Moshfeghinia Reza, Kavari Kiarash, Mostafavi Sara, Sanaei Erfan, Farjadian Shirin, Javanbakht Arash
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
J Affect Disord. 2025 Sep 15;385:119371. doi: 10.1016/j.jad.2025.05.031. Epub 2025 May 7.
Suicide is a significant global health issue linked to neuroinflammation. This study assessed neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) as systemic inflammation indicators in suicidal behaviour of major depressive disorder (MDD) patients.
The search included databases like Scopus, PubMed, PsycINFO, Web of Science, and CINAHL Complete, focusing on English-language observational studies up to March 2025. It examined the NLR, PLR, and MLR in individuals with MDD exhibiting suicidal behaviour, comparing them to MDD patients without such behaviors or healthy controls. Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and data analysis utilized Stata software version 17.
From an initial 131 articles, ten studies were included, analyzing 2017 participants. MDD patients with suicidal behaviour had significantly elevated NLR levels compared to non-suicidal MDD patients (SMD: 0.34 [0.12, 0.56]; I: 67.68 %) and healthy controls (SMD: 1.02 [0.28, 1.76]; I: 96.15 %). Additionally, no differences in PLR levels were found in suicidal MDD patients compared to their non-suicidal counterparts (SMD: 0.11 [-0.04, 0.27]; I: 38.39 %), but PLR levels were higher in comparison to healthy controls (SMD: 0.38 [0.17, 0.59]; I: 38.02 %). Four studies showed higher MLR levels in suicidal MDD patients compared to the non-suicidal group (SMD: 0.33 [0.04, 0.62]; I: 71.60 %) and healthy controls (SMD: 0.32 [0.06, 0.59]; I: 44.37 %).
Increased inflammatory biomarkers in MDD patients with suicidal tendencies highlight the need for further research on their potential as suicide vulnerability indicators and the utility of NLR, PLR and MLR in clinical practice.
自杀是一个与神经炎症相关的重大全球健康问题。本研究评估了中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和单核细胞与淋巴细胞比值（MLR）作为重度抑郁症（MDD）患者自杀行为中的全身炎症指标。
检索了Scopus、PubMed、PsycINFO、Web of Science和CINAHL Complete等数据库，重点关注截至2025年3月的英文观察性研究。研究了有自杀行为的MDD个体的NLR、PLR和MLR，并将其与无此类行为的MDD患者或健康对照进行比较。使用纽卡斯尔-渥太华量表（NOS）评估研究质量，数据分析使用Stata软件版本17。
从最初的131篇文章中，纳入了10项研究，分析了2017名参与者。有自杀行为的MDD患者的NLR水平显著高于无自杀行为的MDD患者（标准化均值差：0.34 [0.12, 0.56]；I²：67.68%）和健康对照（标准化均值差：1.02 [0.28, 1.76]；I²：96.15%）。此外，有自杀行为的MDD患者与无自杀行为的患者相比，PLR水平没有差异（标准化均值差：0.11 [-0.04, 0.27]；I²：38.39%），但与健康对照相比，PLR水平更高（标准化均值差：0.38 [0.17, 0.59]；I²：38.02%）。四项研究表明，有自杀行为的MDD患者的MLR水平高于无自杀行为的组（标准化均值差：0.33 [0.04, 0.62]；I²：71.60%）和健康对照（标准化均值差：0.32 [0.06, 0.59]；I²：44.37%）。
有自杀倾向的MDD患者炎症生物标志物升高，凸显了对其作为自杀易感性指标的潜力以及NLR、PLR和MLR在临床实践中的效用进行进一步研究的必要性。
