Han Xi-Xi, Zhang Hui-Ying, Kong Jing-Wen, Liu Yu-Xin, Zhang Ke-Ren, Ren Wen-Ying
Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Nephrology Department, Beijing Integrated Traditional Chinese and Western Medicine Hospital, Beijing, China.
Front Psychiatry. 2024 Aug 5;15:1423200. doi: 10.3389/fpsyt.2024.1423200. eCollection 2024.
Maintenance hemodialysis (MHD) patients suffer from enormous physical, mental stress and poor quality of life, so an increasing number of patients are in a long-term state of depression. A prominent feature of MHD patients is chronic persistent inflammation, which is also an important mechanism for the onset of depression. Therefore, finding economically convenient inflammatory markers to predict and diagnose the onset of depression in MHD patients is of great value. As a novel inflammatory marker, systemic immune inflammation index (SII) can more comprehensively reflect the inflammation and immunity level of patients. This study aims to explore the relationship between SII and depressive symptoms in MHD patients.
A cross-sectional study was conducted on 206 MHD patients from three dialysis centers. Based on the Hospital Anxiety and Depression Scale (HADS) scores, patients were divided into non-depression and depression groups. Inter group comparison and multivariate logistic regression analysis were performed to determine whether SII is an independent risk factor for depression in MHD patients. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of SII on depression symptoms in MHD patients.
According to the HADS scale score, 38.83% of the included patients were in a state of depression. After adjusting for all confounding factors, MHD patients with SII>963.93 had a 4.709 times higher risk of depression than those with SII ≤ 478.32 (OR=4.709, 95% CI 1.821-12.178, P<0.01). ROC analysis showed that SII>685.11 was the best cutoff value for MHD depression patients, and the area under the curve (AUC) was 0.681.
High SII is an independent risk factor for depressed MHD patients and an ideal inflammatory marker for predicting and identifying depression in MHD patients as assessed by the HADS scale.
维持性血液透析（MHD）患者承受着巨大的身心压力，生活质量较差，因此越来越多的患者处于长期抑郁状态。MHD患者的一个突出特征是慢性持续性炎症，这也是抑郁症发病的重要机制。因此，寻找经济便捷的炎症标志物来预测和诊断MHD患者抑郁症的发病具有重要价值。作为一种新型炎症标志物，全身免疫炎症指数（SII）能更全面地反映患者的炎症和免疫水平。本研究旨在探讨MHD患者中SII与抑郁症状之间的关系。
对来自三个透析中心的206例MHD患者进行横断面研究。根据医院焦虑抑郁量表（HADS）评分，将患者分为非抑郁组和抑郁组。进行组间比较和多因素logistic回归分析，以确定SII是否为MHD患者抑郁的独立危险因素。采用受试者工作特征（ROC）曲线评估SII对MHD患者抑郁症状的预测价值。
根据HADS量表评分，纳入的患者中有38.83%处于抑郁状态。在调整所有混杂因素后，SII>963.93的MHD患者发生抑郁的风险是SII≤478.32患者的4.709倍（OR=4.709，95%CI 1.821-12.178,P<0.01）。ROC分析显示，SII>685.11是MHD抑郁患者的最佳截断值，曲线下面积（AUC）为0.681。
高SII是MHD抑郁患者的独立危险因素，是通过HADS量表评估预测和识别MHD患者抑郁的理想炎症标志物。
