Nonlinear PHQ-9 thresholds and mortality in cardiovascular-kidney-metabolic syndrome: A prospective cohort study of mediation by socioeconomic factors and physical activity.

CKD risk approached significance (moderate/high vs low: HR = 1.04, 95% CI: 1.01–1.07, P = .010; P -interaction = .071), while MeTS absence was unexpectedly associated with increased risk (HR = 1.03, 95% CI: 1.00–1.07, P = .041) despite non-significant interaction ( P -interaction = .449).

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For cardiovascular mortality, the association was in the same direction but did not reach statistical significance (adjusted HR = 0.84, 95% CI: 0.69–1.03).

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