Adhikari A, Dikshit R, Karia S, Sonavane S, Shah N, De Sousa A
Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India.
East Asian Arch Psychiatry. 2018 Jun;28(2):53-58.
Neutrophil-lymphocyte ratio (NLR) and C-reactive protein (CRP) level are useful biomarkers of inflammation. This study aimed to assess NLR and CRP level in patients with major depressive disorder before and after pharmacotherapy to determine whether NLR or CRP could be used as biomarkers of severity of major depression and whether there was any sex difference.
Patients with major depression who received no pharmacotherapy 1 month prior to the study were included. Their haemoglobin, total white blood cell count, neutrophil and lymphocyte counts, NLR, and CRP levels were evaluated at baseline and 12 weeks post pharmacotherapy, as were the Montgomery Asberg Rating Scale for Depression, the Scale for Impact of Suicidality Management and Assessment and Planning of Care (SIS-MAP), and the Clinical Global Impression Scale - Severity.
24 male and 26 female patients were included. At 12 weeks after pharmacotherapy, males had a higher haemoglobin level (p = 0.025), higher total white blood cell count (p = 0.018), and lower percentage of neutrophils (p = 0.019) than females. There was no sex difference in NLR or CRP. From baseline to 12 weeks, males had no significant change in any blood parameter, but females had a significantly greater increase in the percentage of neutrophils (p = 0.0001) and decrease in the percentage of lymphocytes (p = 0.012), resulting in a significantly increased NLR (p = 0.001). Both males and females had significant improvement on all 3 scales (p < 0.001). At 12 weeks, in males, the increase in NLR positively correlated with CRP as well as the Montgomery-Asberg Depression Rating Scale and the SIS-MAP, but not the Clinical Global Impression-Severity Scale. In females, the increase in NLR did not correlate with CRP or any of the scales.
In female patients, the NLR increased in response to antidepressant therapy while CRP remained unchanged. This indicated that inflammation has a role in the pathogenesis of major depression.
中性粒细胞与淋巴细胞比值（NLR）和C反应蛋白（CRP）水平是炎症的有用生物标志物。本研究旨在评估重度抑郁症患者药物治疗前后的NLR和CRP水平，以确定NLR或CRP是否可作为重度抑郁症严重程度的生物标志物，以及是否存在性别差异。
纳入在研究前1个月未接受药物治疗的重度抑郁症患者。在基线和药物治疗后12周评估他们的血红蛋白、白细胞总数、中性粒细胞和淋巴细胞计数、NLR和CRP水平，以及蒙哥马利抑郁评定量表、自杀管理影响量表和护理评估与计划量表（SIS-MAP）和临床总体印象量表-严重程度。
纳入24名男性和26名女性患者。药物治疗12周后，男性的血红蛋白水平较高（p = 0.025），白细胞总数较高（p = 0.018），中性粒细胞百分比较低（p = 0.019）。NLR或CRP无性别差异。从基线到12周，男性的任何血液参数均无显著变化，但女性的中性粒细胞百分比显著增加（p = 0.0001），淋巴细胞百分比显著降低（p = 0.），导致NLR显著增加（p = 0.001）。男性和女性在所有3个量表上均有显著改善（p < 0.001）。在12周时，男性的NLR升高与CRP以及蒙哥马利-阿斯伯格抑郁评定量表和SIS-MAP呈正相关，但与临床总体印象-严重程度量表无关。在女性中，NLR的升高与CRP或任何量表均无相关性。
在女性患者中，NLR因抗抑郁治疗而升高，而CRP保持不变。这表明炎症在重度抑郁症的发病机制中起作用。
