Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis
BackgroundResearch on neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in depression is still emerging and has increased 3-fold since the first meta-analysis. An updated meta-analysis with sufficient studies can provide more evidence fo...
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.893097/full |
| _version_ | 1818546297571901440 |
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| author | Yanwei Cheng Yiwen Wang Xiangyi Wang Zhuoya Jiang Lijun Zhu Shaokuan Fang |
| author_facet | Yanwei Cheng Yiwen Wang Xiangyi Wang Zhuoya Jiang Lijun Zhu Shaokuan Fang |
| author_sort | Yanwei Cheng |
| collection | DOAJ |
| description | BackgroundResearch on neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in depression is still emerging and has increased 3-fold since the first meta-analysis. An updated meta-analysis with sufficient studies can provide more evidence for a potential relationship between NLR, PLR, MLR, and depression.MethodsWe identified 18 studies from the PubMed, EMBASE, Cochrane library, and Web of Science databases. Meta-analyses were performed to generate pooled standardized mean differences (SMDs) and 95% confidence intervals (CIs) between patients with depression and controls. Sensitivity analysis, subgroup analysis, meta-regression, and publication bias were conducted.ResultsA total of 18 studies including 2,264 depressed patients and 2,415 controls were included. Depressed patients had significantly higher NLR and PLR compared with controls (SMD = 0.33, 95% CI: 0.15–0.52, p < 0.001 and SMD = 0.24, 95% CI: 0.02–0.46, p < 0.05, respectively). MLR was slightly higher in depressed individuals compared to controls (SMD = 0.15, 95% CI: −0.26 to 0.55, p > 0.05), despite the absence of significance. Sensitivity analysis removing one study responsible for heterogeneity showed a higher and significant effect (SMD = 0.32, 95% CI: 0.20–0.44) of MLR. Three subgroup analyses of NLR, PLR, MLR, and depression revealed obvious differences in the inflammatory ratios between depressed patients and controls in China and the matched age and gender subgroup. Individuals with post-stroke depression (PSD) had higher NLR and MLR values as compared to non-PSD patients (SMD = 0.51, 95% CI: 0.36–0.67, p < 0.001 and SMD = 0.46, 95% CI: 0.12–0.79, p < 0.01, respectively). Meta-regression analyses showed that male proportion in the case group influenced the heterogeneity among studies that measured NLR values (p < 0.05).ConclusionsHigher inflammatory ratios, especially NLR, were significantly associated with an increased risk of depression. In the subgroup of China and matched age and gender, NLR, PLR, and MLR were all elevated in depressed patients vs. controls. Individuals with PSD had higher NLR and MLR values as compared to non-PSD patients. Gender differences may have an effect on NLR values in patients with depression. |
| first_indexed | 2024-12-12T07:51:19Z |
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| language | English |
| last_indexed | 2024-12-12T07:51:19Z |
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| spelling | doaj.art-6ba71969d6dc4dc08861e4cef2ec2b412022-12-22T00:32:26ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-06-011310.3389/fpsyt.2022.893097893097Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-AnalysisYanwei Cheng0Yiwen Wang1Xiangyi Wang2Zhuoya Jiang3Lijun Zhu4Shaokuan Fang5Department of Neurology, Neuroscience Centre, The First Hospital of Jilin University, Changchun, ChinaDepartment of Neurology, Neuroscience Centre, The First Hospital of Jilin University, Changchun, ChinaDepartment of Neurology, Neuroscience Centre, The First Hospital of Jilin University, Changchun, ChinaDepartment of Neurology, Neuroscience Centre, The First Hospital of Jilin University, Changchun, ChinaChina-Japan Union Hospital of Jilin University, Changchun, ChinaDepartment of Neurology, Neuroscience Centre, The First Hospital of Jilin University, Changchun, ChinaBackgroundResearch on neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in depression is still emerging and has increased 3-fold since the first meta-analysis. An updated meta-analysis with sufficient studies can provide more evidence for a potential relationship between NLR, PLR, MLR, and depression.MethodsWe identified 18 studies from the PubMed, EMBASE, Cochrane library, and Web of Science databases. Meta-analyses were performed to generate pooled standardized mean differences (SMDs) and 95% confidence intervals (CIs) between patients with depression and controls. Sensitivity analysis, subgroup analysis, meta-regression, and publication bias were conducted.ResultsA total of 18 studies including 2,264 depressed patients and 2,415 controls were included. Depressed patients had significantly higher NLR and PLR compared with controls (SMD = 0.33, 95% CI: 0.15–0.52, p < 0.001 and SMD = 0.24, 95% CI: 0.02–0.46, p < 0.05, respectively). MLR was slightly higher in depressed individuals compared to controls (SMD = 0.15, 95% CI: −0.26 to 0.55, p > 0.05), despite the absence of significance. Sensitivity analysis removing one study responsible for heterogeneity showed a higher and significant effect (SMD = 0.32, 95% CI: 0.20–0.44) of MLR. Three subgroup analyses of NLR, PLR, MLR, and depression revealed obvious differences in the inflammatory ratios between depressed patients and controls in China and the matched age and gender subgroup. Individuals with post-stroke depression (PSD) had higher NLR and MLR values as compared to non-PSD patients (SMD = 0.51, 95% CI: 0.36–0.67, p < 0.001 and SMD = 0.46, 95% CI: 0.12–0.79, p < 0.01, respectively). Meta-regression analyses showed that male proportion in the case group influenced the heterogeneity among studies that measured NLR values (p < 0.05).ConclusionsHigher inflammatory ratios, especially NLR, were significantly associated with an increased risk of depression. In the subgroup of China and matched age and gender, NLR, PLR, and MLR were all elevated in depressed patients vs. controls. Individuals with PSD had higher NLR and MLR values as compared to non-PSD patients. Gender differences may have an effect on NLR values in patients with depression.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.893097/fullmeta-analysisdepressionneutrophil-to-lymphocyte ratioplatelet-to-lymphocyte ratiomonocyte-to-lymphocyte ratio |
| spellingShingle | Yanwei Cheng Yiwen Wang Xiangyi Wang Zhuoya Jiang Lijun Zhu Shaokuan Fang Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis Frontiers in Psychiatry meta-analysis depression neutrophil-to-lymphocyte ratio platelet-to-lymphocyte ratio monocyte-to-lymphocyte ratio |
| title | Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis |
| title_full | Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis |
| title_fullStr | Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis |
| title_full_unstemmed | Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis |
| title_short | Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis |
| title_sort | neutrophil to lymphocyte ratio platelet to lymphocyte ratio and monocyte to lymphocyte ratio in depression an updated systematic review and meta analysis |
| topic | meta-analysis depression neutrophil-to-lymphocyte ratio platelet-to-lymphocyte ratio monocyte-to-lymphocyte ratio |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.893097/full |
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