Randomized trial of early exercise rehabilitation and its effects on patients with acute coronary syndrome.

To assess the psychological and physiological benefits of early exercise rehabilitation in patients with acute coronary syndrome (ACS). Among 559 ACS-diagnosed patients at Fuzhou University Affiliated Provincial Hospital from January to December 2021, 200 eligible participants were assigned to two groups. The control group received standard care, while the experimental group received early exercise rehabilitation in addition to standard care. The outcomes measured included changes in depression levels (PHQ-9), fasting blood glucose, and troponin I (TnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. Data were analyzed using SPSS, with t tests and chi-square tests for group comparisons. In comparison to the control group, the experimental group demonstrated significant improvements in PHQ-9 scores (P < 0.001) and lower fasting blood glucose levels before discharge (P = 0.046). Additionally, the experimental group had notably reduced TnI levels at 72 h after admission (P = 0.001), especially among non-diabetic NSTEMI patients over 60 years old, who showed decreased TnI levels at the 48-hour mark (P = 0.016). However, there were no significant differences in NT-ProBNP change values between the two groups (P > 0.05). Subgroup analysis revealed enhanced outcomes in the intervention group for ACS patients without smoking or drinking history and no heart failure (P = 0.025,P = 0.014,P = 0.018). Early exercise rehabilitation has notable benefits for ACS patients, including reduced depression, improved blood glucose control, and enhanced myocardial protection, especially in nondiabetic NSTEMI patients aged 60 and above.

Serotonin, cortisol, and DHEA-S levels in anxious and depressive pregnant women living with HIV.

Pregnancy in women living with human immunodeficiency virus (WLWH) represents an important challenge for maternal-fetal health. Besides, they can also present anxiety (Anx) and depression (Dep). Imbalances in serotonin (5-HT), dehydroepiandrosterone sulfate (DHEA-S), and cortisol (CORT) levels can contribute to Anx and Dep manifestations. Currently, there is not enough data about the neuroendocrine and neurochemical changes in pregnant WLWH with affective disorders. This study aimed to characterize 5-HT, DHEA-S, and CORT plasma levels in Mexican pregnant WLWH presenting Anx/Dep. Forty-two adult pregnant women were recruited during the third trimester of gestation at the National Institute of Perinatology in Mexico during 2019-2022. These patients were divided into three groups: (1) pregnant WLWH with Anx/Dep (n = 16), (2) pregnant without HIV but with Anx/Dep (n = 12), and (3) healthy pregnant women without Anx/Dep (n = 14). WLWH presented a marked reduction in 5-HT (41.33 ± 39.37 ng/dL) compared to non-infected pregnant women with Anx/Dep (220.2 ± 151.8 ng/dL) and the healthy group (370.0 ± 145.3 ng/dL). Anx/Dep infected and uninfected pregnant women showed a significant reduction in DHEA-S levels (86.58 ± 30.59 and 76.9 ± 36.7 µg/dL, respectively) compared to healthy subjects (149.7 ± 44.6 µg/dL). Anx and Dep symptoms were inversely correlated with 5-HT and DHEA-S levels. No significant differences were observed in CORT levels among the three groups (p = 0.094). Our results suggest the presence of a disbalance in 5-HT and DHEA-S levels in pregnant WLWH with affective symptoms.

Association between uric acid and the risk of depressive symptoms in US adults: results from NHANES 2005-2018.

BACKGROUND: This study explores the relationship between serum uric acid(UA) levels and depression. UA is the final product of purine metabolism in the human body, possessing certain physiological functions such as blood pressure regulation, antioxidation, DNA protection, and anti-aging, thereby drawing attention for its potential role in preventing and treating depression. METHODS: This cross-sectional study includes 32,424 participants aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2018, generating a nationally representative database. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Serum uric acid concentration was measured using the uricase-peroxidase coupled method, and participants were divided into quartiles of serum uric acid concentration. Weighted data were calculated according to analysis guidelines. The association between serum uric acid and depressive symptoms was analyzed using weighted multivariable logistic regression models and restricted cubic spline regression analyses. Subgroup analyses were also performed. RESULTS: Among 32,424 participants, 3,421 were defined as having depressive symptoms. The crude prevalence of depressive symptoms was 10.5% (weighted prevalence: 9.086% [95% confidence interval: 9.032-9.139%]). Compared with the first quartile, individuals with higher UA levels had a decreased risk of depressive symptoms by 9% (OR: 0.910, 95% CI: 0.797-10.40), 14.6% (OR: 0.854, 95% CI: 0.741-0.983), and 20.5% (OR: 7795, 95% CI: 0.680-0.930), respectively. Further restricted cubic spline regression analysis revealed a nonlinear association between UA and depressive symptoms, with an inflection point of 319.72 µmol/L. Subgroup multivariable weighted logistic regression analysis found that the association between UA and the risk of depressive symptoms remained consistent across all subgroups, demonstrating high stability and reliability. CONCLUSION: This study emphasizes a significant nonlinear negative correlation between serum uric acid and depressive symptoms. This suggests that proper control of serum uric acid levels may play a role in preventing and treating depression.

Are BDNF and Stress Levels Related to Antidepressant Response?

Antidepressant response is a multifactorial process related to biological and environmental factors, where brain-derived neurotrophic factor (BDNF) may play an important role in modulating depressive and anxious symptoms. We aimed to analyze how BDNF impacts antidepressant response, considering the levels of anxiety. METHODS: A total of 40 depressed adults were included. We evaluated initial serum BDNF, anxiety through the State-Trait Anxiety Inventory (STAI), and the severity of depressive symptoms by the Hamilton Depression Rating Scale (HDRS). Participants received antidepressant treatment for 8 weeks, and response to treatment was evaluated according to the final HDRS scores. RESULTS: Basal BDNF was higher in responders compared to non-responder depressed patients, in addition to being inversely associated with the severity of anxiety and depression. CONCLUSIONS: Baseline BDNF serum is an adequate predictive factor for response to antidepressant treatment with SSRI, with lower pre-treatment levels of BDNF associated with higher anxiety symptoms after treatment. Stress levels could influence the response to treatment, but its association was not conclusive.

Sex-specific associations between levels of high-sensitivity C-reactive protein and severity of depression: retrospective cross-sectional analysis of inpatients in China.

BACKGROUND: We aimed to clarify the controversial relationship between levels of high-sensitivity C-reactive protein (hs-CRP) and severity of depression in men and women. METHODS: Medical records were retrospectively analyzed for 1,236 inpatients at our medical center who were diagnosed with depression at discharge between January 2018 and August 2022. Depression severity was assessed during hospitalization using the 24-item Hamilton Depression Rating Scale. Potential associations between severity scores and hs-CRP levels were explored using multivariate linear regression as well as smooth curve fitting to detect non-linear patterns. RESULTS: In male patients, hs-CRP levels between 2.00 mg/L and 10.00 mg/L showed a non-linear association with depression severity overall (fully adjusted ß = 1.69, 95% CI 0.65 to 2.72), as well as with severity of specific symptoms such as hopelessness, sluggishness, and cognitive disturbance. In female patients, hs-CRP levels showed a linear association with severity of cognitive disturbance (fully adjusted ß = 0.07, 95% CI 0.01 to 0.12). These results remained significant after adjusting for age, body mass index, diabetes, hypertension, history of drinking, history of smoking, and estradiol levels. DISCUSSION: Levels of hs-CRP show sex-specific associations with depression severity, particularly levels between 2.00 and 10.00 mg/L in men. These findings may help develop personalized anti-inflammatory treatments for depression, particularly for men with hs-CRP levels of 2.00-10.00 mg/L.

The impact of psychological stress on physiological indicators in healthcare workers: a cross-sectional study.

Background: Medical health workers play an essential role in the healthcare system and face unique workplace stressors. However, the impact of psychological stress on their physical health has received less attention compared to the general population. Methods: We retrospectively analyzed the Self-rating Depression Scale (SDS) questionnaires and blood testing results from 1963 medical health workers. Multivariate linear regression analysis using a backward stepwise selection strategy to identify physical examination indicators that were significantly affected by depression. Results: Depression severity, as measured by SDS index score, was positively correlated with the levels of hemoglobin (coefficient 0.0027, p = 0.0412), platelet count (coefficient 0.0005, p = 0.0198), and uric acid (coefficient 0.0004, p = 0.0492), while negatively correlated with red blood cell count (coefficient-0.0895, p = 0.0406). Similar results were observed in the subgroup analysis stratified by age and sex. Conclusion: Our study found a significant association between higher levels of depression and specific physiological indicators in healthcare professionals, including elevated hemoglobin, platelet counts, and uric acid levels, as well as decreased red blood cell counts. These changes in blood parameters may reflect underlying physiological stress and inflammation, potentially increasing overall health risks for healthcare workers. Addressing these physiological changes may be crucial for mitigating the health risks associated with depression. To validate our findings and develop targeted interventions, larger multi-center studies are needed to further explore the relationship between depression severity and blood parameters in healthcare professionals.

Associations between plasma markers and symptoms of anxiety and depression in patients with breast cancer.

BACKGROUND AND PURPOSE: Among patients with solid tumors, those with breast cancer (BC) experience the most severe psychological issues, exhibiting a high global prevalence of depression that negatively impacts prognosis. Depression can be easily missed, and clinical markers for its diagnosis are lacking. Therefore, this study in order to investigate the diagnostic markers for BC patients with depression and anxiety and explore the specific changes of metabolism. METHOD AND RESULTS: Thirty-eight BC patients and thirty-six matched healthy controls were included in the study. The anxiety and depression symptoms of the participants were evaluated by the 17-item Hamilton Depression Scale (HAMD-17) and Hamilton Anxiety Scale (HAMA). Plasma levels of glial fibrillary acidic protein (GFAP) and lipocalin-2 (LCN2) were evaluated using enzyme linked immunosorbent assay, and plasma lactate levels and metabolic characteristics were analyzed. CONCLUSION: This study revealed that GFAP and LCN2 may be good diagnostic markers for anxiety or depression in patients with BC and that plasma lactate levels are also a good diagnostic marker for anxiety. In addition, specific changes in metabolism in patients with BC were preliminarily explored.

Relationships between depression level and serum inflammatory factors and thyroxine levels in patients with malignant bone tumors associated with depression.

OBJECTIVE: To elucidate the relationships between depression level and serum inflammatory factors and thyroxine levels in patients with malignant bone tumors associated with depression. METHODS: The depression (n = 28) and non-depression groups (n = 35) were established. Another 35 healthy subjects were selected as the control group. The severity of depression was assessed, and the depression group received the selective serotonin reuptake inhibitor antidepressant sertraline for 4 weeks. Serum levels of inflammatory factors and thyroxine, and the correlation between inflammatory factors, thyroxine, and HAMD-17 score were analyzed. RESULTS: The IL-1ß, IL-6, and IL-21 levels were lower and TGF-ß1, IL-10, and IL-27 were higher in the depression group after treatment than before treatment. After treatment, T3 levels were higher and T4 levels were lower in the depression group. T4 levels were higher in patients with major depression than those with mild depression. IL-1ß and IL-21 levels were elevated in moderately depressed patients [(11.13 ± 1.49) ng/L、(9.71 ± 1.26) ng/L], and IL-1ß levels were elevated in severely depressed patients [(11.26 ± 1.95) ng/L], compared to mildly depressed patients [(9.36 ± 1.25) ng/L, (7.95 ± 1.31) ng/L] (all p < 0.05). Serum IL-1ß, IL-6, and IL-21 were positively correlated with the total HAMD-17 score, and TGF-ß1 and IL-10 were negatively correlated with the total HAMD-17 score. CONCLUSION: Depression degree in patients with malignant bone tumors correlates with serum inflammatory factors and thyroxine levels. Measurement of serum inflammatory factors and thyroxine levels can assess the progression and prognosis of depressed patients.

Association between triglyceride and depression: A systematic review and meta-analysis.

Depression is accompanied by dyslipidemia, which may increase the risk of stroke and coronary heart disease. This study sought to quantitatively summarize the clinical data comparing peripheral blood triglyceride (TG) concentrations between patients with major depressive disorder (MDD) and healthy controls (HCs). Studies were searched in PubMed, EMBASE, PsycINFO, and Cochrane Databases up to March 2023. We also reviewed the reference lists of obtained articles. Mean (±SD) for TG concentrations were extracted, combined quantitatively using random-effects meta-analysis, and summarized as a standardized mean difference (SMD). Subgroup analysis and meta-regression was performed to explore the resource of heterogeneity. Thirty-eight studies measuring the concentrations of peripheral blood TG in 2604 patients with MDD and 3272 HCs were included. Meta-analysis results indicated that TG levels were significant higher in patients with MDD than in HCs (SMD = 0.31, 95% confidence interval [CI]: 0.16 to 0.46, Z46 = 4.05, p < 0.01). Heterogeneity was detected (χ2 = 269.97, p < 0.01, I2 = 85%). Subgroup analysis demonstrated significant differences in TG levels between patients with MDD and HCs depended on age, body mass index and drug use (p < 0.05), but no differences between groups. Meta-regression also found no significant variables. TG level was significantly elevated in depression, which may explain the increased risk of cardiovascular and cerebrovascular events in depression.

Association between neutrophil-to-lymphocyte ratio and specific depressive symptoms: an analysis of a population-based cross-sectional survey.

BACKGROUND: The exact mechanisms underlying depression are not well understood. Chronic, low-grade inflammation is believed to play an important role in its development. The present study investigates the potential association between depressive symptoms and the neutrophil-to-lymphocyte ratio (NLR). METHODS: Seven data cycles of the National Health and Nutrition Examination Survey were extracted. Multivariable logistic regression and a generalized additive model were employed to determine the association. RESULTS: Thirty thousand eight hundred ninety-six subjects were analyzed. The results indicated that anhedonia and fatigue were significantly associated with NLR. Additionally, the generalized additive model results indicated a non-linear relationship between anhedonia, sleep disturbance and NLR. Subgroup analyses demonstrated that the correlation between anhedonia and NLR was significant in the above-60-year-old group (OR: 1.63, 95% CI: 1.14-2.33) and the male group (OR: 1.50, 95% CI: 1.07-2.10). Sleep disturbance was associated with NLR in the female group (OR: 1.36, 95% CI: 1.04-1.77). Fatigue was associated with NLR (OR: 1.30, 95% CI: 1.02-1.67) in the female group, as was the case in the non-Hispanic White group (OR: 1.32, 95% CI: 1.02-1.70). CONCLUSIONS: There were associations between NLR and specific symptoms, and these associations varied across demographic subgroups. There was a non-linear association between anhedonia, sleep disturbance and NLR. These findings could potentially contribute to the advancement of precision medicine within the field of mental health.

The combined effects of depression or anxiety with high-sensitivity C-reactive protein in predicting the prognosis of coronary heart disease patients.

BACKGROUND: Depression, anxiety and high-sensitivity C-reactive protein (hs-CRP) are individually associated with poor prognosis in patients with coronary heart disease (CHD). However, the combined effects of depression with inflammation or anxiety with inflammation on the prognosis have been rarely explored. METHODS: This prospective cohort study included 414 patients diagnosed with CHD. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess depression and anxiety. A score ≥ 5 points was defined as elevated depression or anxiety. High hs-CRP was defined as ≥ 3 mg/L. Follow-up was performed 2 years after the patients were discharged. The clinical results included noncardiac readmission, cardiac readmission, major cardiovascular events (MACEs), and composite events. The composite events included noncardiac readmission and MACEs. The Cox proportional hazard regression model was used to analyze the prognostic risk. RESULTS: After full adjustment, patients with elevated depression and high hs-CRP had a higher risk in predicting noncardiac readmission (hazard ratio (HR) = 3.87, 95% confidence interval (CI) = 1.10-9.02, p = 0.002) and composite events (HR = 1.93, 95% CI = 1.13-3.30, p = 0.016) than those with high hs-CRP alone. For the anxiety and hs-CRP group, high hs-CRP alone predicted a higher risk of noncardiac readmission (HR = 3.32, 95% CI = 1.57-7.03, p = 0.002) and composite events (HR = 1.75, 95% CI = 1.12-2.76, p = 0.015) than references. Elevated anxiety had no significant effects on all the endpoints. Furthermore, we didn't find interactions between depression and hs-CRP or anxiety and hs-CRP. CONCLUSION: In patients with CHD, elevated depression with high hs-CRP was found to be significant in predicting the risk of noncardiac readmission and composite events. Early diagnosis and treatment of depression with inflammation are necessary in CHD patients.

Predicted vitamin D levels and risk of depression in the SUN Project: A prospective cohort study.

The current study aimed to investigate the association between predicted vitamin D status and depression in a prospective Spanish cohort of university graduates. The SUN Project is a dynamic cohort study designed to investigate multiple aspects of health and lifestyle. Participants were asked to complete a comprehensive questionnaire consisting of 556 items, that included a validated food-frequency questionnaire. Participants initially free of depression were classified as incident cases if they reported a medical diagnosis of depression during follow-up. Serum vitamin D levels were predicted by a previously validated equation. Vitamin D deficiency was defined as vitamin D levels below 20 ng/mL. Cox models were used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (95% CI). We included 15,175 Spanish university graduates [mean (SD) age: 36.9 year (11.5)] followed-up for a median of 12.7 years. Among 192,976 person-years of follow-up, we identified 753 incident cases of depression. Participants with vitamin D deficiency had a 27% higher risk of depression as compared to those with vitamin D sufficiency (HR: 1.27, 95% CI: 1.09-1.48; p = 0.002) after adjusting for potential confounders. Furthermore, a significant effect modification by female sex was observed with higher depression risks associated with vitamin D deficiency in women than in men (p for interaction = 0.034). In educated middle-aged Spanish adults, we observed a direct association between vitamin D deficiency and the risk of depression, that was stronger among women.

Serum Metabolomics Analysis Revealed Metabolic Pathways Related to AECOPD Complicated with Anxiety and Depression.

Background: Anxiety and depression are two of the most common comorbidities of COPD, which can directly lead to the number of acute exacerbations and hospitalizations of COPD patients and reduce their quality of life. At present, there are many studies on anxiety and depression in stable COPD, but few studies on anxiety and depression in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients. Objective: We aim to explore the changes of serum metabolomics in AECOPD complicated with anxiety and depression and to provide some clues for further understanding its pathogenesis. Methods: This is an observational high-throughput experimental study based on retrospective data extraction. Twenty-one AECOPD with anxiety and depressive patients and 17 healthy controls (HCs) were retrospectively enrolled in the Second Affiliated Hospital of Anhui Medical University. Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) for anxiety and depression were used to assess the patients with AECOPD. Untargeted metabolomics analysis was carried out to investigate different molecules in the serum of all participants. General information of all participants, baseline data and clinical measurement data of AECOPD patients were collected. Statistical analysis and bioinformatics analysis were performed to reveal different metabolites and perturbed metabolic pathways. Results: A total of 724 metabolites in positive ionization mode and 555 metabolites in negative ionization mode were different in AECOPD patients with anxiety and depression. The 1,279 serum metabolites could be divided into 77 categories. Based on multivariate and univariate analysis, 74 metabolites were detected in positive ionization mode, and 60 metabolites were detected in negative ionization as differential metabolites. The 134 metabolites were enriched in 18 pathways, including biosynthesis of unsaturated fatty acids, aldosterone synthesis and secretion, protein digestion and absorption, ovarian steroidogenesis, long-term depression, retrograde endocannabinoid signaling, and so on. Conclusion: This work highlights the key metabolites and metabolic pathways disturbed in AECOPD patients with anxiety and depression. These findings support the use of metabolomics to understand the pathogenic mechanisms involved in AECOPD patients with anxiety and depression.

Adiponectin and Inflammatory Marker Levels in the Elderly Patients with Diabetes, Mild Cognitive Impairment and Depressive Symptoms.

Some studies suggest that low-grade inflammation and adipokines may be involved in mild cognitive impairment (MCI) and depression in subjects with type 2 diabetes; however, the available data concerning the elderly population are limited. Therefore, we conducted novel research to determine the serum adiponectin, hs-CRP and TNF-α levels in elderly diabetic patients with MCI and depressive symptoms and to identify the factors associated with MCI in this group. A total of 178 diabetic patients (mean age 84.4 ± 3.4 years) were screened for MCI and depressive symptoms. Various biochemical and biomarker data were collected. We found that patients with MCI and depressive symptoms demonstrated lower adiponectin levels and high hs-CRP and TNF-α. In this group, adiponectin concentration was negatively correlated with hs-CRP, TNF-α, HbA1c, and GDS-30 scores and positively correlated with MoCA scores. Multivariable analysis found the risk of MCI to be associated with higher TNF-α levels, fewer years of formal education, an increased number of comorbidities, and the presence of CVD. We concluded that low-grade inflammation and the presence of adipokines are associated with MCI and depressive symptoms in elderly diabetics. Further research should evaluate the suitability of Hs-CRP, TNF-α, and adiponectin as diagnostic markers for MCI and potential therapeutic targets.

Glycemic indicators and mental health symptoms: results from the greater Beirut area cardiovascular cohort.

Introduction: Depression and anxiety present high and complex comorbidity with diabetes. One proposed explanation is that glycemic dysregulations and diabetes-related processes can influence mental health risk. We examined the associations of concurrent and prior glycemic indicators (Hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) levels) with depression and anxiety symptoms in a community-based sample of middle-aged Lebanese adults. Methods: Data come from the Greater Beirut Area Cardiovascular Cohort (GBACC), with baseline and 5-year assessments of sociodemographic, lifestyle, and biological factors (n=198). Depression (Patient Health Questionnaire-9) and anxiety (General Anxiety Disorder-7) symptoms were assessed at follow-up. We investigated associations between glycemic indicators and continuous mental health scores using first linear and then piecewise regression models. Results: Adjusted piecewise regression models showed different associations with mental outcomes across glycemic indicators in the diabetic/clinical compared to the non-diabetic range: Among participants with <126 mg/dl baseline FBG, higher FBG levels in this range were significantly associated with lower depressive (beta=-0.12, 95%CI= [-0.207, -0.032]) and anxiety symptoms (beta=-0.099, 95%CI= [-0.186, -0.012]). In contrast, among participants with baseline FBG levels ≥126 mg/dl, higher FBG levels were significantly associated with higher anxiety symptoms (beta=0.055; 95%CI= 0.008, 0.102). Higher baseline FBG levels in the ≥126 mg/dl range showed a not statistically significant trend for higher depressive symptoms. Although not significant, baseline HbA1c levels showed similar patterns with negative associations with mental health symptoms in the <6.5% range. Discussion: Results show that FBG levels were associated with poorer mental health symptoms only in the clinical/diabetic range, and not in the normal range. Associations were observed with baseline glycemic indicators, highlighting potentially early and prolonged associations with mental health. Findings highlight the importance of clinical changes in glycemic indicators for mental health and motivate further research into the transition toward adverse associations between diabetes and mental health.

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and the risk of post-stroke depression: A cross-sectional study.

BACKGROUND: Limited observational research has explored the relationship between the non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio (NHHR) and the risk of post-stroke depression (PSD). This study aims to investigate the potential associations between NHHR and PSD. METHODS: A cross-sectional study was conducted using data from stroke participants aged 20 and older, sourced from the National Health and Nutrition Examination Survey (NHANES) spanning 2005 to 2018. Depression was assessed using the PHQ-9 questionnaire. The association between NHHR and PSD risk was evaluated through weighted multivariate logistic regression and restricted cubic spline (RCS) models. Subgroup and sensitivity analyses were performed to validate the findings. RESULTS: In the continuous model, the NHHR value for the PSD group (3.23±1.84) was significantly higher than that of the non-PSD group (2.79±1.40, p=0.015). Logistic regression analysis in the fully adjusted model revealed a positive association between NHHR and PSD (OR 1.16, 95 % CI 1.03-1.30, p=0.016). Interaction tests showed no significant differences across strata (p > 0.05 for interaction). Restricted cubic spline results indicated a linear dose-response relationship between NHHR and PSD risk (P for non-linearity = 0.6). This association persisted in various subgroup analyses. CONCLUSION: NHHR was significantly correlated with an increased risk of PSD among U.S. adults. Further re-search on NHHR could contribute to the prevention and treatment of PSD.

Acute and chronic effects of physical exercise in inflammatory biomarkers in people with depression: A systematic review with meta-analysis.

People with depression have increased levels of pro-inflammatory cytokines compared to healthy subjects. Physical exercise can alleviate depressive symptoms and has anti-inflammatory properties. The aim of this study was to identify the effects of exercise on inflammatory biomarkers in people with depression. Clinical trials evaluating the acute and chronic effects of exercise on inflammatory biomarkers in adults with clinical depression were included. The search was conducted on the following databases: PubMed, Embase, Web of Science, PsycINFO, and SPORTDiscus. The risk of bias was assessed with the "Risk of bias in randomized trials" (RoB2) tool. Random effects meta-analyses estimated the acute and chronic effects of exercise for each marker separately. Heterogeneity was estimated with the l2 test. A total of 10 studies (497 participants) were included. No significant acute effects interleukins (IL)-6, IL-10, and IL-8 levels were found. Chronically, exercise increased the levels of TNF-α (Standardized Mean Difference = 0.296; 0.03-0.562, p = 0.029). No chronic effects were found for IL-6 and IL-1B. Overall, 90% of the studies had a moderate or high risk of bias. Exercise seems to promote a small increase in TNF-α, but literature is scarce and with a high risk of bias.

The association between neutrophil percentage-to-albumin ratio (NPAR) and depression among US adults: a cross-sectional study.

Inflammation plays an important role in depression, and the neutrophil-to-albumin ratio (NPAR) is a cost-effective and readily available novel biomarker of inflammation. The association between NPAR and depression is unclear; therefore, to assess the relationship between NPAR and depression, we conducted a cross-sectional study of 33,768 participants ≥ 18 years of age from the 2005-2018 NHANES database. NPAR was calculated as Neutrophil percentage (in total WBC count) (%) × 100/Albumin (g/dL). Multivariate logistic regression models were used to test the independent association between NPAR and depression, adjusting for demographic factors, education, smoking status, alcohol consumption, hypertension, diabetes mellitus, body mass index, the ratio of income to poverty, and history of cardiovascular disease. Results showed that NPAR was significantly and positively associated with depression. When NPAR were analyzed as a categorical variable, there was a 20% increase in the prevalence of depression in the quartile with the highest NPAR compared to the quartile with the lowest NPAR (OR 1.20[95% CI 1.06, 1.36]). Smoothed curve fitting and threshold effect analyses also showed a positive association between NPAR and depression, with an inflection point for threshold and saturation effects of 12.65. NPAR was positively associated with the likelihood of developing depression when NPAR > 12.65 (OR 1.06[95% CI 1.04, 1.09]). The results of subgroup analyses and interaction tests indicated that smoking status had a significant effect on the relationship between NPAR and depression (P < 0.05). Our study reveals a positive association between NPAR levels and depression, suggesting that higher NPAR levels are associated with an increased likelihood of developing depression.

[Significance of immunological markers in patients with obstructive sleep apnea and comorbid pathology]. / Znachimost' immunologicheskikh markerov u patsientov s obstruktivnym apnoe sna i komorbidnoi patologiei.

OBJECTIVE: To determine the significance of immunological markers in patients with obstructive sleep apnea (OSA) and comorbid pathology. MATERIAL AND METHODS: Sixty-five patients were examined. Two groups of patients were distinguished: the main group with moderate and severe OSA and the control group without OSA. The subjects underwent anthropometry, polysomnography, assessment of cognitive and emotional disorders. Glial fibrillar acidic protein (GFAP), antibodies against NR1-NR2 subunits of NMDA receptors (AT to GRIN2A) and the acetylcholine receptor (AT to AChR), and brain-derived neurotrophic factor (BDNF) were studied by enzyme immunoassay. RESULTS: In patients with OSA, indicators of markers: GFAP (p=0.017), BDNF (p=0.006), antibodies to AChR (p=0.002), as well as chronic cerebral ischemia (p=0.000), depression on the HADS (p=0.004) and the Beck scale (p=0.000), drowsiness on the Epworth scale (p=0.001), asthenia on the visual analogue scale (p=0.000) and the MFI 20 (p=0.013) were higher than in the control group. A relationship was established in the main group between the identified subjective disorders on the Mini-Mental State Examination scale (MMSE) and BDNF (r=0.302, p=0.014) and the average score on the MMSE and BDNF (r=-0.266, p=0.032). CONCLUSION: The results demonstrate the relationship of neurospecific proteins with cognitive impairment in patients with OSA. The neuromarker GFAP in patients with sleep apnea has shown itself to be a predictor of decreased neurogenesis, and BDNF as a representative marker of neuroplasticity. Large values of AT to AChR in patients with OSA may indicate possible neuromuscular transmission disorders. Along with drowsiness and asthenia, patients with OSA have changes in the emotional background, mainly due to depression. The severity of depression and the severity of asthenia increase with increasing severity of apnea and are probably associated with low levels of saturation, which in turn leads to dysregulation of the prefrontal cortex, hippocampus and amygdala.

The impact of depression on platelet activation, cardiocerebral vascular events and arteriovenous fistula dysfunction in patients undergoing haemodialysis.

Depression is a common psychiatric disorder among patients undergoing maintenance haemodialysis (MHD). Depression may reportedly contribute to poor prognosis in several ways, including its effects on platelet function. We hypothesised that depression contributes to the occurrence of cardiocerebral vascular events (CCVE) and dysfunction of arteriovenous fistula (DAVF) in patients undergoing MHD through its effects on platelets. In this prospective cohort study, patients undergoing MHD were recruited and divided into depression and non-depression groups according to their Hamilton Depression Scale (HAMD) scores. The 286 enrolled patients had 103 occurrences of depressive symptoms (prevalence = 36.01%). Compared with the non-depression group, depression group had a significantly higher cumulative prevalence of CCVE and DAVF during follow-up. Cox regression analysis indicated that higher HAMD scores and lower plasma platelet distribution width (PDW) were common risk factors for CCVE and DAVF. Furthermore, HAMD scores were significantly negatively correlated with plasma PDW and was the main variable affecting changes in PDW, as indicated by multiple linear regression analysis. Depression may increase the risk of CCVE and DAVF in patients undergoing MHD by activating platelets. Plasma PDW may be a convenient indicator of platelet activation status and may predict the risk of CCVE and DAVF.