Previously submitted to: JMIR Public Health and Surveillance (no longer under consideration since Mar 15, 2024)
Date Submitted: Sep 27, 2023
Open Peer Review Period: Sep 27, 2023 - Oct 11, 2023
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Association of Depression with Systemic Immune-Inflammation Index and Platelet Parameters among Survivors of Myocardial Infarction: Cross-sectional NHANES Study
ABSTRACT
Background:
Inflammation has been associated with increased risk for depressive disorder (DD) post myocardial infarction (MI). Platelets are increasingly considered as the linking of thrombosis and inflammation with depression.
Objective:
Despite that the systemic immune-inflammatory index (SII), platelet count (PLT) and mean platelet volume (MPV) are known as readily available circulatory inflammatory or platelet parameters, few studies have investigated the relationship of these indicators with cardiac depression. Hence, we performed the analysis on the associations of depression with SII, PLT and MPV among heart attack survivors.
Methods:
This cross-sectional investigation was conducted among adults in National Health and Nutrition Examination Survey (NHANES) 2009-2020. Multivariable regression analysis and subgroup analysis were performed to explore the independent relationship of depression with log2SII, log2MPV and log2PLT. A dose-response analysis was performed to observe whether they were linearly correlated, and sensitivity analysis was used to examine the robustness of the associations.
Results:
A total of 1,352 individuals with the history of heart attacks were included in our study. In a multivariate linear regression analysis, we observed a significantly positive association of depression with log2SII (OR=1.22, 95%CI=1.06-1.41, P=0.0069) and log2PLT (OR=1.78, 95%CI=1.30-2.43, P=0.0003), and there was no significant difference between log2MPV and depression (OR=0.53, 95%CI=0.24-1.17, P=0.1150). Subgroup analysis and interaction test showed that this positive association between log2SII and depression was maintained except in female and BMI<25 group. There was no significant dependence of age, sex, race, BMI, smoking status, hypertension, stroke, insomnia and anti-platelet agents on the association of depression with log2PLT and log2MPV. The dose-response analysis showed a positive correlation of depression with log2SII and log2PLT, as well as an inverted U-shaped curve between log2MPV and depression with an inflection point of 3.04. Sensitivity analysis confirmed that the results of this study were robust either after using the methods of multiple imputation or excluding stroke participants. We also observed a strong association of log2SII and log2PLT with trouble sleeping, feeling tired and poor appetite, of log2MPV with poor appetite.
Conclusions:
In a nationally representative sample of US adults, log2SII and log2PLT was positively associated with increased risk of depression. There was an inverted U-shaped curve between log2MPV and depression with an inflection point of 3.04.
Citation
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