Unipolar ve Bipolar Depresif Bozuklukta Bazı Hematolojik Parametrelerin

Amaç: Duygudurum bozukluklarının en şiddetli türleri olan majör depresif bozukluk ve bipolar bozukluk, dünya çapında en fazla yeti yitimi oluşturan hastalıklar arasında yer almaktadır. Unipolar depresif bozukluk (UD) ve bipolar depresif bozuklukta(BD) etkin tedavi sağlamanın önündeki en büyük zorluklardan biri, UD ile BD arasında erken ayırıcı tanının yapılamamasıdır. Bu nedenle klinik olarak ayırt edilemeyen olgularda ayırıcı tanıda kullanılabilecek basit ve ucuz biyobelirteçlerin bulunması büyük önem taşımaktadır. Birçok çalışma, duygudurum bozukluklarının patofizyolojisinde nöroinflamasyonun rol oynayabileceğini öne sürmüştür. Nötrofil/lenfosit oranı (NLO), trombosit/lenfosit oranı (PLO) ve monosit/lenfosit oranı (MLO), inflamasyon düzeyini ölçmek için önerilen nispeten ucuz hematolojik parametrelerdir. Bu çalışmada, NLO, PLO ve MLO analiz edilerek bu inflamatuar belirteçlerin UD ve BD ayırıcı tanısındaki potansiyel rolü araştırıldı. Materyal ve Metod: Hasta grubu 54 (UD: 31, BD: 23), sağlıklı kontrol(SK) grubu ise 40 kişiden oluştu. UD, BD VE SK grupları arasındaki NLO, PLO ve MLO hematolojik belirteçleri karşılaştırdı. Bulgular: Çalışmada analiz edilen hematolojik belirteçler arasında sadece NLO düzeylerinde anlamlı fark bulundu(p=0.004). UD ve BD grupları SK ile ayrı ayrı karşılaştırıldığında, NLO hem UD hem de BD gruplarında SK grubuna göre anlamlı olarak yüksekti (p=0,002, p=0,015). UD ve BD karşılaştırıldığında NLO açısından anlamlı fark yoktu(P=0,416). Sonuç: Çalışmamızda NLO, PLO ve MLO açısından UD ve BD arasında anlamlı fark bulunmamakla birlikte, her iki hasta grubunda NLO'nun SK'ye göre yüksek olması hem UD hem de BD hastalarında inflamasyonun varlığını düşündürmektedir. Hastalığa özgü bir belirteç olarak değerlendirmek için daha fazla kanıt gereklidir.

Anahtar Kelimeler:

Majör Depresyon, Bipolar Depresyon, hemogram, Enflamasyon, Biyobelirteç

Comparison of Some Hematological Parameters in Unipolar and Bipolar Depressive Disorder

Background: Major depressive disorder and bipolar disorder, which are the most severe types of mood disorders, are among the diseases that cause the most disability worldwide. One of the biggest challenges in providing early and effective treatment in mood disorders is the inability to make an early differential diagnosis between UD and BD. Many studies have suggested that neuroinflammation may play a role in the pathophysiology of mood disorders. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) are relatively cheap hematological parameters recommended to measure the level of inflammation. This study aimed to examine the potential role of inflammatory processes in the pathogenesis of unipolar depression(UD) and bipolar depression(BD) by analyzing various hematologic markers, including NLR, PLR, and MLR Materials and Methods: The patient group comprised 54 individuals(UD: 31, BD: 23), while the healthy control(HC) group comprised 40 individuals. The study compared the values of hematologic markers between the groups. Results:The study found significant differences only in the levels of NLR among the analyzed hematologic markers(p=0.004). When the UD and BD groups were compared with HC separately, NLR was significantly higher in both the UD and BD groups compared to the HC group(p=0.002, p=0.015). When UD and BD were compared with each other, there was no significant difference in terms of NLR(P=0,416). Conclusions: In our study, although there was no significant difference between BD and UD in terms of NLR, PLR and MLR, the higher NLR in both patient groups compared to HC suggests the presence of inflammation in both BD and UD patients. More evidence is needed to evaluate it as a disease-specific marker.

Keywords:

Major Depression, Bipolar Depression, hemogram, İnflammation, Biomarker,

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