中性粒细胞/淋巴细胞对妊娠糖尿病合并抑郁预测价值的研究

Study on the Predictive Value of Neutrophil/Lymphocyte in Gestational Diabetes Mellitus Combined with Depression

目的分析中性粒细胞(N)与淋巴细胞(L)的比值(NLR)对妊娠糖尿病(gestational diabetes mellitus,GDM)合并抑郁的影响以及预测价值。方法便利抽样法选取2021年1月—2022年5月间于厦门大学附属东南医院诊疗的GDM孕妇134例,根据是否合并抑郁分为抑郁组(n=51)和非抑郁组(n=83),比较两组临床指标的差异,二元Logistic回归检验NLR对GDM合并抑郁的影响,并分析NLR对GDM合并抑郁预测价值。结果134例GDM孕妇抑郁自评量表(SDS)评分为(50.47±9.42)分、社会支持评分为(35.49±7.62)分,其中51例合并抑郁(38.06%),社会支持与SDS评分呈负相关(P<0.05)。年龄≥35岁、空腹血糖(FPG)、使用胰岛素、NLR均为GDM合并抑郁的危险因素,社会支持评分为保护因素(OR=2.383、2.891、3.048、3.505、0.714,P<0.05)。NLR预测GDM合并抑郁的曲线下面积为0.713(0.595~0.874),最佳截断值为4.54,预测敏感度为78.43%,特异性为61.45%。结论NLR为GDM孕妇合并抑郁的危险因素,且对其有较好的预测价值。

Objective To analyze the effect of neutrophil(N)to lymphocyte(L)ratio(NLR)on gestational diabetes mellitus(GDM)combined with depression and its predictive value.Methods Convenient sampling method was used to select 134 pregnant women with GDM who were diagnosed and treated by Southeast Hospital Affiliated to Xiamen University between January 2021 and May 2022.They were divided into depression group(n=51)and non depression group(n=83)based on whether they were complicated with depression,to compare the differences in clinical indicators between the two groups,binary logistic regression test was conducted to examine the effect of NLR on GDM with depression,and analyzed the predictive value of NLR on GDM combined with depression.Results The Self-Depression scale(SDS)score of 134 pregnant women with GDM was(50.47±9.42)points,and the social support score was(35.49±7.62)points.Among them,51 cases were complicated with depression(38.06%).The social support was negatively correlated with the SDS score(P<0.05).Age≥35 years old,fasting blood glucose(FPG),insulin use,and NLR were all risk factors for GDM associated with depression,while social support scores were protective factors(OR=2.383,2.891,3.048,3.505,0.714,P<0.05).The area under the curve for NLR to predict GDM with depression was 0.713(0.595-0.874),with an optimal cutoff value of 4.54,a predictive sensitivity of 78.43%,and a specificity of 61.45%.Conclusion NLR is a risk factor for comorbid depression in pregnant women with GDM and has a good predictive value for it.