeloperoxidase levels and anxiety risk: a cross-sectional study in a Chinese population

ObjectiveThis study investigates the association between myeloperoxidase (MPO) levels and anxiety risk in Chinese adults and explores potential effect modifiers, with implications for neuroinflammatory biomarker-guided anxiety prevention strategies.MethodsUsing cross-sectional data from 30,418 adult...

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Main Authors: Junteng Zhou, Qihang Kong, Xiaojing Liu, Yan Huang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1596844/full
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author Junteng Zhou
Qihang Kong
Xiaojing Liu
Xiaojing Liu
Yan Huang
Yan Huang
Yan Huang
Yan Huang
author_facet Junteng Zhou
Qihang Kong
Xiaojing Liu
Xiaojing Liu
Yan Huang
Yan Huang
Yan Huang
Yan Huang
author_sort Junteng Zhou
collection DOAJ
description ObjectiveThis study investigates the association between myeloperoxidase (MPO) levels and anxiety risk in Chinese adults and explores potential effect modifiers, with implications for neuroinflammatory biomarker-guided anxiety prevention strategies.MethodsUsing cross-sectional data from 30,418 adults undergoing routine health examinations (July 2020–June 2021), anxiety severity was assessed via the Self-Rating Anxiety Scale (SAS; score ≥ 50 as clinically relevant). Plasma MPO was quantified by ELISA. Multivariate logistic regression, restricted cubic splines (RCS), threshold effect analysis, and subgroup interactions were conducted to evaluate nonlinear associations.ResultsA U-shaped relationship between MPO and anxiety risk was identified. In fully adjusted models, participants in the lowest (Q1: ≤29.77 ng/mL, OR = 1.15, 95% CI: 1.03–1.28, p = 0.01) and highest quintiles (Q5: ≥47.3 ng/mL, OR = 1.17, 95% CI: 1.05–1.31, p = 0.004) exhibited significantly elevated anxiety risks compared to the reference quintile (Q2: 29.8–34.7 ng/mL). RCS analysis confirmed a nonlinear association (p for nonlinearity < 0.01), with an inflection point at 30 ng/mL: below this threshold, each 1 ng/mL MPO increase reduced anxiety risk (OR = 0.982, CI: 0.970–0.994), while levels above it heightened risk (OR = 1.004, CI: 1.001–1.008). Diabetes mellitus significantly modified this relationship (p-interaction = 0.028), with diabetic individuals showing amplified risks at higher plasma MPO (Q5 OR = 1.84 vs. non-diabetic Q5 OR = 1.15).ConclusionPlasma MPO demonstrates a U-shaped association with anxiety risk independent of cardiometabolic confounders. Diabetic individuals exhibit heightened susceptibility to MPO-related anxiety, suggesting synergistic neuroinflammatory pathways. Monitoring MPO may aid in risk stratification and personalized interventions, particularly in populations with diabetes.
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spelling doaj-art-aebbd73fd4f94f07b0ce88efd0f08ccb2025-08-20T02:14:54ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-05-011310.3389/fpubh.2025.15968441596844U-shaped association between myeloperoxidase levels and anxiety risk: a cross-sectional study in a Chinese populationJunteng Zhou0Qihang Kong1Xiaojing Liu2Xiaojing Liu3Yan Huang4Yan Huang5Yan Huang6Yan Huang7Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, ChinaLaboratory of Cardiovascular Diseases, Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, ChinaLaboratory of Cardiovascular Diseases, Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu, ChinaHealth Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, ChinaState Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, ChinaResearch Laboratory for Prediction and Evaluation of Chronic Diseases in the Elderly, National Clinical Research Center for Geriatric Diseases, West China Hospital, Sichuan University, Chengdu, ChinaGeneral Practice Research Institute, West China Hospital, Sichuan University, Chengdu, ChinaObjectiveThis study investigates the association between myeloperoxidase (MPO) levels and anxiety risk in Chinese adults and explores potential effect modifiers, with implications for neuroinflammatory biomarker-guided anxiety prevention strategies.MethodsUsing cross-sectional data from 30,418 adults undergoing routine health examinations (July 2020–June 2021), anxiety severity was assessed via the Self-Rating Anxiety Scale (SAS; score ≥ 50 as clinically relevant). Plasma MPO was quantified by ELISA. Multivariate logistic regression, restricted cubic splines (RCS), threshold effect analysis, and subgroup interactions were conducted to evaluate nonlinear associations.ResultsA U-shaped relationship between MPO and anxiety risk was identified. In fully adjusted models, participants in the lowest (Q1: ≤29.77 ng/mL, OR = 1.15, 95% CI: 1.03–1.28, p = 0.01) and highest quintiles (Q5: ≥47.3 ng/mL, OR = 1.17, 95% CI: 1.05–1.31, p = 0.004) exhibited significantly elevated anxiety risks compared to the reference quintile (Q2: 29.8–34.7 ng/mL). RCS analysis confirmed a nonlinear association (p for nonlinearity < 0.01), with an inflection point at 30 ng/mL: below this threshold, each 1 ng/mL MPO increase reduced anxiety risk (OR = 0.982, CI: 0.970–0.994), while levels above it heightened risk (OR = 1.004, CI: 1.001–1.008). Diabetes mellitus significantly modified this relationship (p-interaction = 0.028), with diabetic individuals showing amplified risks at higher plasma MPO (Q5 OR = 1.84 vs. non-diabetic Q5 OR = 1.15).ConclusionPlasma MPO demonstrates a U-shaped association with anxiety risk independent of cardiometabolic confounders. Diabetic individuals exhibit heightened susceptibility to MPO-related anxiety, suggesting synergistic neuroinflammatory pathways. Monitoring MPO may aid in risk stratification and personalized interventions, particularly in populations with diabetes.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1596844/fullmyeloperoxidaseanxietyU-shaped associationdiabetes mellituscross-sectional studyneuroinflammation
spellingShingle Junteng Zhou
Qihang Kong
Xiaojing Liu
Xiaojing Liu
Yan Huang
Yan Huang
Yan Huang
Yan Huang
U-shaped association between myeloperoxidase levels and anxiety risk: a cross-sectional study in a Chinese population
Frontiers in Public Health
myeloperoxidase
anxiety
U-shaped association
diabetes mellitus
cross-sectional study
neuroinflammation
title U-shaped association between myeloperoxidase levels and anxiety risk: a cross-sectional study in a Chinese population
title_full U-shaped association between myeloperoxidase levels and anxiety risk: a cross-sectional study in a Chinese population
title_fullStr U-shaped association between myeloperoxidase levels and anxiety risk: a cross-sectional study in a Chinese population
title_full_unstemmed U-shaped association between myeloperoxidase levels and anxiety risk: a cross-sectional study in a Chinese population
title_short U-shaped association between myeloperoxidase levels and anxiety risk: a cross-sectional study in a Chinese population
title_sort u shaped association between myeloperoxidase levels and anxiety risk a cross sectional study in a chinese population
topic myeloperoxidase
anxiety
U-shaped association
diabetes mellitus
cross-sectional study
neuroinflammation
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1596844/full
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