Clinical Value Of Peripheral Blood Cell Parameters In Depression

Object:Depression is a common mental disorder with high prevalence,recurrence,and suicide rates,and has become a serious public health problem that endangers public health in our country.In recent years,many studies on the etiology and pathogenesis of depression have been conducted by scholars from home and abroad,but the results have shown several contradictions.The aim of this study is to explore risk factors for depression and search for reliable biomarkers that may shed new light on the diagnosis of depression.Methods:A total of 97 patients with depression who visited the psychological clinic of Changchun sixth Hospital from June 2020 to May 2021 were recruited as the case group.In addition,a total of 96 healthy subjects who were admitted to the First Hospital of Jilin University during the same period and matched in gender and age to the case group were screened as the control group.The clinical characteristics of the case group were recorded,including demographic characteristics(age,gender,household registration,marriage status,education level,whether for the only-child,family history of depression),medical history(total score of 24 items of Hamilton Depression Scale(HAMD-24)and scores of each factor,Hamilton Anxiety Scale(HAMA)score,and suicidal tendency).Blood routine indexes of the two groups were collected,including Neutrophil count(Neu),Lymphocyte count(Lym),platelet count and red blood cell distribution width(RDW).Neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)were calculated.SPSS 26.0 software was used for statistical analysis.The HAMD-24 score was used to divide patients into mild-moderate and severe case groups,the differences in clinical characteristics between the two groups were analyzed.The differences in blood routine indexes were compared between the case and control groups,the mild-moderate case group and the severe case group,respectively.Spearman correlation was used to analyze the correlation between the aforementioned blood indexes and the HAMD-24 score and each factor score,and binary logistic regression was used to analyze the independent risk factors that influence the occurrence of depression.Receiver Operator Characteristic Curve(ROC)was used to evaluate its diagnostic value for depression.Results:1.The mean age of onset in the case group was 39.44 years.The proportion of females with depression(67.0%)was higher than that of males(33.0%).Married patients accounted for more(74.2%),the proportion of urban patients(58.8%)was slightly higher than rural patients(41.2%),and patients with no family history of depression accounted for a higher proportion(79.4%).Only children accounted for 32.0 percent and non-only children accounted for 68.0 percent.There were no differences in marital status,household registration type,whether for the only-child or family history of depression between mild-moderate depression and severe case groups(P>0.05).The proportion of individuals with high school education or above in the major depression group(78.0%)was higher than that in the mild-moderate depression group(57.4%)(P<0.05).The proportion of individuals with anxiety in the major depression group(96.0%)was significantly higher than that in the mild-moderate depression group(74.5%)(P<0.001),and the mean HAMA score in the major depression group(29.88 points)was higher than that in the mild-moderate depression group(19.07 points)(P<0.001).The proportion of individuals with suicidal tendency in major depression group(78.0%)was higher than that in mild-moderate depression group(40.4%),and the difference was statistically significant(P<0.001).2.The levels of Neu and NLR in the case group were significantly higher than those in the control group(all P<0.001),and the level of Lym in the case group was lower than that in the control groups(P<0.05).RDW levels in the case group were significantly higher than that in the control group(P<0.01).There were no significant differences in PLR levels between the case and control group(P>0.05).RDW level in male patients with major depression was higher than that in the mild-moderate depression group,the difference was statistically significant(P<0.05),but there was no significant statistical difference in other indicators.3.Neu was positively correlated with suicide score,with statistical significance(r_s=0.219,P<0.05).RDW was positively correlated with sleep disorders,with statistical significance(r_s=0.235,P<0.05).4.Binary logistic regression analysis showed that NLR、RDW were independent risk factors for depression.5.The area under the curve(AUC)of NLR for predicting depression was 0.709(95%CI:0.636-0.782),and the best truncation value of NLR for diagnosing depression was 1.69.The sensitivity and specificity were 76.3%and 56.3%,respectively.The area under the curve(AUC)of RDW for predicting depression was 0.643(95%CI:0.566-0.721).The best cutoff value of RDW for diagnosing depression was 12.45%,with sensitivity and specificity of61.9%and 64.6%,respectively.The area under the curve(AUC)of Neu and RDW combined to predict depression was 0.725(95%CI:0.654-0.796).The sensitivity and specificity were75.3%and 61.5%,respectively.Conclusions:1.Females and higher levels of education are risk factors for depression.Compared with the mild-moderate depression group,the major depression group has higher anxiety scores and a higher percentage of individuals with suicidal tendency.2.Neu,Lym,NLR and RDW are related to the prevalence of depression,and NLR and RDW are reliable peripheral biomarkers to predict the occurrence of depression.PLR is not associated with the occurrence of depression,whereas RDW may be associated with the severity of depression in males.3.Increased Neu levels are associated with suicidal tendencies in depressed patients,and RDW levels are associated with sleep disturbances in depressed patients.