Influence of Magnesium Status on the Association of Tobacco Exposure With Depression in Old Patients With Heart Failure: A Cross-Sectional Study of the NHANES Database.

AIM: The aim of this study is to examine the effect of magnesium depletion score (MDS) on the relationship between tobacco exposure and depression in older patients with heart failure (HF).

METHODS

Data from the National Health and Nutrition Examination Surveys (NHANES, 2005-2018) were analyzed in this cross-sectional study. Weighted logistic regression models were used to assess associations between MDS, tobacco exposure, and depression. Propensity score matching (PSM) was applied to minimize potential confounding.

RESULTS

Among 554 eligible participants, 166 presented with depression. After covariate adjustment, quitting smoking (robustness OR = 2.179, 95% CI: 1.190-3.685), current smoking (robustness OR = 1.941, 95% CI: 0.904-3.770), and serum cotinine ≥3 ng/mL (robustness OR = 1.968, 95% CI: 0.986-3.590) were significantly associated with increased depression risk. After PSM, quitting smoking (OR = 2.16, 95% CI: 1.13-4.12) and cotinine ≥3 ng/mL (OR = 2.47, 95% CI: 1.06-5.75) remained significantly associated with depression. Compared with MDS ≤ 2 combined with no smoking, MDS ≤ 2 combined with quitting smoking (robustness OR = 2.375, 95% CI: 1.076-4.739) and MDS > 2 combined with quitting smoking (robustness OR = 3.142, 95% CI: 1.413-5.824) or currently smoking (robustness OR = 5.608, 95% CI: 1.790-13.661) were all linked to higher odds of depression. A significant multiplicative interaction between MDS and smoking was observed with p < 0.001. Also, MDS > 2 combined with serum cotinine ≥3 ng/mL was associated with higher odds of depression compared with MDS ≤ 2 combined with serum cotinine < 0.05 ng/mL (robustness OR = 5.258, 95% CI: 1.869-11.546).

CONCLUSION

MDS appears a possible interaction on the association between self-reported tobacco exposure and depression. Whether maintaining adequate magnesium status can help reduce depression risk in HF patients needs further validation.