High platelet-to-lymphocyte ratio are associated with post-stroke depression

Huang, Guiqian; Chen, Huijun; Wang, Qiongzhang; Hong, Xianchai; Hu, Pinglang; Xiao, Mingzhao; Shu, Meichun; He, Jincai

doi:10.1016/j.jad.2018.12.012

Cited by 60 publications

(51 citation statements)

References 49 publications

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“…A total of 46.59% of stroke patients presented with PSD in this study, which is more than the incidence reported in previous studies. This could be potentially explained by that Tongji hospital was the highestranked large general 3A hospital in Central China and recruited more serious stroke patients whose the median NIHSS score (IQR) was 3 (2, 6.5) (7). Previous study has reported the higher levels of SUA on admission was associated with the occurrence of 3-month major PSD, while lower level of SUA on admission was closely related to the occurrence of major PSD between 3-and 6month post-stroke.…”

Section: Discussionmentioning

confidence: 99%

“…There are few clinical concerns about the decreased odds ratio (OR) value in PSD for each unit change of UA, which could be obtained by taking SUA as a continuous measure. Therefore, we divided the SUA into tertiles to observe whether any enhanced performance could be quantified while maintaining statistical effect in each category, according to the patients' amount and the skewed distribution of the raw SUA values (7,16). All patients involved in this study or their family members gave written informed consents according to the Declaration of Helsinki.…”

Section: Methodsmentioning

confidence: 99%

“…To date, there is a lack of understanding of what the exactly underlying pathophysiological mechanisms of PSD are (7). Among these discovered biological factors, oxidative and nitrosative stress pathways are regarded as the most conclusive factors because there are low antioxidant levels and high metabolic rates and levels in the brain (8,9).…”

Section: Introductionmentioning

confidence: 99%

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Lower Serum Uric Acid Is Associated With Post-Stroke Depression at Discharge

et al. 2020

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Background: Serum uric acid (SUA) has been shown to play an important role in the pathophysiology of mood disorders including 3-and 6-month post-stroke depression (PSD). This study aimed to investigate whether SUA levels on admission were associated with PSD at discharge.Methods: A total of 498 stroke patients were consecutively recruited from Tongji Hospital. Clinical and laboratory test data were collected on admission. They were categorized into equal tertiles according to the distribution of SUA and the number of patients. PSD status was evaluated by DSM-V criteria and 17-item Hamilton Rating Scale for Depression at discharge. Results:The optimal cut-off points of SUA were: (T1) 80.00~300.80 µmo1/L, (T2) 300.81~391.67 µmo1/L, (T3) 391.68~710.0 µmo1/L. A total of 232 patients (46.59%) were diagnosed as PSD at discharge. Significant differences were found between the PSD and non-PSD groups in SUA tertiles of patients (P = 0.00). After adjustment for conventional confounding factors, the odds ratios of PSD were 5.777 (95% CI = 3.463~9.637, P = 0.00) for the lowest tertile and 4.153 (95% CI = 2.492~6.921, P = 0.00) for the middle tertile of SUA, as compared with the highest tertile. In restricted cubic spline regression, continuous SUA showed linear relation with PSD risk at discharge after 300 µmol/L. Conclusions:Lower SUA levels on admission were found to be associated with PSD at discharge and the threshold effect was also revealed. For stroke patients, doctors should pay attention to the baseline SUA for screening high-risk PSD at discharge in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lower Serum Uric Acid Is Associated With Post-Stroke Depression at Discharge

et al. 2020

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“…The current study supports these findings and shows that the N/L ratio is high in patients with moderatesevere depression who use antidepressants. Furthermore, it is assumed that the inclusion of antidepressants in the complex therapy of depression may alleviate chronic inflammation [19]. In a study conducted with post-stroke patients, it was reported that elevated P/L ratios may be predictive as an independent marker for the development of depression [20].…”

Section: Discussionmentioning

confidence: 99%

Neutrophil/Lymphocyte ratio in patients with major depression and the impact of electroconvulsive therapy

2020

Ann Clin Anal Med

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Aim: An accumulation of evidence supports the role of inflammation in the etiology of depression, particularly in severe depression. In this study, we aimed to investigate the effect of electroconvulsive therapy (ECT) treatment on the rates of neutrophil/lymphocytes (N/L), platelets/lymphocyte (P/L) which are subclinical inflammatory markers in patients with moderate/severe depression who went into remission. Materials and Methods: Patients with major depression who had been admitted to hospital in the preceding 2 years with a diagnosis of major depression according to DSM 5 and who had undergone ECT were included in this study as well as a similar number of patients were included as a control group. The groups were compared with respect to the subclinical inflammatory markers N/L, P/L at baseline and after ECT. Fifty-seven patients were compared with respect to N/L, P/L ratios before and after ECT. Results: A total of 116 patients were included in the study, of whom 57 had major depression and 59 were in the control group. The N/L values were significantly higher in the pre-ECT patient group compared to the control group. The post-ECT N/L value was significantly higher compared to the control group and no difference was found between the P/L ratios. There was no significant difference between pre and post-ECT N/L, P/L values in the patient group. Discussion: This study suggests the presence of subclinical inflammation in moderate to severe major depression patients which persists after ECT. Largescale studies are needed to determine the effects of ECT on inflammation.

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“…Moreover, the PLR in patients with major depression has also been found to be increased (19). Recent studies have suggested that the NLR or PLR are associated with PSD 1 month following stroke occurrence (20,21), which highlighted the relationship between early PSD and the inflammation index. However, there was not clear association between these indicators and 6-month PSD.…”

Section: Introductionmentioning

confidence: 99%

Elevated neutrophil‑to‑lymphocyte and platelet‑to‑lymphocyte ratios predict post‑stroke depression with acute ischemic stroke

Wei

Zhou

et al. 2020

Exp Ther Med

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Post-stroke depression (PSD) is the most prevalent psychiatric complication of acute ischemic stroke. The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) are indicators of inflammation and are associated with stroke and depression. Therefore, the purpose of the present study was to examine the relationship between NLR/PLR and PSD. Retrospective analysis was carried out in 376 patients with first-ever acute ischemic stroke in the First Affiliated Yijishan Hospital of Wannan Medical College between March 2015 and September 2017. Patients were divided into PSD (n=104; 27.7%) and non-PSD (n=272; 72.3%) groups according to the Diagnostic and Statistical Manual of Mental Disorders-IV criteria at 6 months after stroke. Clinical data were collected retrospectively. NLR and PLR were acquired retrospectively from the routine blood tests performed at admission. A total of 120 healthy volunteers from the physical examination center in the First Affiliated Yijishan Hospital of Wannan Medical College were recruited as controls. Using logistic regression analysis, NLR (≥4.02) and PLR (≥203.74) were independently associated with PSD. NLR, odds ratio (OR) 3.926, 95% confidence intervals (CI, 2.365-7.947), P<0.001; PLR, OR 3.853, 95% CI (2.214-6.632), P=0.002. The ability of the combined index [area under the receiver operating characteristic curve, 0.701; 95% CI (0.622-0.780); P<0.001] to diagnose PSD was greater than that of either ratio alone. Higher NLRs and PLRs (≥4th quartile) were associated with PSD with a 5.79-fold (P<0.001) increase compared with lower levels of both. Higher NLRs and PLRs were found to be associated with depression 6 months after stroke, and the combined index was more meaningful than either alone in the early clinical detection of PSD.

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High platelet-to-lymphocyte ratio are associated with post-stroke depression

Cited by 60 publications

References 49 publications

Lower Serum Uric Acid Is Associated With Post-Stroke Depression at Discharge

Lower Serum Uric Acid Is Associated With Post-Stroke Depression at Discharge

Neutrophil/Lymphocyte ratio in patients with major depression and the impact of electroconvulsive therapy

Elevated neutrophil‑to‑lymphocyte and platelet‑to‑lymphocyte ratios predict post‑stroke depression with acute ischemic stroke

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