Zhao Leiyong, Li Chengjun, Lv Hequn, Zeng Chunli, Peng Yongjun
Department of Acupuncture and Rehabilitation, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China.
Department of Neurology, Huangdao District Hospital of Traditional Chinese Medicine, Qingdao, Shandong Province, China.
Behav Neurol. 2025 Mar 27;2025:4199054. doi: 10.1155/bn/4199054. eCollection 2025.
The association between inflammatory markers and depression has garnered increasing attention. The neutrophil percentage-to-albumin ratio (NPAR) is an emerging inflammatory marker, but its association with depression in middle-aged and elderly adults was not previously explored. The purpose of this study was to investigate the association through a national study in the United States. All study data were weighted to ensure representativeness. Multivariate logistic regression models were applied to explore the independent relationship of NPAR with depression in middle-aged and elderly adults. Restricted cubic splines were employed to examine potential nonlinear association, with turning points calculated using a recursive algorithm upon detecting nonlinearity. Stratified analyses and interaction tests were conducted to explore subgroup differences. In the model adjusted for all confounding factors, no significant relationship was found between NPAR and depression in middle-aged and elderly adults [1.02 (0.92, 1.12)]. Further sensitivity analysis indicated a potential U-shaped relationship between NPAR and depression in middle-aged and elderly adults, with the OR (95% CI) of 0.74 (0.60, 0.92), 0.87 (0.70, 1.08), 0.92 (0.72, 1.19) for Q2, Q3, and Q4, respectively, compared to Q1. The U-shaped association was confirmed by the restricted cubic spline. Subsequent analysis identified an inflection point at 14.05, revealing inverse relationships before and after this point. Subgroup analysis indicated sex differences in this association. This large-scale cross-sectional study identified a U-shaped association between NPAR and depression in American middle-aged and elderly adults.
炎症标志物与抑郁症之间的关联已引起越来越多的关注。中性粒细胞与白蛋白比值（NPAR）是一种新兴的炎症标志物，但此前尚未探讨其与中老年成年人抑郁症的关联。本研究的目的是通过在美国进行的一项全国性研究来调查这种关联。所有研究数据均经过加权以确保代表性。应用多变量逻辑回归模型来探讨NPAR与中老年成年人抑郁症之间的独立关系。采用受限立方样条来检验潜在的非线性关联，并在检测到非线性时使用递归算法计算转折点。进行分层分析和交互检验以探讨亚组差异。在调整了所有混杂因素的模型中，未发现NPAR与中老年成年人抑郁症之间存在显著关系[1.02（0.92，1.12）]。进一步的敏感性分析表明，NPAR与中老年成年人抑郁症之间可能存在U型关系，与第一四分位数相比，第二、第三和第四四分位数的比值比（95%置信区间）分别为0.74（0.60，0.92）、0.87（0.70，1.08）、0.92（0.72，1.19）。受限立方样条证实了这种U型关联。随后的分析确定了一个拐点为14.05，表明在此点前后存在反向关系。亚组分析表明这种关联存在性别差异。这项大规模横断面研究确定了美国中老年成年人中NPAR与抑郁症之间存在U型关联。
