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. 2016 Jan;13(1):121-6.
doi: 10.4306/pi.2016.13.1.121. Epub 2015 Nov 20.

Increased Neutrophil/Lymphocyte Ratio in Patients with Depression is Correlated with the Severity of Depression and Cardiovascular Risk Factors

Esra Aydin Sunbul  1 , Murat Sunbul  2 , Omer Yanartas  3 , Fatma Cengiz  1 , Mehmet Bozbay  2 , Ibrahim Sari  2 , Huseyin Gulec  1
Affiliations

Increased Neutrophil/Lymphocyte Ratio in Patients with Depression is Correlated with the Severity of Depression and Cardiovascular Risk Factors

Esra Aydin Sunbul et al. Psychiatry Investig. 2016 Jan.

Abstract

Objective: Chronic inflammation is associated with cardiovascular (CV) risk factors and psychiatric disorders. The neutrophil to lymphocyte ratio (NLR) has been investigated as a new biomarker for systemic inflammatory response. The aim of the study is to investigate the relation of NLR with severity of depression and CV risk factors.

Methods: The study population consisted of 256 patients with depressive disorder. Patients were evaluated with the Hamilton Rating Scale for Depression (HAM-D). Patients were classified into four groups according to their HAM-D score such as mild, moderate, severe, and very severe depression. Patients were also evaluated in terms of CV risk factors.

Results: Patients with higher HAM-D score had significantly higher NLR levels compared to patients with lower HAM-D score. Correlation analysis revealed that severity of depression was associated with NLR in depressive patients (r=0.333, p<0.001). Patients with one or more CV risk factors have significantly higher NLR levels. Correlation analysis revealed that CV risk factors were associated with NLR in depressive patients (r=0.132, p=0.034). In logistic regression analyses, NLR levels were an independent predictor of severe or very severe depression (odds ratio: 3.02, 95% confidence interval: 1.867-4.884, p<0.001). A NLR of 1.57 or higher predicted severe or very severe depression with a sensitivity of 61.4% and specificity of 61.2%.

Conclusion: Higher HAM-D scores are associated with higher NLR levels in depressive patients. NLR more than 1.57 was an independent predictor of severe or very severe depression. A simple, cheap white blood cell count may give an idea about the severity of depression.

Keywords: Cardiovascular risk; Depression; Inflammatory; Lymphocyte; Neutrophil.

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Figures

Figure 1
Figure 1. Comparison of neutrophil to lymphocyte ratio between patients with depression according to severity of disease.
Figure 2
Figure 2. Comparison of neutrophil to lymphocyte ratio between patients with depression according to presence of cardiovascular risk factors.
See this image and copyright information in PMC

References

    1. World Health Organization. Mental Health: New Understanding, New Hope. Geneva, Switzerland: World Health Organization; 2001. - PubMed
    1. Ebmeier KP, Donaghey C, Steele JD. Recent developments and current controversies in depression. Lancet. 2006;367:153–167. - PubMed
    1. Thornton LM, Andersen BL, Schuler TA, Carson WE., 3rd A psychological intervention reduces inflammatory markers by alleviating depressive symptoms: secondary analysis of a randomized controlled trial. Psychosom Med. 2009;71:715–724. - PMC - PubMed
    1. Dekker RL, Moser DK, Tovar EG, Chung ML, Heo S, Wu JR, et al. Depressive symptoms and inflammatory biomarkers in patients with heart failure. Eur J Cardiovasc Nurs. 2014;13:444–450. - PMC - PubMed
    1. Elovainio M, Aalto AM, Kivimäki M, Pirkola S, Sundvall J, Lönnqvist J, et al. Depression and C-reactive protein: population-based Health 2000 study. Psychosom Med. 2009;71:423–430. - PubMed

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