Department of Psychiatry, University of Oviedo, Oviedo, Spain.
Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain.
Eur Psychiatry. 2020 Feb 17;63(1):e14. doi: 10.1192/j.eurpsy.2019.20.
Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as important peripheral inflammatory biomarkers. Recent data suggest a possible role of the immune system in the pathophysiology of suicidal behavior (SB). The aim of this study is to evaluate the association among NLR, MLR, and PLR and SB in patients with major depressive disorder (MDD), and to test its validity as a biomarker for suicidality.
We evaluated 538 patients with MDD (mean age [standard deviation] = 43.87 [14.36] years; females: 68.8%). A logistic regression model was estimated to determine the independent factors associated with suicide risk in patients with and without a history of suicide attempt (SA).
Three hundred ninety-three patients (74.7%) had a personal history of SA. Patients with a previous SA were more frequently female (71.9% vs. 59.6%; p = 0.007), significantly younger (41.20 vs. 51.77 years; p < 0.001), had lower depression severity at enrolment (15.58 vs. 18.42; p < 0.000), and significantly higher mean NLR and PLR ratios (2.27 vs. 1.68, p = 0.001; 127.90 vs. 109.97, p = 0.007, respectively). In the final logistic regression model, after controlling for age, sex, and depression severity, NLR was significantly associated with SB (β = 0.489, p = 0.000; odds ratio [95% confidence intervals] = 1.631 [1.266-2.102]). We propose a cut-off value of NLR = 1.30 (sensitivity = 75% and specificity = 35%).
Our data suggest that NLR may be a valuable, reproducible, easily accessible, and cost-effective strategy to determine suicide risk in MDD.
中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）和血小板与淋巴细胞比值（PLR）已成为重要的外周炎症生物标志物。最近的数据表明，免疫系统可能在自杀行为（SB）的病理生理学中起作用。本研究旨在评估 NLR、MLR 和 PLR 与重度抑郁症（MDD）患者 SB 之间的关联，并检验其作为自杀风险生物标志物的有效性。
我们评估了 538 名 MDD 患者（平均年龄[标准差]为 43.87 [14.36] 岁；女性占 68.8%）。使用逻辑回归模型来确定与有或无自杀未遂（SA）史的患者自杀风险相关的独立因素。
393 名患者（74.7%）有自杀史。有自杀史的患者更常为女性（71.9%比 59.6%；p=0.007），年龄显著更小（41.20 岁比 51.77 岁；p<0.001），入组时抑郁严重程度更低（15.58 分比 18.42 分；p<0.000），NLR 和 PLR 比值显著更高（2.27 比 1.68，p=0.001；127.90 比 109.97，p=0.007）。在最终的逻辑回归模型中，在校正年龄、性别和抑郁严重程度后，NLR 与 SB 显著相关（β=0.489，p=0.000；优势比[95%置信区间]为 1.631[1.266-2.102]）。我们提出 NLR=1.30 的截断值（敏感性为 75%，特异性为 35%）。
我们的数据表明，NLR 可能是一种有价值的、可重复的、易于获得且经济有效的策略，可用于确定 MDD 患者的自杀风险。
