Li Yaqiang, Zhang Mei, Xue Min, Liu Dalei, Sun Jinglong
Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People's Hospital of Huainan, Huainan, China.
Department of Neurology, People's Hospital of Lixin County, Bozhou, China.
Front Psychiatry. 2022 Jul 22;13:902022. doi: 10.3389/fpsyt.2022.902022. eCollection 2022.
Inflammation plays an important role in the development of depression after stroke. Monocyte-to-HDL Cholesterol Ratio (MHR) recently emerged as a novel comprehensive inflammatory indicator in recent years. This study aimed to investigate whether there is a relationship between MHR levels and post-stroke depression (PSD).
From February 2019 to September 2021, patients with acute ischemic stroke (AIS) were recruited within 7 days post-stroke from the two centers and blood samples were collected after admission. The 17-item Hamilton Depression Scale (HAMD-17) was used to measure depressive symptoms at 3 months after stroke. Patients were given the DSM-V criteria for diagnosis of PSD.
Of the 411 enrolled patients, 92 (22.38%) patients were diagnosed with PSD at 3-months follow-up. The results also showed significantly higher level of MHR in patients with depression [0.81 (IQR 0.67-0.87) vs. 0.61 (IQR 0.44-0.82), < 0.001] at admission than patients without depression. Multivariate logistic regression revealed that MHR (OR 6.568, 95% CI: 2.123-14.565, = 0.015) was an independent risk factor for the depression at 3 months after stroke. After adjustment for potential confounding factors, the odds ratio of PSD was 5.018 (95% CI: 1.694-14.867, = 0.004) for the highest tertile of MHR compared with the lowest tertile. Based on the ROC curve, the optimal cut-off value of MHR as an indicator for prediction of PSD was projected to be 0.55, which yielded a sensitivity of 87% and a specificity of 68.3%, with the area under the curve at 0.660 (95% CI: 0.683-0.781; = 0.003).
Elevated level of MHR was associated with PSD at 3 months, suggesting that MHR might be a useful Inflammatory markers to predict depression after stroke.
炎症在中风后抑郁症的发生发展中起重要作用。近年来，单核细胞与高密度脂蛋白胆固醇比值（MHR）作为一种新的综合炎症指标逐渐出现。本研究旨在探讨MHR水平与中风后抑郁症（PSD）之间是否存在关联。
2019年2月至2021年9月，从两个中心招募急性缺血性中风（AIS）患者，在中风后7天内入院并采集血样。采用17项汉密尔顿抑郁量表（HAMD-17）在中风后3个月测量抑郁症状。根据《精神疾病诊断与统计手册》第五版（DSM-V）标准对PSD进行诊断。
在411名登记患者中，92名（22.38%）患者在3个月随访时被诊断为PSD。结果还显示，入院时抑郁症患者的MHR水平[0.81（四分位间距0.67 - 0.87）vs. 0.61（四分位间距0.44 - 0.82），<0.001]显著高于无抑郁症患者。多因素逻辑回归显示，MHR（比值比6.568，95%置信区间：2.123 - 14.565，P = 0.015）是中风后3个月抑郁症的独立危险因素。在调整潜在混杂因素后，与最低三分位数相比，MHR最高三分位数的PSD比值比为5.018（95%置信区间：1.694 - 14.867，P = 0.004）。根据ROC曲线，预测PSD的MHR最佳截断值预计为0.55，灵敏度为87%，特异度为68.3%，曲线下面积为0.660（95%置信区间：0.683 - 0.781；P = 0.003）。
MHR水平升高与3个月时的PSD相关，提示MHR可能是预测中风后抑郁症的有用炎症标志物。
