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Avşar PA, Kara T, Kocaman O, Akkuş M. Evaluation of primary markers of inflammation and the systemic inflammation index in specific learning disabilities. Biomark Med 2024:1-10. [PMID: 39360657 DOI: 10.1080/17520363.2024.2404387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 09/11/2024] [Indexed: 10/04/2024] Open
Abstract
Aim: Specific learning disorder (SLD) is a term that refers to reading, writing and arithmetic difficulties. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and systemic inflammation index (SII) are affordable and accessible inflammatory biomarkers. This research aims to evaluate the relationship between NLR, PLR, SII and SLD to determine whether inflammation contributes to pathogenesis.Methods: This study included 90 SLD-diagnosed patients and 90 age-, sex- and ethnicity-matched healthy controls. Blood cell counts and NLR, PLR and SII values were obtained from medical records and compared between the two groups.Results: The NLR, PLR and SII were significantly higher (p = 0.029, p = 0.033 and p = 0.018 respectively) and lymphocyte counts were significantly lower (p = 0.041) in the SLD group. WISC-R total scores decreased with age in the SLD group (-1.988 coefficient, Beta = -0.247 ß, p = 0.041). Multivariate logistic regression analysis revealed that the SII was the only parameter independently associated with the diagnosis of SLD (Beta = 0.003, p = 0.023).Conclusion: Inflammation might play a role in SLD etiopathogenesis. NLR, PLR and SII may be potential biomarkers for SLD in children. Further research may lead to early diagnosis and additional anti-inflammatory pharmacological therapies for SLDs.
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Affiliation(s)
- Pınar Aydoğan Avşar
- Department of Child & Adolescent Psychiatry, Alanya Education & Research Hospital, Antalya, 07425, Turkey
| | - Tayfun Kara
- Department of Child & Adolescent Psychiatry, Alanya Alaaddin Keykubat University Faculty of Medicine, Antalya, 07425, Turkey
| | - Orhan Kocaman
- Department of Child & Adolescent Psychiatry, Alanya Alaaddin Keykubat University Faculty of Medicine, Antalya, 07425, Turkey
| | - Merve Akkuş
- Department of Psychiatry, Faculty of Medicine, Kütahya Health Sciences University, Kütahya, 43100, Turkey
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Ghafori SS, Yousefi Z, Bakhtiari E, mohammadi mahdiabadi hasani MH, Hassanzadeh G. Neutrophil-to-lymphocyte ratio as a predictive biomarker for early diagnosis of depression: A narrative review. Brain Behav Immun Health 2024; 36:100734. [PMID: 38362135 PMCID: PMC10867583 DOI: 10.1016/j.bbih.2024.100734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/23/2024] [Accepted: 02/04/2024] [Indexed: 02/17/2024] Open
Abstract
Depression is a mood disorder that causes persistent feelings of sadness, hopelessness, loss of interest, and decreased energy. Early diagnosis of depression can improve its negative impacts and be effective in its treatment. Previous studies have indicated that inflammation plays an important role in the initiation and development of depression, hence, various inflammatory biomarkers have been investigated for early diagnosis of depression, the most popular of which are blood biomarkers. The Neutrophil to lymphocyte ratio (NLR) may be more informative in the early diagnosis of depression than other widely used markers, such as other leukocyte characteristics or interleukins. Considering the importance of early diagnosis of depression and the role of NLR in early diagnosis of depression, our paper reviews the literature on NLR as a diagnostic biomarker of depression, which may be effective in its treatment. Various studies have shown that elevated NLR is associated with depression, suggesting that NLR may be a valuable, reproducible, easily accessible, and cost-effective method for the evaluation of depression and it may be used in outpatient clinic settings. Closer follow-up can be performed for these patients who have higher NLR levels. However, it seems that further studies on larger samples, taking into account important confounding factors, and assessing them together with other inflammatory markers are necessary to draw some conclusive statements.
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Affiliation(s)
- Sayed Soran Ghafori
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Yousefi
- School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Elham Bakhtiari
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Gholamreza Hassanzadeh
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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3
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Puangsri P, Jinanarong V, Ninla-Aesong P. Impact of antidepressant treatment on complete blood count parameters and inflammatory ratios in adolescents with major depressive disorder. J Psychiatr Res 2023; 157:26-35. [PMID: 36436425 DOI: 10.1016/j.jpsychires.2022.11.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/23/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) are novel biomarkers of systemic inflammation in depression. This study aims to examines the impact of selective serotonin reuptake inhibitor (SSRI) treatment on complete blood count (CBC) parameters and inflammatory ratios in major depressive disorder (MDD). CBC parameters and inflammatory ratios were examined in a total of 45 drug-naive adolescents with MDD and were compared before and after SSRI treatment for 12 weeks and between responders and nonresponders. Following SSRI treatment in MDD, the red blood cell (RBC) count, hematocrit, and red cell distribution width (RDW) significantly increased. Hemoglobin tended to increase. The MCV, MCH, and MCHC values decreased significantly. White blood cell count, neutrophil percentage, monocyte count, and monocyte and basophil percentages decreased significantly. The percentage of lymphocytes significantly increased. The MLR decreased, whereas the NLR tended to decrease. Platelet count and PLR did not change significantly. A higher platelet count at baseline has been associated with non-response to SSRI treatment in patients with MDD. SSRI treatment increased RBC count, hematocrit, RDW, and lymphocyte percentage, and reduced MLR, and neutrophil and monocyte percentages in responders MDD. We suggest higher platelet counts at baseline as a potential predictor of nonresponders.
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Affiliation(s)
- Pavarud Puangsri
- Department of Clinical Science, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.
| | - Vinn Jinanarong
- Prachuap Khiri Khan Hospital, Prachuap Khiri Khan, Thailand.
| | - Putrada Ninla-Aesong
- Department of Preclinical Science, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.
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Bhikram T, Sandor P. Neutrophil-lymphocyte ratios as inflammatory biomarkers in psychiatric patients. Brain Behav Immun 2022; 105:237-246. [PMID: 35839998 DOI: 10.1016/j.bbi.2022.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 07/08/2022] [Accepted: 07/09/2022] [Indexed: 10/17/2022] Open
Abstract
PURPOSE There is a growing amount of evidence to suggest that inflammation may have a role in the onset and prognosis of psychiatric disorders. We reviewed the literature of studies investigating neutrophil-lymphocyte ratios (NLR), a biomarker of inflammation, in both adult and youth psychiatric populations. The limitations of NLR, in addition to the potential mechanisms underlying its relationship with psychiatric disorders, are also discussed. RECENT FINDINGS Unlike in the general population, NLR is elevated in a proportion of adult patients with schizophrenia, major depressive disorder and bipolar disorder, though associations with symptom severity and other clinical parameters are less clear. When compared to baseline, reductions in NLR are sometimes reported after treatment and remission. Results in youth populations largely resemble findings obtained from adult samples, even though youth studies are far fewer in number. SUMMARY The consistent findings of elevated NLR across the reviewed psychiatric disorders suggest that abnormal NLR is not specific to any one disorder but may reflect a pathological brain process that leads to brain dysfunction. These findings support hypotheses of neuroinflammation being important to the etiology of psychiatric disorders. More research is needed to further elucidate the relationship between specific diagnostic and behavioural constructs and NLR. Future work is also needed to determine the specific neuroinflammatory mechanisms that give rise to specific disorders.
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Affiliation(s)
- Tracy Bhikram
- Tourette Syndrome Neurodevelopmental Clinic, University Health Network, Toronto, Ontario, Canada.
| | - Paul Sandor
- Tourette Syndrome Neurodevelopmental Clinic, University Health Network, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Division of Child Psychiatry, Department of Psychiatry, Youthdale Treatment Centers, Toronto, Ontario, Canada; Youthdale Treatment Centers, Toronto, Ontario, Canada
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5
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Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and monocyte to lymphocyte ratio in depression: A meta-analysis. J Affect Disord 2022; 308:375-383. [PMID: 35439466 DOI: 10.1016/j.jad.2022.04.038] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/07/2022] [Accepted: 04/09/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND The possible associations between depression and neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte ratio (MLR) have been evaluated in numerous studies. But the results were still controversial. METHODS The WEB OF SCIENCE, PUBMED, EMBASE, and COCHRANE LIBRARY databases were searched for eligible studies. Standardized mean difference (SMD) and 95% confidence interval (CI) were used to assess the differences in NLR, PLR, and MLR levels between depressed patients and controls. RESULTS Two thousand five hundred and eighty cases and 2664 controls, 1393 cases and 1370 controls, 744 cases and 765 controls were identified in the meta-analyses for NLR, PLR, and MLR, respectively. The pooled analyses showed that depressed subjects had significantly higher levels of NLR than healthy controls (SMD = 0.33, 95% CI = 0.15-0.15, P < 0.001). Sensitivity analysis and publication bias test confirmed the result. Subgroup analyses suggested that the association between depression and NLR could be affected by country, study design, and antidepressant treatment. While no significant difference of PLR (SMD = 0.13, 95% CI = -0.04-0.31, P = 0.140) and MLR (SMD = 0.02, 95% CI = -0.24-0.28, P = 0.892) values was found between depressed subjects and controls. LIMITATIONS High heterogeneity was noted across studies. CONCLUSIONS The present meta-analysis supported the hypothesis that depression is associated with inflammation, and NLR can be used as an indicator of depression. Further large-scale studies are warranted, especially those that evaluate PLR or MLR in depression.
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Flow cytometry based platelet activation markers and state of inflammation among subjects with type 2 diabetes with and without depression. Sci Rep 2022; 12:10039. [PMID: 35710773 PMCID: PMC9203543 DOI: 10.1038/s41598-022-13037-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 05/19/2022] [Indexed: 11/08/2022] Open
Abstract
Type 2 Diabetes Mellitus (T2DM) and Major Depressive Disorder (MDD) are highly disabling disorders associated with a multitude of vascular complications. Platelets are known to play a role in the pathogenesis of vascular complications in both T2DM and MDD. These complications could increase in patients with comorbid diabetes and depression. To quantify and compare flow cytometry based platelet activation markers and the inflammatory state between individuals of diabetes with depression, individuals of diabetes without depression and healthy controls. Out of 114 participants, each study group contained 38 participants in diabetic group, diabetics with depression group and matched control group. Diabetes was diagnosed with the American Diabetes Association (ADA) criteria. Screening of MDD was done with Patient Health Questionnaire 2 (PHQ2) and severity of depression assessed with Hamilton Depression Rating (HAM-D) scale. Platelet markers CD41, CD42b, CD62P and CD63 were assayed using flow cytometer. Platelet count, surface expression of platelet activation markers CD62P and CD63, hs-CRP, insulin and HOMA-IR score differed significantly between the groups. Post hoc analysis showed significantly high CD63 expression in patients with comorbid diabetes and depression compared to those having diabetes without depression. Patients with comorbid diabetes and depression have enhanced platelet hyperactivation and a pro inflammatory state which increases susceptibility to vascular complications.
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Miranda O, Fan P, Qi X, Yu Z, Ying J, Wang H, Brent DA, Silverstein JC, Chen Y, Wang L. DeepBiomarker: Identifying Important Lab Tests from Electronic Medical Records for the Prediction of Suicide-Related Events among PTSD Patients. J Pers Med 2022; 12:524. [PMID: 35455640 PMCID: PMC9025406 DOI: 10.3390/jpm12040524] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 11/25/2022] Open
Abstract
Identifying patients with high risk of suicide is critical for suicide prevention. We examined lab tests together with medication use and diagnosis from electronic medical records (EMR) data for prediction of suicide-related events (SREs; suicidal ideations, attempts and deaths) in post-traumatic stress disorder (PTSD) patients, a population with a high risk of suicide. We developed DeepBiomarker, a deep-learning model through augmenting the data, including lab tests, and integrating contribution analysis for key factor identification. We applied DeepBiomarker to analyze EMR data of 38,807 PTSD patients from the University of Pittsburgh Medical Center. Our model predicted whether a patient would have an SRE within the following 3 months with an area under curve score of 0.930. Through contribution analysis, we identified important lab tests for suicide prediction. These identified factors imply that the regulation of the immune system, respiratory system, cardiovascular system, and gut microbiome were involved in shaping the pathophysiological pathways promoting depression and suicidal risks in PTSD patients. Our results showed that abnormal lab tests combined with medication use and diagnosis could facilitate predicting SRE risk. Moreover, this may imply beneficial effects for suicide prevention by treating comorbidities associated with these biomarkers.
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Affiliation(s)
- Oshin Miranda
- Department of Pharmaceutical Sciences, Computational Chemical Genomics Screening Center, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15206, USA; (O.M.); (P.F.); (X.Q.)
| | - Peihao Fan
- Department of Pharmaceutical Sciences, Computational Chemical Genomics Screening Center, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15206, USA; (O.M.); (P.F.); (X.Q.)
| | - Xiguang Qi
- Department of Pharmaceutical Sciences, Computational Chemical Genomics Screening Center, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15206, USA; (O.M.); (P.F.); (X.Q.)
| | - Zeshui Yu
- Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15206, USA;
| | - Jian Ying
- Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, USA;
| | - Haohan Wang
- Language Technologies Institute, School of Computer Science, Carnegie Mellon University, Pittsburgh, PA 15213, USA;
| | - David A. Brent
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA;
| | - Jonathan C. Silverstein
- Department of Biomedical Informatics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Yu Chen
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46225, USA
| | - Lirong Wang
- Department of Pharmaceutical Sciences, Computational Chemical Genomics Screening Center, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15206, USA; (O.M.); (P.F.); (X.Q.)
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Buoli M, Capuzzi E, Caldiroli A, Ceresa A, Esposito CM, Posio C, Auxilia AM, Capellazzi M, Tagliabue I, Surace T, Legnani F, Cirella L, Di Paolo M, Nosari G, Zanelli Quarantini F, Clerici M, Colmegna F, Dakanalis A. Clinical and Biological Factors Are Associated with Treatment-Resistant Depression. Behav Sci (Basel) 2022; 12:bs12020034. [PMID: 35200285 PMCID: PMC8869369 DOI: 10.3390/bs12020034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/19/2022] [Accepted: 01/29/2022] [Indexed: 12/13/2022] Open
Abstract
Background: Treatment-resistant depression (TRD) is a debilitating condition associated with unmet clinical needs. Few studies have explored clinical characteristics and serum biomarkers associated with TRD. Aims: We investigated whether there were differences in clinical and biochemical variables between patients affected by TRD than those without. Methods: We recruited 343 patients (165 males and 178 females) consecutively hospitalized for MDD to the inpatient clinics affiliated to the Fondazione IRCCS Policlinico, Milan, Italy (n = 234), and ASST Monza, Italy (n = 109). Data were obtained through a screening of the clinical charts and blood analyses conducted during the hospitalization. Results: TRD versus non-TRD patients resulted to be older (p = 0.001), to have a longer duration of illness (p < 0.001), to be more currently treated with a psychiatric poly-therapy (p < 0.001), to have currently more severe depressive symptoms as showed by the Hamilton Depression Rating Scale (HAM-D) scores (p = 0.016), to have lower bilirubin plasma levels (p < 0.001). In addition, more lifetime suicide attempts (p = 0.035), more antidepressant treatments before the current episode (p < 0.001), and a lower neutrophil to lymphocyte ratio at borderline statistically significant level (p = 0.060) were all associated with the TRD group. Conclusion: We identified candidate biomarkers associated with TRD such as bilirubin plasma levels and NLR, to be confirmed by further studies. Moreover, TRD seems to be associated with unfavorable clinical factors such as a predisposition to suicidal behaviors. Future research should replicate these results to provide robust data in support of the identification of new targets of treatment and implementation of prevention strategies for TRD.
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Affiliation(s)
- Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Enrico Capuzzi
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (A.C.); (M.C.); (F.C.)
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (A.C.); (M.C.); (F.C.)
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-02-55035983
| | - Cecilia Maria Esposito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Cristina Posio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
| | - Anna Maria Auxilia
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (A.M.A.); (M.C.); (I.T.); (A.D.)
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (A.M.A.); (M.C.); (I.T.); (A.D.)
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (A.M.A.); (M.C.); (I.T.); (A.D.)
| | - Teresa Surace
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (A.C.); (M.C.); (F.C.)
| | - Francesca Legnani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Luisa Cirella
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
| | - Martina Di Paolo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
| | - Francesco Zanelli Quarantini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (M.B.); (C.M.E.); (C.P.); (T.S.); (F.L.); (L.C.); (M.D.P.); (G.N.); (F.Z.Q.)
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (A.C.); (M.C.); (F.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (A.M.A.); (M.C.); (I.T.); (A.D.)
| | - Fabrizia Colmegna
- Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, 20900 Monza, Italy; (E.C.); (A.C.); (M.C.); (F.C.)
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy; (A.M.A.); (M.C.); (I.T.); (A.D.)
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Cheng Y, Wang Y, Wang X, Jiang Z, Zhu L, Fang S. Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis. Front Psychiatry 2022; 13:893097. [PMID: 35782448 PMCID: PMC9240476 DOI: 10.3389/fpsyt.2022.893097] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research on neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in depression is still emerging and has increased 3-fold since the first meta-analysis. An updated meta-analysis with sufficient studies can provide more evidence for a potential relationship between NLR, PLR, MLR, and depression. METHODS We identified 18 studies from the PubMed, EMBASE, Cochrane library, and Web of Science databases. Meta-analyses were performed to generate pooled standardized mean differences (SMDs) and 95% confidence intervals (CIs) between patients with depression and controls. Sensitivity analysis, subgroup analysis, meta-regression, and publication bias were conducted. RESULTS A total of 18 studies including 2,264 depressed patients and 2,415 controls were included. Depressed patients had significantly higher NLR and PLR compared with controls (SMD = 0.33, 95% CI: 0.15-0.52, p < 0.001 and SMD = 0.24, 95% CI: 0.02-0.46, p < 0.05, respectively). MLR was slightly higher in depressed individuals compared to controls (SMD = 0.15, 95% CI: -0.26 to 0.55, p > 0.05), despite the absence of significance. Sensitivity analysis removing one study responsible for heterogeneity showed a higher and significant effect (SMD = 0.32, 95% CI: 0.20-0.44) of MLR. Three subgroup analyses of NLR, PLR, MLR, and depression revealed obvious differences in the inflammatory ratios between depressed patients and controls in China and the matched age and gender subgroup. Individuals with post-stroke depression (PSD) had higher NLR and MLR values as compared to non-PSD patients (SMD = 0.51, 95% CI: 0.36-0.67, p < 0.001 and SMD = 0.46, 95% CI: 0.12-0.79, p < 0.01, respectively). Meta-regression analyses showed that male proportion in the case group influenced the heterogeneity among studies that measured NLR values (p < 0.05). CONCLUSIONS Higher inflammatory ratios, especially NLR, were significantly associated with an increased risk of depression. In the subgroup of China and matched age and gender, NLR, PLR, and MLR were all elevated in depressed patients vs. controls. Individuals with PSD had higher NLR and MLR values as compared to non-PSD patients. Gender differences may have an effect on NLR values in patients with depression.
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Affiliation(s)
- Yanwei Cheng
- Department of Neurology, Neuroscience Centre, The First Hospital of Jilin University, Changchun, China
| | - Yiwen Wang
- Department of Neurology, Neuroscience Centre, The First Hospital of Jilin University, Changchun, China
| | - Xiangyi Wang
- Department of Neurology, Neuroscience Centre, The First Hospital of Jilin University, Changchun, China
| | - Zhuoya Jiang
- Department of Neurology, Neuroscience Centre, The First Hospital of Jilin University, Changchun, China
| | - Lijun Zhu
- China-Japan Union Hospital of Jilin University, Changchun, China
| | - Shaokuan Fang
- Department of Neurology, Neuroscience Centre, The First Hospital of Jilin University, Changchun, China
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10
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Puangsri P, Ninla-Aesong P. Potential usefulness of complete blood count parameters and inflammatory ratios as simple biomarkers of depression and suicide risk in drug-naive, adolescents with major depressive disorder. Psychiatry Res 2021; 305:114216. [PMID: 34571404 DOI: 10.1016/j.psychres.2021.114216] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/06/2021] [Accepted: 09/18/2021] [Indexed: 12/15/2022]
Abstract
We determined whether an elevated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were associated with depression in major depressive disorder (MDD), or suicide risk in MDD patients. A total of 137 adolescents with MDD who were antidepressant-naïve and 56 healthy controls (HC) were included. Recent suicidal behaviors were assessed. The NLR, PLR, and MLR were calculated from parameters obtained from a routine complete blood cell count parameters and compared between the MDD subgroups and HC. Cohen's d was calculated as a measure of effect size. The linear relationship between biomarkers with depression severity or suicidality severity was also analysed. Changes in CBC parameters and inflammatory ratios appeared to be more closely related to the suicidality severity than depressive severity. As compared with HC, the WBC count, neutrophil percentage, platelet count, NLR, and PLR were higher in MDD, whereas the lymphocyte percentage was lower. As compared to non-suicidal ideation (non-SI) MDD and HC, the lymphocyte percentage was decreased in MDD with suicidal attempts (SA), whereas monocyte count and MLR were increased. Suicidal attempts in MDD patients were associated with the lower lymphocytes percentage, as well as the elevated monocyte count and MLR.
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Affiliation(s)
- Pavarud Puangsri
- Department of Clinical Sciences, School of Medicine, Walailak University, Nakhon Si Thammarat 80161, Thailand
| | - Putrada Ninla-Aesong
- Department of Preclinical Sciences, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand 80161.
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Krivosova M, Grendar M, Hrtanek I, Ondrejka I, Tonhajzerova I, Sekaninova N, Bona Olexova L, Mokra D, Mokry J. Potential major depressive disorder biomarkers in pediatric population - a pilot study. Physiol Res 2020; 69:S523-S532. [PMID: 33476174 DOI: 10.33549/physiolres.934590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mental disorders affect 10-20 % of the young population in the world. Major depressive disorder (MDD) is a common mental disease with a multifactorial and not clearly explained pathophysiology. Many cases remain undetected and untreated, which influences patients' physical and mental health and their quality of life also in adulthood. The aim of our pilot study was to assess the prediction value of selected potential biomarkers, including blood cell counts, blood cell ratios, and parameters like peroxiredoxin 1 (PRDX1), tenascin C (TNC) and type IV collagen (COL4) between depressive pediatric patients and healthy peers and to evaluate a short effect of antidepressant treatment. In this study, 27 young depressive patients and 26 non-depressed age-matched controls were included. Blood analyses and immunological assays using commercial kits were performed. Platelet count was the only blood parameter for which the case/control status was statistically significant (p=0.01) in a regression model controlling for the age and gender differences. The results from ELISA analyses showed that the case/control status is a significant predictor of the parameters PRDX1 (p=0.05) and COL4 (p=0.009) in respective regression model considering the age and gender differences between MDD patients and controls. A major finding of this study is that values of platelet count, monocyte to lymphocyte ratio, white blood cell, and monocyte counts were assessed by the Random Forest machine learning algorithm as relevant predictors for discrimination between MDD patients and healthy controls with a power of prediction AUC=0.749.
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Affiliation(s)
- M Krivosova
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
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