Elevated Monocyte-to-HDL Cholesterol Ratio Predicts Post-stroke Depression

Overview

Journal Front Psychiatry

Specialty Psychiatry

Date 2022 Aug 8

PMID 35935403

Authors

Yaqiang Li

Mei Zhang

Min Xue

Dalei Liu

Jinglong Sun

Affiliations

Soon will be listed here.

Abstract

Objectives: Inflammation plays an important role in the development of depression after stroke. Monocyte-to-HDL Cholesterol Ratio (MHR) recently emerged as a novel comprehensive inflammatory indicator in recent years. This study aimed to investigate whether there is a relationship between MHR levels and post-stroke depression (PSD).

Methods: From February 2019 to September 2021, patients with acute ischemic stroke (AIS) were recruited within 7 days post-stroke from the two centers and blood samples were collected after admission. The 17-item Hamilton Depression Scale (HAMD-17) was used to measure depressive symptoms at 3 months after stroke. Patients were given the DSM-V criteria for diagnosis of PSD.

Results: Of the 411 enrolled patients, 92 (22.38%) patients were diagnosed with PSD at 3-months follow-up. The results also showed significantly higher level of MHR in patients with depression [0.81 (IQR 0.67-0.87) vs. 0.61 (IQR 0.44-0.82), < 0.001] at admission than patients without depression. Multivariate logistic regression revealed that MHR (OR 6.568, 95% CI: 2.123-14.565, = 0.015) was an independent risk factor for the depression at 3 months after stroke. After adjustment for potential confounding factors, the odds ratio of PSD was 5.018 (95% CI: 1.694-14.867, = 0.004) for the highest tertile of MHR compared with the lowest tertile. Based on the ROC curve, the optimal cut-off value of MHR as an indicator for prediction of PSD was projected to be 0.55, which yielded a sensitivity of 87% and a specificity of 68.3%, with the area under the curve at 0.660 (95% CI: 0.683-0.781; = 0.003).

Conclusion: Elevated level of MHR was associated with PSD at 3 months, suggesting that MHR might be a useful Inflammatory markers to predict depression after stroke.

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References

Murphy A, Woollard K, Hoang A, Mukhamedova N, Stirzaker R, McCormick S . High-density lipoprotein reduces the human monocyte inflammatory response. Arterioscler Thromb Vasc Biol. 2008; 28(11):2071-7. DOI: 10.1161/ATVBAHA.108.168690. View

Chatterjee K, Fall S, Barer D . Mood after stroke: a case control study of biochemical, neuro-imaging and socio-economic risk factors for major depression in stroke survivors. BMC Neurol. 2011; 10:125. PMC: 3022771. DOI: 10.1186/1471-2377-10-125. View

Hamilton M . A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960; 23:56-62. PMC: 495331. DOI: 10.1136/jnnp.23.1.56. View

Alvarez-Mon M, Gomez A, Orozco A, Lahera G, Sosa M, Diaz D . Abnormal Distribution and Function of Circulating Monocytes and Enhanced Bacterial Translocation in Major Depressive Disorder. Front Psychiatry. 2019; 10:812. PMC: 6873610. DOI: 10.3389/fpsyt.2019.00812. View

Ayerbe L, Ayis S, Wolfe C, Rudd A . Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. Br J Psychiatry. 2013; 202(1):14-21. DOI: 10.1192/bjp.bp.111.107664. View

Ding K, Lai Z, Zhang Y, Yang G, He J, Zeng L . Monocyte-to-Lymphocyte Ratio is Associated with Depression 3 Months After Stroke. Neuropsychiatr Dis Treat. 2021; 17:835-845. PMC: 7989958. DOI: 10.2147/NDT.S299462. View

Villa R, Ferrari F, Moretti A . Post-stroke depression: Mechanisms and pharmacological treatment. Pharmacol Ther. 2017; 184:131-144. DOI: 10.1016/j.pharmthera.2017.11.005. View

Hasselmann H, Gamradt S, Taenzer A, Nowacki J, Zain R, Patas K . Pro-inflammatory Monocyte Phenotype and Cell-Specific Steroid Signaling Alterations in Unmedicated Patients With Major Depressive Disorder. Front Immunol. 2018; 9:2693. PMC: 6265986. DOI: 10.3389/fimmu.2018.02693. View

Fang M, Zhong L, Jin X, Cui R, Yang W, Gao S . Effect of Inflammation on the Process of Stroke Rehabilitation and Poststroke Depression. Front Psychiatry. 2019; 10:184. PMC: 6470379. DOI: 10.3389/fpsyt.2019.00184. View

10.

MAHONEY F, BARTHEL D . FUNCTIONAL EVALUATION: THE BARTHEL INDEX. Md State Med J. 1965; 14:61-5. View

11.

Hansson G, Libby P, Schonbeck U, Yan Z . Innate and adaptive immunity in the pathogenesis of atherosclerosis. Circ Res. 2002; 91(4):281-91. DOI: 10.1161/01.res.0000029784.15893.10. View

12.

Liegey J, Sagnier S, Debruxelles S, Poli M, Olindo S, Renou P . Influence of inflammatory status in the acute phase of stroke on post-stroke depression. Rev Neurol (Paris). 2021; 177(8):941-946. DOI: 10.1016/j.neurol.2020.11.005. View

13.

Cheng L, Tu W, Shen Y, Zhang L, Ji K . Combination of High-Sensitivity C-Reactive Protein and Homocysteine Predicts the Post-Stroke Depression in Patients with Ischemic Stroke. Mol Neurobiol. 2017; 55(4):2952-2958. DOI: 10.1007/s12035-017-0549-8. View

14.

Maes M, Meltzer H, Bosmans E, Bergmans R, Vandoolaeghe E, Ranjan R . Increased plasma concentrations of interleukin-6, soluble interleukin-6, soluble interleukin-2 and transferrin receptor in major depression. J Affect Disord. 1995; 34(4):301-9. DOI: 10.1016/0165-0327(95)00028-l. View

15.

Peng H, Ning H, Wang Q, Lu W, Chang Y, Wang T . Monocyte chemotactic protein-induced protein 1 controls allergic airway inflammation by suppressing IL-5-producing T2 cells through the Notch/Gata3 pathway. J Allergy Clin Immunol. 2017; 142(2):582-594.e10. PMC: 5924426. DOI: 10.1016/j.jaci.2017.09.031. View

16.

Maes M, Smith R, Christophe A, Vandoolaeghe E, Van Gastel A, Neels H . Lower serum high-density lipoprotein cholesterol (HDL-C) in major depression and in depressed men with serious suicidal attempts: relationship with immune-inflammatory markers. Acta Psychiatr Scand. 1997; 95(3):212-21. DOI: 10.1111/j.1600-0447.1997.tb09622.x. View

17.

Liu H, Liu K, Pei L, Gao Y, Zhao L, Sun S . Monocyte-to-High-Density Lipoprotein Ratio Predicts the Outcome of Acute Ischemic Stroke. J Atheroscler Thromb. 2020; 27(9):959-968. PMC: 7508725. DOI: 10.5551/jat.51151. View

18.

Sun M, Liang C, Lin H, Meng Y, Tang Q, Shi X . Monocyte to HDL cholesterol ratio as a marker of the presence and severity of obstructive sleep apnea in hypertensive patients. Sci Rep. 2021; 11(1):15821. PMC: 8338958. DOI: 10.1038/s41598-021-95095-3. View

19.

Liberale L, Montecucco F, Bonaventura A, Casetta I, Seraceni S, Trentini A . Monocyte count at onset predicts poststroke outcomes during a 90-day follow-up. Eur J Clin Invest. 2017; 47(10):702-710. DOI: 10.1111/eci.12795. View

20.

Hilgendorf I, Swirski F, Robbins C . Monocyte fate in atherosclerosis. Arterioscler Thromb Vasc Biol. 2014; 35(2):272-9. DOI: 10.1161/ATVBAHA.114.303565. View