Research Article
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Comparison of Some Hematological Parameters in Unipolar and Bipolar Depressive Disorder

Year 2023, Volume: 20 Issue: 2, 305 - 309, 31.08.2023
https://doi.org/10.35440/hutfd.1321421

Abstract

Background: Major depressive disorder and bipolar disorder, which are the most severe types of mood disorders, are among the diseases that cause the most disability worldwide. One of the biggest challenges in providing early and effective treatment in mood disorders is the inability to make an early differential diagnosis between UD and BD. Many studies have suggested that neuroinflammation may play a role in the pathophysiology of mood disorders. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) are relatively cheap hematological parameters recommended to measure the level of inflammation. This study aimed to examine the potential role of inflammatory processes in the pathogenesis of unipolar depression(UD) and bipolar depression(BD) by analyzing various hematologic markers, including NLR, PLR, and MLR
Materials and Methods: The patient group comprised 54 individuals(UD: 31, BD: 23), while the healthy control(HC) group comprised 40 individuals. The study compared the values of hematologic markers between the groups.
Results:The study found significant differences only in the levels of NLR among the analyzed hematologic markers(p=0.004). When the UD and BD groups were compared with HC separately, NLR was significantly higher in both the UD and BD groups compared to the HC group(p=0.002, p=0.015). When UD and BD were compared with each other, there was no significant difference in terms of NLR(P=0,416).
Conclusions: In our study, although there was no significant difference between BD and UD in terms of NLR, PLR and MLR, the higher NLR in both patient groups compared to HC suggests the presence of inflammation in both BD and UD patients. More evidence is needed to evaluate it as a disease-specific marker.

References

  • 1. Ferrari AJ, Charlson FJ, Norman RE, Patten SB, Freedman G, Murray CJ, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of dise-ase study 2010. PLoS Med. 2013;10(11):e1001547.
  • 2. Ferrari AJ, Stockings E, Khoo JP, Erskine HE, Degenhardt L, Vos T, et al. The prevalence and burden of bipolar disorder: findings from the Global Burden of Disease Study 2013. Bipolar Disord. 2016;18(5):440-450.
  • 3. McIntyre RS, Filteau MJ, Martin L, Patry S, Carvalho A, Cha DS, et al. Treatment-resistant depression: definitions, re-view of the evidence, and algorithmic approach. J Affect Di-sord. 2014;156:1-7.
  • 4. Hawton K, Casañas I Comabella C, Haw C, Saunders K. Risk factors for suicide in individuals with depression: a systema-tic review. J Affect Disord. 2013;147(1-3):17-28.
  • 5. Miller JN, Black DW. Bipolar Disorder and Suicide: a Re-view. Curr Psychiatry Rep. 2020;22(2):6. Published 2020 Jan 18.
  • 6. Angst J. The bipolar spectrum. Br J Psychiatry. 2007;190:189-191. do
  • 7. Forty L, Smith D, Jones L, Jones I, Caesar S, Cooper C, et al. Clinical differences between bipolar and unipolar depres-sion. Br J Psychiatry. 2008;192(5):388-389.
  • 8. Vai B, Parenti L, Bollettini I, Cara C, Verga C, Melloni E, et al. Predicting differential diagnosis between bipolar and unipo-lar depression with multiple kernel learning on multimodal structural neuroimaging. Eur Neuropsychopharmacol. 2020;34:28-38.
  • 9. Mazza MG, Tringali AGM, Rossetti A, Botti RE, Clerici M. Cross-sectional study of neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in mood di-sorders. Gen Hosp Psychiatry. 2019;58:7-12.
  • 10. Marazziti D, Torrigiani S, Carbone MG, et al. Neutrop-hil/Lymphocyte, Platelet/Lymphocyte, and Monocy-te/Lymphocyte Ratios in Mood Disorders. Curr Med Chem. 2022;29(36):5758-5781.
  • 11. Boyacı F, Akçay M, Gökdeniz, T. Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Predicting Chronic Total Occlusion in ST-Segment Elevation Myocardial Infarc-tion. Journal of Harran University Medical Fa-culty.2022; 19(2), 277-283.
  • 12. Karahan S, Ergun, H. Which is Best for Predicting Uveitis in Behcet's Syndrome: Systemic Immune Inflammatory Index, Mean Platelet Volume, Platelet/Lymphocyte Ratio, or Ne-utrophil/Lymphocyte Ratio?. European Journal of Therape-utics. 2021; 27(3), 210-215.
  • 13. Şeyhanlı SE. Acil serviste akut apandisit tanisi almiş çocuk-larda trombosit kütle indeksi ve diğer hemogram paramet-relerinin tanisal değeri. Journal of Harran University Medical Faculty. 2020;17(3):420-4
  • 14. Zhang Y, Chen B, Wang L, Wang R, Yang X. Systemic immu-ne-inflammation index is a promising noninvasive marker to predict survival of lung cancer: A meta-analysis. Medicine (Baltimore). 2019; 98: 1-7.
  • 15. Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol. 2018;9:754.
  • 16. Saadeh C. The erythrocyte sedimentation rate: old and new clinical applications. South Med J. 1998;91(3):220-225.
  • 17. Dionisie V, Filip GA, Manea MC, Movileanu RC, Moisa E, Manea M, et al. Neutrophil-to-Lymphocyte Ratio, a Novel Inflammatory Marker, as a Predictor of Bipolar Type in Dep-ressed Patients: A Quest for Biological Markers. J Clin Med. 2021;10(9):1924. Published 2021 Apr 29.
  • 18. Wei Y, Feng J, Ma J, Chen D, Chen J. Neutrop-hil/lymphocyte, platelet/lymphocyte and monocy-te/lymphocyte ratios in patients with affective disorders. J Affect Disord. 2022;309:221-228.
  • 19. Shahyad S, Kheirabadi GR, Jahromi GP, Massaly M. Brain-derived Neurotrophic Factor and High Sensitive C-reactive Protein in Bipolar Depression and Unipolar Depression: The Practical Usage as a Discriminatory Tool. Clin Psychopharma-col Neurosci. 2023;21(1):108-117.
  • 20. Chang HH, Wang TY, Lee IH, et al. C-reactive protein: A differential biomarker for major depressive disorder and bipolar II disorder. World J Biol Psychiatry. 2017;18(1):63-70.
  • 21. Cheng Y, Wang Y, Wang X, Jiang Z, Zhu L, Fang S. Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis. Front Psychiatry. 2022;13:893097.
  • 22. Su M, Ouyang X, Song Y. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and monocyte to lymphocyte ratio in depression: A meta-analysis. J Affect Disord. 2022;308:375-383.
  • 23. Orsolini L, Ricci L, Pompili S, Cicolini A, Volpe U. Eveningness chronotype and depressive affective temperament associa-ted with higher high-sensitivity C-reactive protein in unipo-lar and bipolar depression. J Affect Disord. 2023;332:210-220.
  • 24. Tan M, Luo Y, Hu J, et al. Elevated C-Reactive Protein and Erythrocyte Sedimentation Rate Correlates with Depression in Psoriasis: A Chinese Cross-Sectional Study. Clin Cosmet Investig Dermatol. 2023;16:397-405.
  • 25. Dadouli K, Janho MB, Hatziefthimiou A, Voulgaridi I, Piaha K, Anagnostopoulos L, et al. Neutrophil-to-Lymphocyte, Mo-nocyte-to-Lymphocyte, Platelet-to-Lymphocyte Ratio and Systemic Immune-Inflammatory Index in Different States of Bipolar Disorder. Brain Sci. 2022;12(8):1034.
  • 26. Inanli I, Aydin M, Çaliskan AM, Eren I. Neutrop-hil/lymphocyte ratio, monocyte/lymphocyte ratio, and mean platelet volume as systemic inflammatory markers in different states of bipolar disorder. Nord J Psychiatry. 2019;73(6):372-379.
  • 27. Ayhan MG, Cicek IE, Inanli I, Caliskan AM, Kirci Ercan S, Eren I, Neutrophil/lymphocyte and platelet/lymphocyte ratios in all mood states of bipolar disorder. Psychiat Clin Psychop-harmacol. 2017;27:278–282.
  • 28. Fernandes BS, Steiner J, Molendijk ML, et al. C-reactive protein concentrations across the mood spectrum in bipolar disorder: a systematic review and meta-analysis. Lancet Psychiatry. 2016;3(12):1147-1156.

Unipolar ve Bipolar Depresif Bozuklukta Bazı Hematolojik Parametrelerin

Year 2023, Volume: 20 Issue: 2, 305 - 309, 31.08.2023
https://doi.org/10.35440/hutfd.1321421

Abstract

Amaç: Duygudurum bozukluklarının en şiddetli türleri olan majör depresif bozukluk ve bipolar bozukluk, dünya çapında en fazla yeti yitimi oluşturan hastalıklar arasında yer almaktadır. Unipolar depresif bozukluk (UD) ve bipolar depresif bozuklukta(BD) etkin tedavi sağlamanın önündeki en büyük zorluklardan biri, UD ile BD arasında erken ayırıcı tanının yapılamamasıdır. Bu nedenle klinik olarak ayırt edilemeyen olgularda ayırıcı tanıda kullanılabilecek basit ve ucuz biyobelirteçlerin bulunması büyük önem taşımaktadır. Birçok çalışma, duygudurum bozukluklarının patofizyolojisinde nöroinflamasyonun rol oynayabileceğini öne sürmüştür. Nötrofil/lenfosit oranı (NLO), trombosit/lenfosit oranı (PLO) ve monosit/lenfosit oranı (MLO), inflamasyon düzeyini ölçmek için önerilen nispeten ucuz hematolojik parametrelerdir. Bu çalışmada, NLO, PLO ve MLO analiz edilerek bu inflamatuar belirteçlerin UD ve BD ayırıcı tanısındaki potansiyel rolü araştırıldı.
Materyal ve Metod: Hasta grubu 54 (UD: 31, BD: 23), sağlıklı kontrol(SK) grubu ise 40 kişiden oluştu. UD, BD VE SK grupları arasındaki NLO, PLO ve MLO hematolojik belirteçleri karşılaştırdı.
Bulgular: Çalışmada analiz edilen hematolojik belirteçler arasında sadece NLO düzeylerinde anlamlı fark bulundu(p=0.004). UD ve BD grupları SK ile ayrı ayrı karşılaştırıldığında, NLO hem UD hem de BD gruplarında SK grubuna göre anlamlı olarak yüksekti (p=0,002, p=0,015). UD ve BD karşılaştırıldığında NLO açısından anlamlı fark yoktu(P=0,416).
Sonuç: Çalışmamızda NLO, PLO ve MLO açısından UD ve BD arasında anlamlı fark bulunmamakla birlikte, her iki hasta grubunda NLO'nun SK'ye göre yüksek olması hem UD hem de BD hastalarında inflamasyonun varlığını düşündürmektedir. Hastalığa özgü bir belirteç olarak değerlendirmek için daha fazla kanıt gereklidir.

References

  • 1. Ferrari AJ, Charlson FJ, Norman RE, Patten SB, Freedman G, Murray CJ, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of dise-ase study 2010. PLoS Med. 2013;10(11):e1001547.
  • 2. Ferrari AJ, Stockings E, Khoo JP, Erskine HE, Degenhardt L, Vos T, et al. The prevalence and burden of bipolar disorder: findings from the Global Burden of Disease Study 2013. Bipolar Disord. 2016;18(5):440-450.
  • 3. McIntyre RS, Filteau MJ, Martin L, Patry S, Carvalho A, Cha DS, et al. Treatment-resistant depression: definitions, re-view of the evidence, and algorithmic approach. J Affect Di-sord. 2014;156:1-7.
  • 4. Hawton K, Casañas I Comabella C, Haw C, Saunders K. Risk factors for suicide in individuals with depression: a systema-tic review. J Affect Disord. 2013;147(1-3):17-28.
  • 5. Miller JN, Black DW. Bipolar Disorder and Suicide: a Re-view. Curr Psychiatry Rep. 2020;22(2):6. Published 2020 Jan 18.
  • 6. Angst J. The bipolar spectrum. Br J Psychiatry. 2007;190:189-191. do
  • 7. Forty L, Smith D, Jones L, Jones I, Caesar S, Cooper C, et al. Clinical differences between bipolar and unipolar depres-sion. Br J Psychiatry. 2008;192(5):388-389.
  • 8. Vai B, Parenti L, Bollettini I, Cara C, Verga C, Melloni E, et al. Predicting differential diagnosis between bipolar and unipo-lar depression with multiple kernel learning on multimodal structural neuroimaging. Eur Neuropsychopharmacol. 2020;34:28-38.
  • 9. Mazza MG, Tringali AGM, Rossetti A, Botti RE, Clerici M. Cross-sectional study of neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in mood di-sorders. Gen Hosp Psychiatry. 2019;58:7-12.
  • 10. Marazziti D, Torrigiani S, Carbone MG, et al. Neutrop-hil/Lymphocyte, Platelet/Lymphocyte, and Monocy-te/Lymphocyte Ratios in Mood Disorders. Curr Med Chem. 2022;29(36):5758-5781.
  • 11. Boyacı F, Akçay M, Gökdeniz, T. Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Predicting Chronic Total Occlusion in ST-Segment Elevation Myocardial Infarc-tion. Journal of Harran University Medical Fa-culty.2022; 19(2), 277-283.
  • 12. Karahan S, Ergun, H. Which is Best for Predicting Uveitis in Behcet's Syndrome: Systemic Immune Inflammatory Index, Mean Platelet Volume, Platelet/Lymphocyte Ratio, or Ne-utrophil/Lymphocyte Ratio?. European Journal of Therape-utics. 2021; 27(3), 210-215.
  • 13. Şeyhanlı SE. Acil serviste akut apandisit tanisi almiş çocuk-larda trombosit kütle indeksi ve diğer hemogram paramet-relerinin tanisal değeri. Journal of Harran University Medical Faculty. 2020;17(3):420-4
  • 14. Zhang Y, Chen B, Wang L, Wang R, Yang X. Systemic immu-ne-inflammation index is a promising noninvasive marker to predict survival of lung cancer: A meta-analysis. Medicine (Baltimore). 2019; 98: 1-7.
  • 15. Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol. 2018;9:754.
  • 16. Saadeh C. The erythrocyte sedimentation rate: old and new clinical applications. South Med J. 1998;91(3):220-225.
  • 17. Dionisie V, Filip GA, Manea MC, Movileanu RC, Moisa E, Manea M, et al. Neutrophil-to-Lymphocyte Ratio, a Novel Inflammatory Marker, as a Predictor of Bipolar Type in Dep-ressed Patients: A Quest for Biological Markers. J Clin Med. 2021;10(9):1924. Published 2021 Apr 29.
  • 18. Wei Y, Feng J, Ma J, Chen D, Chen J. Neutrop-hil/lymphocyte, platelet/lymphocyte and monocy-te/lymphocyte ratios in patients with affective disorders. J Affect Disord. 2022;309:221-228.
  • 19. Shahyad S, Kheirabadi GR, Jahromi GP, Massaly M. Brain-derived Neurotrophic Factor and High Sensitive C-reactive Protein in Bipolar Depression and Unipolar Depression: The Practical Usage as a Discriminatory Tool. Clin Psychopharma-col Neurosci. 2023;21(1):108-117.
  • 20. Chang HH, Wang TY, Lee IH, et al. C-reactive protein: A differential biomarker for major depressive disorder and bipolar II disorder. World J Biol Psychiatry. 2017;18(1):63-70.
  • 21. Cheng Y, Wang Y, Wang X, Jiang Z, Zhu L, Fang S. Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis. Front Psychiatry. 2022;13:893097.
  • 22. Su M, Ouyang X, Song Y. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and monocyte to lymphocyte ratio in depression: A meta-analysis. J Affect Disord. 2022;308:375-383.
  • 23. Orsolini L, Ricci L, Pompili S, Cicolini A, Volpe U. Eveningness chronotype and depressive affective temperament associa-ted with higher high-sensitivity C-reactive protein in unipo-lar and bipolar depression. J Affect Disord. 2023;332:210-220.
  • 24. Tan M, Luo Y, Hu J, et al. Elevated C-Reactive Protein and Erythrocyte Sedimentation Rate Correlates with Depression in Psoriasis: A Chinese Cross-Sectional Study. Clin Cosmet Investig Dermatol. 2023;16:397-405.
  • 25. Dadouli K, Janho MB, Hatziefthimiou A, Voulgaridi I, Piaha K, Anagnostopoulos L, et al. Neutrophil-to-Lymphocyte, Mo-nocyte-to-Lymphocyte, Platelet-to-Lymphocyte Ratio and Systemic Immune-Inflammatory Index in Different States of Bipolar Disorder. Brain Sci. 2022;12(8):1034.
  • 26. Inanli I, Aydin M, Çaliskan AM, Eren I. Neutrop-hil/lymphocyte ratio, monocyte/lymphocyte ratio, and mean platelet volume as systemic inflammatory markers in different states of bipolar disorder. Nord J Psychiatry. 2019;73(6):372-379.
  • 27. Ayhan MG, Cicek IE, Inanli I, Caliskan AM, Kirci Ercan S, Eren I, Neutrophil/lymphocyte and platelet/lymphocyte ratios in all mood states of bipolar disorder. Psychiat Clin Psychop-harmacol. 2017;27:278–282.
  • 28. Fernandes BS, Steiner J, Molendijk ML, et al. C-reactive protein concentrations across the mood spectrum in bipolar disorder: a systematic review and meta-analysis. Lancet Psychiatry. 2016;3(12):1147-1156.
There are 28 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Research Article
Authors

Okan İmre 0000-0002-2142-4916

Early Pub Date August 17, 2023
Publication Date August 31, 2023
Submission Date July 1, 2023
Acceptance Date August 1, 2023
Published in Issue Year 2023 Volume: 20 Issue: 2

Cite

Vancouver İmre O. Comparison of Some Hematological Parameters in Unipolar and Bipolar Depressive Disorder. Harran Üniversitesi Tıp Fakültesi Dergisi. 2023;20(2):305-9.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty