Background

The association of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte ratio (MLR) with depression has been investigated extensively while the results were conflicting. We aim to investigate whether NLR, PLR, and MLR are associated with depression, as well as to explore the potential non-linear relationship between them.

Methods

This cross-sectional study was conducted based on representative samples of US adults from the National Health and Nutrition Examination Survey 2005–06 to 2017–18. Major depression was defined as a 9-item Patient Health Questionnaire of 10 or more. Multivariable logistic regression models were used to calculate the odds ratio of depression in relation to NLR, PLR, and MLR with the first quartile of their values as the reference. Restricted cubic splines (RCS) were added to the regression model to estimate the non-linear relationship between NLR, PLR, or MLR and depression.

Results

A total of 34,324 participants were included in the study and 3009 of them were diagnosed with major depression. Only PLR was significantly associated with depression after adjustment of all covariates in the multivariable logistic regression analysis. RCS showed that NLR was significantly associated with depression after adjustment of all covariates and NLR, PLR, and MLR were associated with depression in a non-linear manner.

Limitations

The cross-sectional design did not imply any causal inferences.

Conclusion

NLR and PLR were associated with depression after adjustment of potential confounders in a non-linear manner. Prospective studies might be needed to further reveal the non-linear relationships.

中文翻译：

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中性粒细胞与淋巴细胞比率、血小板与淋巴细胞比率以及单核细胞与淋巴细胞比率与抑郁症的关联：NHANES 数据的横断面分析

背景

中性粒细胞与淋巴细胞比率 (NLR)、血小板与淋巴细胞比率 (PLR) 和单核细胞与淋巴细胞比率 (MLR) 与抑郁症的关系已被广泛研究，但结果相互矛盾。我们旨在调查 NLR、PLR 和 MLR 是否与抑郁症相关，并探索它们之间潜在的非线性关系。

方法

这项横断面研究是根据 2005-06 年至 2017-18 年全国健康和营养检查调查中美国成年人的代表性样本进行的。重度抑郁症被定义为 10 个或更多的 9 项患者健康问卷。使用多变量逻辑回归模型计算抑郁症与 NLR、PLR 和 MLR 相关的优势比，并以它们值的第一个四分位数作为参考。将限制三次样条 (RCS) 添加到回归模型中以估计 NLR、PLR 或 MLR 与抑郁症之间的非线性关系。

结果

共有 34,324 名参与者被纳入研究，其中 3009 人被诊断出患有重度抑郁症。在多变量逻辑回归分析中调整所有协变量后，只有 PLR 与抑郁症显着相关。RCS 显示，调整所有协变量后，NLR 与抑郁症显着相关，并且 NLR、PLR 和 MLR 与抑郁症呈非线性相关。

限制

横截面设计没有暗示任何因果推论。

结论

在以非线性方式调整潜在混杂因素后，NLR 和 PLR 与抑郁症相关。可能需要进行前瞻性研究以进一步揭示非线性关系。