Neutrophil to albumin ratio as a novel associated factor for depression; results from NHANES 2017-2018

Abstract

Background: Depression is a leading public health problem globally. Inflammatory mechanisms are thought to have a role in the pathophysiology of the disease.

Methods: Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 were analyzed. The study design was cross-sectional. The main variables of the study were Depression and NPAR. Covariates of the study were age, sex, race, educational level, marital status, body mass index (BMI), and alcohol intake, as well as hypertension, coronary artery disease, cancer or malignancy, and diabetes.

Results: Finally, 302 participants with Depression and 3731 without Depression were included in the analysis. Multiple logistic regression analysis using backward elimination showed that participants in the fourth quartile for NPAR are at greater risk for Depression compared with participants in the first quartile (OR: 1.55, 95 % CI: 1.08-2.22). Areas under the receiver operating curve (AUROC) of the NPAR to classify depression were 57.6 % (95 % CI: 53.3-61.9), 60.4 % (95 % CI: 53.2-67.6), 61.5 % (95 % CI: 55.2-67.7), and 70.0 % (95 % CI: 52.4-87.6) in the general population, males, participants hypertension and diabetes, respectively.

Conclusion: In conclusion, these results suggested that NPAR is associated with depression and could serve as a fair biomarker in subpopulations including males, and patients with diabetes and hypertension. It is suggested to use NPAR in combination with other associated factors with depression to classify or screen the subjects regarding depression in the general population. Also, present findings could be used to further elucidate the underlying pathophysiology of the disease.

Keywords: Albumin; Depression; National health and nutrition survey; Neutrophil.