ObjectiveChronic inflammation is associated with cardiovascular (CV) risk factors and psychiatric disorders. The neutrophil to lymphocyte ratio (NLR) has been investigated as a new biomarker for systemic inflammatory response. The aim of the study is to investigate the relation of NLR with severity of depression and CV risk factors.MethodsThe study population consisted of 256 patients with depressive disorder. Patients were evaluated with the Hamilton Rating Scale for Depression (HAM-D). Patients were classified into four groups according to their HAM-D score such as mild, moderate, severe, and very severe depression. Patients were also evaluated in terms of CV risk factors.ResultsPatients with higher HAM-D score had significantly higher NLR levels compared to patients with lower HAM-D score. Correlation analysis revealed that severity of depression was associated with NLR in depressive patients (r=0.333, p<0.001). Patients with one or more CV risk factors have significantly higher NLR levels. Correlation analysis revealed that CV risk factors were associated with NLR in depressive patients (r=0.132, p=0.034). In logistic regression analyses, NLR levels were an independent predictor of severe or very severe depression (odds ratio: 3.02, 95% confidence interval: 1.867-4.884, p<0.001). A NLR of 1.57 or higher predicted severe or very severe depression with a sensitivity of 61.4% and specificity of 61.2%.ConclusionHigher HAM-D scores are associated with higher NLR levels in depressive patients. NLR more than 1.57 was an independent predictor of severe or very severe depression. A simple, cheap white blood cell count may give an idea about the severity of depression.

ObjectiveDepression and anxiety are common disorders in inflammatory bowel disease (IBD). Our aim is to prospectively determine the effect of psychiatric treatment on scores for depression, anxiety, quality of life (QoL), and sexual dysfunction in an outpatient population diagnosed with IBD and also anxiety and/or depression disorder.Patients and methodsPatients who scored higher than the cutoff point on the Hospital Anxiety Depression Scale were referred for further structured psychiatric evaluation and determination of the need for psychiatric drug treatment. Patients who underwent drug therapy completed Short Form-36 (SF-36) and the Arizona Sexual Experience Scale at baseline and after 6 months of follow-up.ResultsMajor depressive disorder and generalized anxiety disorder were the most common diagnoses. After 6 months, 47 patients had completely adhered to drug treatment (group A), whereas 20 were nonadherent (group B). In group A, all domains of SF-36, Arizona Sexual Experience Scale, depression/anxiety scores, and Crohn’s disease activity index were statistically improved after treatment when compared with the baseline. In group B, the three domains of SF-36, platelet count, and mean corpuscular volume were worse between baseline and at 6 months.ConclusionIn IBD patients having any psychiatric disorder, 6 months of antidepressant drug treatment is associated with an improvement in depression, anxiety, QoL, and sexual functioning scores, as well as an improvement in Crohn’s disease activity index. On the other hand, insufficient psychiatric treatment seems to be related to a poor QoL.

OBJECTIVE:In this study we aim to investigate the effects of somatic and related symptoms (SARS), alexithymia, hypochondriasis, anxiety and depression on patients with major depressive disorder, irritable bowel syndrome, inflammatory bowel disease which are the representative diseases of brain gut axis (BGA). METHOD: Sex and age similar groups of participants with major depressive disorder (MDD) (n = 102), irritable bowel syndrome (IBS) (n = 51), inflammatory bowel diseases (IBDs) (n = 54), and control group (n = 67) were included into this study. Depression and IBS were diagnosed according to DSM-5 and ROME 4 criteria, respectively. IBDs were established according to endoscopic, histological, and radiographic investigations. In all participants, somatic and related symptoms were evaluated by self-report scales including Bradford Somatic Inventory (BSI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Whiteley Index (WI), The 20-item Toronto Alexithymia Scale (TAS-20), Somatosensory Amplification Scale (SAS). RESULTS: BSI, BDI, BAI, WI, TAS-20 and SAS scores were found to be highest in patients with MDD; scores of patients with IBS and IBDs were similar but higher than the control group. Gastrointestinal somatic symptoms including nausea, stomach burning, abdominal ache and stomach swelling were observed in more than half of the patients with MDD. The most common extra-intestinal somatic symptoms were, headache and neck pain and/or tension, and leg pain in IBS patients. However leg pain, weakness and lack of energy, and neck pain/tension were highest in IBDs patients. While the strongest correlation determined was between the BSI and anxiety scores in MDD (p < .001, r = .688) and IBS group; (p < .001, r = .51), in IBDs patients, BSI scores were more significantly correlated with depressive scores instead of anxiety (p < .001, r = .712 vs. r = .705, p < .001). CONCLUSION: Our study demonstrates that SARS are commonly observed in the representative diseases of BGA. Extra-intestinal somatic symptoms are common in IBS, and IBDs, and also gastrointestinal somatic symptoms are common in patients with MDD. Assessment of somatic and related symptoms is quite important in the context of BGA.

BACKGROUND: Obstructive sleep apnea (OSA) is characterized by reductions in breathing amplitude during sleep caused by an obstructed or collapsed upper airway. The neutrophil to lymphocyte ratio (NLR) has been proposed as a novel biomarker for systemic infl ammatory response. The aim of the present study was to evaluate the relationship between NLR and OSA. METHODS: The study population consisted of 195 consecutive patients with clinical suspicion of OSA. Full night polysomnography was performed for all patients. Patients with an apnea hypopnea index (AHI) ≥ 5 were considered to have OSA. NLR was calculated as the ratio of neutrophil count to lymphocyte count. RESULTS: While 130 patients (91 male, mean age: 49.9±9.8 years) had OSA, 65 patients (42 male, mean age: 48.7 ± 10.2 years) had normal fi ndings according to AHI scores. Cardiovascular risk factors such as hypertension, hyperlipidemia, diabetes mellitus and smoking were more common in patients with OSA. Patients with OSA had signifi cantly higher NLR than controls (1.87±0.80 vs 1.49±0.48, p=0.005). AHI score was signifi cantly correlated with NLR (r=0.228, p=0.001). NLR and presence of hyperlipidemia were independent predictors of OSA (OR: 2.451, 2.850, p=0.001, 0.004, respectively). NLR of 1.62 or higher predicted OSA with a sensitivity of 56.2 % and specifi city of 63.1 %. CONCLUSIONS: NLR was higher and also correlated with AHI score in patients with OSA which has not been reported previously. NLR more than 1.62 was an independent predictor of OSA. A simple, cheap white blood cell count may also give an idea about the presence and severity of OSA (Tab. 3, Fig. 3, Ref. 30). Text in PDF www.elis.sk. KEY WORDS: infl ammation, cardiovascular risk, neutrophil to lymphocyte ratio, obstructive sleep apnea.

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