Department of Psychiatry, 967th Hospital of PLA Joint Logistics Support Force, Dalian, China.
Outpatient Department of Gulou, Eastern Medical District of Chinese PLA General Hospital, Beijing, China.
J Psychosom Res. 2022 Nov;162:111041. doi: 10.1016/j.jpsychores.2022.111041. Epub 2022 Sep 16.
The study aims to determine the association between neutrophil to lymphocyte ratio (NLR) and depression and severity.
We conducted a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES). The Patient Health Questionnaire (PHQ-9) was administered to assess depression and its severity. NLR was calculated as a neutrophil count-to-lymphocyte count ratio.
The study included 22,207 adults (mean age, 44.43 years; women, 51.05%), and 1671 (6.54%) reported depression. The association between NLR and depression was not significant (odds ratio [OR], 1.06, 95% confidence interval [CI], 0.98 to 1.15, p = 0.12) after fully adjusting the covariates, and similar results (Q1 reference Vs Q2: OR, 0.87, 95%CI, 0.70 to 1.07 Vs Q3: OR, 0.99, 95%CI, 0.80 to 1.21 Vs Q4: OR, 1.08, 95%CI, 0.86 to 1.35, p for trend 0.21) when NLR as a categorical variable. After controlling for all confounding variables, a U-shaped relationship between NLR and depression severity was observed, and the inflection point was 1.78. Subgroup analyses showed a significant association among Mexican American/other Hispanic (OR, 1.13, 95%CI, 1.00 to 1.28, p = 0.04), non-Hispanic blacks (OR, 1.18, 95%CI, 1.07 to 1.32, p = 0.002), the subjects with poverty income ratio above four (OR, 1.24, 95%CI, 1.00 to 1.53, p = 0.048) between NLR and depression. The results from the sensitivity analyses remained stable.
The association between NLR and depression is not general across depressed populations among US adults. This association may be specific to subgroups. The relationship between NLR and depression severity is non-linear.
本研究旨在确定中性粒细胞与淋巴细胞比值（NLR）与抑郁和严重程度之间的关联。
我们对全国健康和营养调查（NHANES）进行了横断面分析。采用患者健康问卷（PHQ-9）评估抑郁及其严重程度。NLR 计算为中性粒细胞计数与淋巴细胞计数的比值。
本研究纳入了 22207 名成年人（平均年龄 44.43 岁；女性占 51.05%），其中 1671 人（6.54%）报告患有抑郁。在充分调整了协变量后，NLR 与抑郁之间的关联并不显著（比值比 [OR]，1.06；95%置信区间 [CI]，0.98 至 1.15；p=0.12），且类似的结果（Q1 参考组与 Q2 组：OR，0.87；95%CI，0.70 至 1.07；Q3 组与 Q4 组：OR，0.99；95%CI，0.80 至 1.21；OR，1.08；95%CI，0.86 至 1.35；p 趋势值=0.21）表明 NLR 作为分类变量时，两者之间也存在关联。在控制所有混杂变量后，观察到 NLR 与抑郁严重程度之间呈 U 形关系，拐点为 1.78。亚组分析表明，墨西哥裔/其他西班牙裔（OR，1.13；95%CI，1.00 至 1.28；p=0.04）、非西班牙裔黑人（OR，1.18；95%CI，1.07 至 1.32；p=0.002）、贫困收入比高于四（OR，1.24；95%CI，1.00 至 1.53；p=0.048）的人群中 NLR 与抑郁之间存在显著关联。敏感性分析的结果仍然稳定。
NLR 与美国成年人抑郁人群中的抑郁之间的关联并非普遍存在。这种关联可能是特定于亚组的。NLR 与抑郁严重程度之间的关系是非线性的。
