Aug 2026· Medicine· Vol 105· 0 citations· 22 references
Medicine
TL;DR
Higher SIRI levels were associated with higher odds of clinically relevant depressive symptoms among adults from the National Health and Nutrition Examination Survey 2005 to 2016, with a nonlinear dose-response pattern.
Abstract
Inflammatory dysregulation has been implicated in depression; however, the association between the systemic inflammation response index (SIRI), a composite inflammatory marker derived from peripheral neutrophil, monocyte, and lymphocyte counts, and depression in the general adult population remains unclear. This study aimed to examine the association between SIRI and depression among adults from the National Health and Nutrition Examination Survey 2005 to 2016. This cross-sectional study included 24,188 adults with available data on the Patient Health Questionnaire-9 (PHQ-9), blood cell counts, and relevant covariates. SIRI was calculated as neutrophil count × monocyte count/lymphocyte count. Depression was assessed using the PHQ-9, with a score ≥10 indicating clinically relevant depressive symptoms. Multivariable logistic regression, restricted cubic spline analysis, threshold effect analysis, and receiver operating characteristic curve analysis were performed to evaluate the association, nonlinear relationship, and incremental discriminatory value of SIRI. Among 24,188 participants, 2055 (8.50%) had clinically relevant depressive symptoms. Higher SIRI was associated with increased odds of depression after multivariable adjustment (odds ratio = 1.07, 95% confidence interval: 1.02–1.13, P = .004). Compared with the lowest quartile, participants in the highest SIRI quartile had higher odds of depression (odds ratio = 1.26, 95% confidence interval: 1.10–1.44, P < .001). Restricted cubic spline analysis demonstrated a significant nonlinear association between SIRI and depression (P for nonlinear = .007). Threshold analysis identified an inflection point at approximately 2.58, below which higher SIRI was associated with increased odds of depression, whereas the association plateaued thereafter. Adding SIRI to the basic model slightly improved discrimination (area under the curve: 0.716 vs 0.725). Higher SIRI levels were associated with higher odds of clinically relevant depressive symptoms among adults from the National Health and Nutrition Examination Survey 2005 to 2016, with a nonlinear dose-response pattern. Given the modest effect size and limited improvement in discrimination, SIRI should be interpreted as an auxiliary peripheral inflammatory marker rather than a standalone screening or diagnostic tool. Further prospective studies are required to clarify causality and clinical relevance.
High BMI correlates with more severe depressive symptoms and increased inflammatory status in adolescents with MDD, especially among females, suggesting that interventions targeting immune and metabolic pathways may offer additional therapeutic benefits.
Ding Yang, Jialu Jiang, Yuan Gao et al.· Journal of Affective Disorde...· 0 citations
Background: Depression is a leading global cause of disability, increasingly recognized as a systemic condition involving low-grade immune-inflammatory activation and neuroendocrine dysregulation. Although complete blood count (CBC) parameters provide an accessible window into systemic physiology, empirical data from African countries, including Sudan, remain scarce. This study evaluated the associations between peripheral CBC parameters and depressive symptoms among adults in Eastern Sudan. Methods: A multistage community-based survey was conducted in Gadarif in Eastern Sudan. The sociodemographic characteristics and clinical data were collected through a face-to-face interview. Depressive symptoms were assessed through the Patient Health Questionnaire-9. Adults with a PHQ-9 score ≥ 10 were considered to have depressive symptoms. CBC parameters were assessed via venous blood samples using automated hematology analyzers. Multivariable linear regression with continuous PHQ-9 scores was performed. Results: Three hundred and thirty-two adults were enrolled. Of the 332 subjects, 166 (50.0%) adults were males, and 102 (30.7%, 95% CI = 25.7–35.7%) had depressive symptoms. There was a significantly higher median platelet count (308.0 × 109/L vs. 291.5 × 109/L; p = 0.025) and plateletcrit count (0.3% vs. 0.2%; p = 0.028), and a significantly lower hematocrit count (37.7% vs. 38.6%; p = 0.043) in adults with depressive symptoms. In the adjusted multivariable linear regression models, erythrocyte oxygen-carrying parameters remained associated with PHQ-9 scores, including hematocrit (B = −0.355, 95% CI = −0.511–−0.199, p < 0.001) and hemoglobin (B = −0.621, 95% CI = −1.191–−0.051, p = 0.033). Conversely, thrombocyte activation markers were associated with PHQ-9 scores, including mean platelet volume (MPV; B = 1.131, 95% CI = 0.221–2.041, p = 0.015) and total platelet count (B = 0.012, 95% CI = 0.00001–0.024, p = 0.047). Leukocyte profiles showed no association with PHQ-9 scores. Conclusions: Peripheral complete blood count parameters, specifically lower hematocrit and hemoglobin, alongside elevated MPV and platelet count, were associated with depressive symptoms in Eastern Sudan. CBC panels may a be useful inflammatory marker tool to detect the correlations with PHQ-9 scores in resource-limited primary care settings.
Unknown authors· Journal of Clinical Medicine· 0 citations
Diabetes is a major global health burden, with chronic inflammation playing a central role in its progression and complications. The pan-immune-inflammation value (PIV) is a novel composite biomarker reflecting systemic immune inflammation. However, its prognostic value for mortality in individuals with diabetes remains unclear.
We conducted a retrospective cohort analysis using the nationally representative National Health and Nutrition Examination Survey (NHANES) data, including participants aged ≥ 20 with available PIV data. PIV was calculated using a validated equation and then log-transformed (ln) before analysis. Multivariable Cox regression models were employed to evaluate this association. We further explored the dose-response relationship using restricted cubic splines (RCS) and threshold analysis to identify potential non-linear effects. The robustness of findings was confirmed through subgroup and sensitivity analyses, and the potential mediating role of estimated glomerular filtration rate (eGFR) was investigated.
During a median follow-up of 94.9 months, 2,549 deaths were recorded, including 727 attributable to cardiovascular diseases. Elevated lnPIV levels were strongly associated with increased all-cause and cardiovascular mortality. Critical thresholds were identified at lnPIV values of 5.056 for all-cause mortality and 5.586 for cardiovascular mortality. These core associations were stable across all subgroup and sensitivity analyses. Furthermore, mediation analysis estimated that eGFR accounted for 5.1% and 6.4% of the lnPIV-associated risk for all-cause and cardiovascular mortality, respectively.
Pan-immune-inflammation value was found to be independently associated with increased risks of all-cause and cardiovascular mortality in individuals with diabetes, characterized by a nonlinear association and a distinct threshold effect. These findings suggest that PIV could serve as a practical biomarker for risk stratification, potentially identifying patients who may benefit from more intensive management of both inflammation and renal function.
Chen Fu, Jiaer Gao, Yijie Mao et al.· Archives of Medical Science· 0 citations
BACKGROUND
This studyaimed to examine the association between Life's Crucial 9 (LC9) score and the prevalence of coronary heart disease (CHD) among U.S. adults, as well as explore the potential statistical contribution of Systemic Inflammatory Response Index (SIRI) in this association.
METHODS
Data were obtained from 23,508 participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. LC9 score quartiles were used to summarize continuous and categorical variables, which were then reported as weighted means ± standard deviations or weighted frequencies and proportions, respectively. Differences among groups were examined using weighted t-tests and weighted chi-square tests. The relationship between LC9 scores, Ln-SIRI values, and the prevalence of CHD was investigated using weighted logistic regression models following the natural logarithmic transformation of skewed SIRI results. Furthermore, restricted cubic spline regression was utilized to investigate plausible nonlinear connections, subgroup and likelihood ratio tests investigated interaction effects, and weighted quantile sum (WQS) regression was incorporated to determine the relative contributions of LC9 components to CHD. An exploratory non-causal mediation analysis using 1,000 bootstrap samples was conducted to assess SIRI as a potential statistical explanatory variable in the association between LC9 and the prevalence of CHD.
RESULTS
In Model 3, a 10-point increase in the LC9 score correlated with a 24% decrease in the odds of CHD prevalence; participants in the Q4 group had 59% lower odds of CHD compared with those in the Q1 group (P < 0.001 trend). Each Ln-SIRI unit was associated with 56% higher odds of CHD, with Q4 showing 2.02-fold higher odds than Q1 (P < 0.001 trend). Restricted cubic spline regression revealed linear relationships between LC9, Ln-SIRI, and the prevalence of CHD. In particular, LC9 was negatively associated with CHD, whereas Ln-SIRI was positively associated with CHD. Age significantly moderated the association between LC9 and CHD (P for interaction < 0.05), with stronger inverse associations in younger adults. WQS regression identified glucose (weight = 0.34) and tobacco (weight = 0.33) as key CHD-associated factors. Exploratory non-causal mediation analysis revealed that about 6.5% of the LC9-CHD relationship was statistically accounted for by SIRI (P < 0.001), with the majority of factors associated with the link remaining unexplained. This indicates that other factors may be the primary contributors to the LC9-CHD relationship.
CONCLUSION
This study showed that higher LC9 scores were significantly associated with lower odds of prevalent self-reported CHD, while higher SIRI was associated with higher odds.
Ji Ouyang, Jia-Yuan Song, Yingjie Wu et al.· BMC Cardiovascular Disorders· 0 citations
Depression has been associated with cardiovascular disorders, including stroke. Although, the graded association and the role of antidepressant medication use continue to be uncertain. To examine the link between depression severity (PHQ-9) and stroke, comprising nonlinear effects and interaction with the use of antidepressant. In this study, data was analysed from NHANES 2007–2018 (n = 35,162), of whom 32,040 participants with complete data were incorporated in the final analysis. Severity of depression was evaluated by using PHQ-9. Self-reported prevalent stroke was the outcome. Odds ratios (ORs) were estimated by survey weighted logistic regression models. Nonlinear associations were evaluated by using natural cubic splines. Greater PHQ-9 scores were significantly linked with augmented odds of self-reported stroke (OR 1.07, 95% CI 1.05–1.09, p < 0.001). Use of antidepressant was independently linked with self-reported stroke (OR 1.74, 95% CI 1.27–2.39). No statistically significant interaction was observed between PHQ-9 score and antidepressant use (p = 0.061). Natural cubic spline analysis demonstrated a significant overall association between PHQ-9 score and self-reported stroke, with no statistically significant evidence of nonlinearity. Both hypertension and diabetes were strong independent predictors of self-reported stroke, while higher income (PIR) was protective. Severity of depression was independently associated with higher odds of self-reported stroke. These findings highlight an association between depression severity and self-reported stroke history.
Unknown authors· Discover Public Health· 0 citations
Depression is a prevalent and underrecognized comorbidity in chronic obstructive pulmonary disease (COPD) that worsens outcomes. The C-reactive protein–albumin–lymphocyte (CALLY) index, a composite immune-nutritional biomarker, has demonstrated prognostic value in various chronic conditions, but its prospective association with incident depression in COPD remains unexplored.
This prospective cohort study included 40,200 UK Biobank participants with baseline COPD. Cox proportional hazards regression was used to estimate the association between the CALLY index and incident depression, with progressive adjustment across five models. Restricted cubic spline (RCS) curves and two-segment Cox regression was applied to characterize non-linear associations and identify inflection points. Subgroup and sensitivity analyses were conducted to assess robustness.
During a mean follow-up of 13.1 ± 2.8 years, 2,059 incident depression events occurred. In the fully adjusted model, each one-standard deviation (SD) increment in ln-CALLY was associated with a 7% lower risk of depression (HR = 0.93, 95% CI: 0.88–0.97,
P
= 0.002). The highest quartile exhibited an 18% risk reduction vs. the lowest (HR = 0.82, 95% CI: 0.72–0.95,
P
= 0.007). RCS analysis revealed a significant L-shaped relationship (
P
for non-linearity = 0.022). Threshold effect analysis identified an inflection point at CALLY = 17.75; below this threshold, each one-unit increase was associated with a 5% risk reduction (HR = 0.95, 95% CI: 0.90–0.99,
P
= 0.037), whereas above the threshold the association was non-significant. A nominally significant age interaction was observed (
P
= 0.017), though this did not survive Bonferroni correction for multiple testing (adjusted threshold
P
< 0.007). Sensitivity analyses including Fine-Gray competing risk models yielded consistent results.
In COPD patients, the CALLY index exhibits a significant L-shaped association with incident depression risk, characterized by a pronounced protective effect below the identified threshold and a risk plateau above it. These findings suggest that the CALLY index may serve as a clinically accessible tool for depression risk stratification, particularly in younger COPD patients, although the age-specific effect requires confirmation in future studies.
Yushan Shi, Xianhai Chen, Yan Wang· Frontiers in Medicine· 0 citations
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