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Cited by 49Inflammatory Biomarkers in Disease PrognosisTryptophan and brain disordersBipolar Disorder and Treatment

Characteristics of platelet-associated parameters and their predictive values in Chinese patients with affective disorders

Open access
Wei, Yanyan, Feng, Junhui, Ma, Jinbao, Chen, Dongning, Xu, Haiting, Yin, Lu, Chen, Jingxu·2022·BMC Psychiatry
DOI 10.1186/s12888-022-03775-9PMC PMC8874305
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Abstract

Objective: Platelets are increasingly considered to play an important role in inflammation and are being regarded as a putative bridge linking mental diseases and inflammatory response. Platelet-associated haematological parameters including mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), systemic immune-inflammation index (SII), platelet to lymphocyte ratio (PLR), platelet to albumin ratio (PAR) and red blood cell distribution width (RDW) to platelet ratio (RPR), have been recently investigated as simple, easily available, and inexpensive inflammatory markers. In this study, we aimed is to use large-scale clinical data to study platelet parameters in patients with affective disorders, to further investigate the predictive power of platelet parameters for major depressive disorder (MDD) and bipolar disorder (BD). Methods: The retrospective, naturalistic, cross-sectional study analysed the data of 14,007 Chinese affective disorder patients, including 4,801 patients with first-episode MDD, 4,098 patients with recurrent MDD, 3,444 patients with BD manic episodes and 1,664 patients with BD depressive episodes. Meanwhile, 6,847 healthy subjects were served as the control group. The differences in the MPV, PDW, PCT, SII, PLR, PAR, RPR and albumin among different groups were compared, and the contributing factors for the occurrence of MDD or BD were analysed. Results: There were significant differences in MPV, PDW, PCT, SII, PLR, RPR and albumin values among the study groups. In the subjects, patients experiencing BD manic episodes had the highest mean values of MPV and SII, patients experiencing BD depressive episodes had the lowest mean values of platelet counts and PAR, and patients with MDD had the highest mean values of PLR and RDW. The levels of MPV, PDW and albumin were independently correlated with MDD and BD, and they are important predictors for differentiating patients with MDD or BD from healthy controls. Conclusions: Our study demonstrated that different affective disorders have unique platelet parameter variation patterns, highlighting the role of platelet parameters and systemic inflammation in the pathophysiology of MDD and BD.

AI snapshot

Written from the paper’s full text.

TL;DR

In a large retrospective cross-sectional study of 14,007 Chinese inpatients with affective disorders and 6,847 healthy controls, platelet-associated parameters differed across first-episode MDD, recurrent MDD, BD depressive episodes, and BD manic episodes. MPV, PDW, and albumin were independent predictors for differentiating MDD or BD from healthy controls.

Key findings

  • BD manic episodes had the highest mean MPV and SII values; BD depressive episodes had the lowest mean platelet counts and PAR values; MDD had the highest mean PLR and RDW values.
  • Compared with healthy controls, both MDD and BD groups showed higher MPV, RDW, and RPR and lower platelet counts, PDW, PCT, and albumin; BD manic episodes additionally showed higher neutrophil counts and SII than controls.
  • In binary logistic regression, age, sex, MPV, PDW, and albumin were independent indicators for MDD and BD (all P < 0.001). For MDD, MPV OR = 2.366 (95% CI 2.265–2.472), PDW OR = 0.559 (0.547–0.571), albumin OR = 0.786 (0.775–0.789); for BD, MPV OR = 2.048 (1.960–2.139), PDW OR = 0.610 (0.596–0.624), albumin OR = 0.778 (0.765–0.791).
  • ROC analysis for MDD: PDW cut-off 15.5% had AUC 0.804 (95% CI 0.791–0.810), sensitivity 81.16%, specificity 87.62%; albumin cut-off 43.8 g/L had AUC 0.742 (0.735–0.749); MPV cut-off 8.4 fL had AUC 0.693 (0.686–0.701). For BD: PDW cut-off 15.5% had AUC 0.789 (0.781–0.796), sensitivity 78.45%, specificity 87.62%; MPV cut-off 8.8 fL had AUC 0.731 (0.723–0.739); albumin cut-off 43.3 g/L had AUC 0.708 (0.699–0.716).

Methods

  • Retrospective, naturalistic, cross-sectional study using Electronic Medical Record System data from Beijing HuiLongGuan Hospital and Jining Psychiatric Hospital, January 2015 to January 2021; included 14,007 patients with ICD-10 MDD or BD and 6,847 age- and sex-matched healthy controls.
  • Patient subgroups: 4,801 first-episode MDD, 4,098 recurrent MDD, 3,444 BD manic episodes, and 1,664 BD depressive episodes; only the first inpatient entry per patient was used, and fasting venous blood was collected after 8 h fasting.
  • Analyses used SPSS 21.0 and R 4.0.3: ANCOVA adjusted for age and sex with Bonferroni post hoc tests, Spearman correlations, binary logistic regression, nomograms, and ROC curves.

Limitations

  • The paper states: the retrospective design prevented structured psychiatric interviews and symptom severity was not analyzed; treatment effects were not considered; the cross-sectional design did not allow causal inferences; and confounders such as smoking, diet, and body mass index were not controlled.
  • Evident from the text: the sample was hospitalized Chinese patients likely in the acute phase, so findings may not generalize to outpatient, euthymic, or non-Chinese populations.
  • Evident from the text: diagnoses came from electronic medical records using ICD-10 criteria without independent structured diagnostic confirmation, and medication status was not included in the analyses.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s12888-022-03775-9

Cites

61 of 61 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 15 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The MDD group had the highest RDW and PLR of the three groups (MDD, BD depressive episodes, BD manic episodes).

    “the MDD group had the highest RDW and PLR of the three groups”
    Quote in the paperSubstantial claim
  • Findingown data

    Patients experiencing BD manic episodes had the highest mean values of MPV and SII among the study groups.

    “patients experiencing BD manic episodes had the highest mean values of MPV and SII”
    Quote in the paperNot a substantial claim
  • Findingown data

    There were significant differences in MPV, PDW, PCT, SII, PLR, RPR and albumin values among the study groups.

    “There were significant differences in MPV, PDW, PCT, SII, PLR, RPR and albumin values among the study groups.”
    Quote in the paperSubstantial claim
  • Findingown data

    After adjusting for age and sex, the affective disorders group showed lower PDW, PCT and albumin than the healthy control group.

    “and lower PDW, PCT and albumin (P < 0.05) than the HC group”
    Quote in the paperSubstantial claim
  • Findingown data

    No significant differences were found in the PLR, SII and PAR values between the affective disorders group and the healthy control group.

    “No significant differences were found in the PLR, SII and PAR values between the groups (P < 0.05).”
    Quote in the paperNot a substantial claim
  • May combine two claims. 39
  • Classified as probably not a substantial claim. 9

  • May combine two claims.

    Findingown data

    In the healthy control group, males presented higher neutrophil counts, lymphocyte counts, albumin and RPR values, and lower platelet counts, PCT, RDW, PLR, SII and PAR values than females.

    “the males presented higher neutrophil counts, lymphocyte counts, albumin and RPR values (P < 0.05), and lower platelet counts, PCT, RDW, PLR, SII and PAR values (P < 0.05) than females.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Both the BD manic episodes group and the BD depressive episodes group had decreased platelet counts, PDW, PCT, albumin and PLR values compared to the healthy control group.

    “and decreased platelet counts, PDW, PCT, albumin and PLR values (P < 0.05)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Compared to the first-episode MDD group, the recurrent MDD group presented with higher neutrophil counts and lower albumin levels.

    “Compared to the first-episode MDD group, the recurrent MDD group presented with higher neutrophil counts and lower albumin levels (P < 0.05).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the first-episode MDD group, males showed higher neutrophil, lymphocyte, albumin and RPR values, and lower platelet, MPV, PCT, RDW, PLR and PAR values than females.

    “The males showed higher neutrophil, lymphocyte, albumin and RPR values (P < 0.05), and lower platelet, MPV, PCT, RDW, PLR and PAR values (P < 0.05) than the females.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    After adjusting for age and sex, the MDD group possessed higher platelet counts, RDW, PLR and PAR values, and lower MPV, neutrophil counts and lymphocyte counts than the BD depressive episodes group.

    “the MDD group possessed higher platelet counts, RDW, PLR and PAR values (P < 0.05), and lower MPV, neutrophil counts and lymphocyte counts (P < 0.05) than the BD depressive episodes group.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Compared to the healthy control group, the MDD group showed lower platelet, PDW, PCT, neutrophil, lymphocyte, albumin and SII values.

    “and lower platelet, PDW, PCT, neutrophil, lymphocyte, albumin and SII values (P < 0.05)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Both the BD manic episodes group and the BD depressive episodes group had increased MPV, RDW, and RPR values compared to the healthy control group.

    “both the BD manic episodes group and the BD depressive episodes group had increased MPV, RDW, and RPR values (P < 0.05)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Compared with the BD depressive episodes group, the BD manic episodes group had elevated platelet counts, MPV, PCT, neutrophil counts, SII and PAR values, and decreased albumin levels and RPR values.

    “Comparison with the BD depressive episodes group showed that the platelet counts, MPV, PCT, neutrophil counts, SII and PAR values were elevated (P < 0.05), and the albumin levels and RPR values were decreased (P < 0.05) in the BD manic episodes group.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There were no differences in age or sex between the affective disorders group and the healthy control group.

    “There were no differences found in age or sex between the affective disorders group and HC group (P > 0.05).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The BD manic group had the highest MPV, PCT, neutrophil counts and SII values of the three groups (MDD, BD depressive episodes, BD manic episodes).

    “The BD manic group had the highest MPV, PCT, neutrophil counts and SII values of the three groups”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Among the MDD, BD and healthy control groups, significant differences were found in platelet, neutrophil and lymphocyte counts, and in MPV, PDW, PCT, RDW, albumin, PLR, SII and RPR.

    “The ANCOVA showed that significant differences were found in the platelet, neutrophil and lymphocyte counts, and in the MPV, PDW, PCT, RDW, albumin, PLR, SII and RPR among the three groups (P < 0.05)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the BD manic episodes group, males presented higher neutrophil, lymphocyte, albumin and RPR values, and lower platelet, MPV, PDW, PCT, RDW, PLR and PAR values than females.

    “the males in the BD manic episodes group presented higher neutrophil, lymphocyte, albumin and RPR values (P < 0.05), and lower platelet, MPV, PDW, PCT, RDW, PLR and PAR values (P < 0.05).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Both the first-episode MDD group and the recurrent MDD group had decreased platelet, PDW, PCT, neutrophil, lymphocyte and albumin levels compared with the healthy control group.

    “and decreased platelet, PDW, PCT, neutrophil, lymphocyte and albumin levels (P < 0.05) compared with the HC group”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The first-episode MDD group had lower SII than the healthy control group, while the recurrent MDD group had no difference in SII compared to the healthy control group.

    “The first-episode MDD group had lower SII than HC group (P < 0.05), while the recurrent MDD group had no difference in SII compared to th HC group (P > 0.05).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Compared to the BD manic episodes group, the RDW and PLR values in the MDD group were increased, and the MPV, PCT, neutrophil counts, lymphocyte counts, albumin and SII values in the MDD group were decreased.

    “When compared to the BD manic episodes group, the RDW and PLR values in the MDD group were increased (P < 0.05), the MPV, PCT, neutrophil counts, lymphocyte counts, albumin and SII values in MDD group were decreased (P < 0.05).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the recurrent MDD group, males had increased neutrophil, lymphocyte, albumin and RPR values, and decreased platelet, MPV, PCT, RDW, PLR and PAR values compared to females.

    “the neutrophil, lymphocyte, albumin and RPR values were increased (P < 0.05), and the platelet, MPV, PCT, RDW, PLR and PAR values were decreased (P < 0.05) in males compared to those in females”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Compared with the MDD group, the BD group exhibited lower platelet counts, RDW and PLR values.

    “and lower platelet counts, RDW and PLR values (P < 0.05)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the BD depressive episodes group, males had higher neutrophil, lymphocyte, albumin and RPR values, and lower platelet, MPV, PCT, RDW, PLR and PAR values than females.

    “the neutrophil, lymphocyte, albumin and RPR values in males were higher than those in females (P < 0.05), The values of platelet, MPV, PCT, RDW, PLR and PAR values in males were lower than those in females (P < 0.05).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Compared to the healthy control group, the BD group had higher MPV, neutrophil, RDW, SII and RPR values.

    “compared to the HC group, the BD group had higher MPV, neutrophil, RDW, SII and RPR values (P < 0.05)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The BD manic episodes group showed higher neutrophil counts and SII values than the healthy control group, while the BD depressive episodes group had no differences in neutrophil or SII with the healthy control group.

    “the BD manic episodes group showed higher neutrophil counts and SII values than the HC group (P < 0.05) when BD depressive episodes group had no differences in neutrophil, SII with HC group (P > 0.05).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Compared to the healthy control group, the BD group had lower platelet counts, PDW, PCT, albumin and PLR values.

    “and lower platelet counts, PDW, PCT, albumin, PLR values (P < 0.05)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Both the first-episode MDD group and the recurrent MDD group had increased MPV, RDW, PLR and RPR values compared with the healthy control group.

    “both the first-episode MDD group and the recurrent MDD possessed increased MPV, RDW, PLR and RPR values(P < 0.05)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Compared with the MDD group, the BD group exhibited higher MPV, PCT, neutrophil counts, lymphocyte counts, albumin levels and SII values.

    “Compared with the MDD group, the BD group exhibited higher MPV, PCT, neutrophil counts, lymphocyte counts, albumin levels and SII values (P < 0.05)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The PDW cut-off point of 15.5% had 81.16% sensitivity and 87.62% specificity, with AUC 0.804 (95% CI: 0.791-0.810), and was the optimal cut-off point for the identification of MDD.

    “The PDW cut-off point of 15.5% which showed 81.16% sensitivity and 87.62% specificity, and with the AUC 0.804 (95% CI: 0.791–0.810) was the optimal cut-off point for the identification of MDD.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    An albumin cut-off point of 43.3 g/L had 51.17% sensitivity and 84.26% specificity, with AUC 0.708 (95% CI: 0.699-0.716), and was the optimal cut-off point for the identification of BD.

    “Furthermore, an albumin cut-off point of 43.3 g/L which displayed 51.17% sensitivity and 84.26% specificity, and with the AUC 0.708 (95% CI: 0.699–0.716) was the optimal cut-off point for the identification of BD.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In patients with MDD, PLR and RPR levels were elevated.

    “Our results showed that in patients with MDD, the PLR and RPR levels were elevated, and SII levels were decreased.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the recurrent MDD group, PLR, SII and RPR values were positively correlated with age, and platelet, MPV, PDW, PCT, neutrophil, lymphocyte, albumin and PAR values were negatively correlated with age.

    “In the recurrent MDD group, the PLR, SII and RPR values were positively correlated with age (P < 0.05), platelet, MPV, PDW, PCT, neutrophil, lymphocyte, albumin, and PAR values were negatively correlated with age (P < 0.05).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    An MPV cut-off point of 8.8 fL had 74.45% sensitivity and 62.92% specificity (AUC: 0.731, 95% CI: 0.723-0.739) and was the optimal cut-off point to differentiate patients with BD from healthy controls.

    “An MPV cut-off point of 8.8 fL (AUC: 0.731, 95% CI: 0.723–0.739) which showed 74.45% sensitivity and 62.92% specificity was the optimal cut-off point to differentiate patients with BD from healthy controls.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    First-episode MDD and recurrent MDD patients both had lower neutrophil counts than healthy controls.

    “Patients with first-episode MDD and recurrent MDD both showed lower neutrophil and lymphocyte counts than HCs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The albumin cut-off point of 43.8 g/L had 60.24% sensitivity and 79.11% specificity, with AUC 0.742 (95% CI: 0.735-0.749), and was the optimal cut-off point for identification of MDD.

    “Albumin cut-off point of 43.8 g/L which displayed 60.24% sensitivity and 79.11% specificity, and with the AUC 0.742 (95% CI: 0.735–0.749) was the optimal cut-off point for identification of MDD.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the healthy control group, PDW, neutrophil, RDW, SII and RPR values were positively correlated with age, and platelet, MPV, PCT, lymphocyte, albumin and PAR values were negatively correlated with age.

    “In the HC group, the PDW, neutrophil, RDW, SII and RPR values were positively correlated with age (P < 0.05), the platelet, MPV, PCT, lymphocyte, albumin and PAR values were negatively correlated with age (P < 0.05).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Both BD manic and BD depressive episodes patients had decreased platelet counts compared to healthy controls.

    “both patients with BD manic episodes and BD depressive episodes had increased MPV and RPR values, and decreased platelet counts, PDW, PCT and PLR values”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the first-episode MDD group, PLR, SII and RPR values were positively correlated with age, and platelet, MPV, PDW, PCT, lymphocyte and albumin values were negatively correlated with age.

    “In the first-episode MDD group, the Spearman correlation analysis showed that there were positive relationships between PLR, SII, RPR values and age (P < 0.05), there were negative relationships between platelet, MPV, PDW, PCT, lymphocyte, albumin values and age (P < 0.05).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Both first-episode MDD and recurrent MDD patients had higher PLR values than healthy controls.

    “both patients with first-episode MDD and recurrent MDD displayed higher MPV, PLR and RPR values and lower platelet counts, PDW and PCT values than healthy controls.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Patients with MDD and BD both had increased RDW levels compared to healthy controls.

    “Our study found that the patients with MDD and BD both had increased RDW levels compared to HCs”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the BD depressive episodes group, PLR, SII and RPR had positive correlations with age, and platelet, MPV, PCT, lymphocyte and albumin values had negative correlations with age.

    “In the BD depressive episodes group, the Spearman correlation analysis revealed that the PLR, SII and RPR had positive correlations with age (P < 0.05), but platelet, MPV, PCT, lymphocyte and albumin values had negative correlations with age (P < 0.05).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the BD manic episodes group, PLR and RPR values were positively correlated with age, and platelet, MPV, PCT, neutrophil, lymphocyte and albumin values were negatively correlated with age.

    “In the BD manic episodes group, the PLR and RPR values were positively correlated with age (P < 0.05), and the platelet, MPV, PCT, neutrophil, lymphocyte and albumin values were negatively correlated with age (P < 0.05).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    First-episode MDD and recurrent MDD patients both had lower lymphocyte counts than healthy controls.

    “Patients with first-episode MDD and recurrent MDD both showed lower neutrophil and lymphocyte counts than HCs.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    MPV is associated with various inflammatory conditions including inflammatory polyps, diabetes mellitus, irritable bowel syndrome, malignancy, and obesity.

    “MPV is associated with various inflammatory conditions including inflammatory polyps [23], diabetes mellitus [24], irritable bowel syndrome [25], malignancy [26], and obesity [27].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [23] Aktas G, Sit M, Tekce H, Alcelik A, Savli H, Simsek T, Ozmen E, Isci AZ, Apuhan T. Mean platelet volume in nasal polyps. West Indian Med J. 2013;62(6):515–8. source

      Not checked in the free run.

    • cites [24] Duman TT, Aktas G, Atak B, Kocak MZ. Bolu Abant Izzet Baysal University Hospital DOIM: Is Mean Platelet Volume to Platelet ratio a promising indicator of diabetic regulation in type 2 diabetes mellitus? The Journal of Medical Research. 2018;4(3):137–9. source

      Not checked in the free run.

    • cites [25] Aktas G, Alcelik A, Tekce BK, Tekelioglu V, Sit M, Savli H. Red cell distribution width and mean platelet volume in patients with irritable bowel syndrome. Prz Gastroenterol. 2014;9(3):160–3.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Activated platelets have inflammatory functions in several physiological and pathological conditions.

    “Activated platelets have inflammatory functions in several physiological and pathological conditions”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [13] Salamanna F, Maglio M, Landini MP, Fini M. Platelet functions and activities as potential hematologic parameters related to Coronavirus Disease 2019 (Covid-19). Platelets. 2020;31(5):627–32. source

      Not checked in the free run.

    • cites [14] Bakogiannis C, Sachse M, Stamatelopoulos K, Stellos K. Platelet-derived chemokines in inflammation and atherosclerosis. Cytokine. 2019;122:154–7. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Analysis of covariance (ANCOVA) was applied to assess differences in platelet parameters among different groups after adjusting for age and sex.

    “To exclude the confounding influence of age and sex, analysis of covariance (ANCOVA) was applied to assess the differences in platelet parameters among different groups.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    RPR is increasingly studied as a marker of chronic inflammation in physical illness and mental illness.

    “the RDW to platelet ratio (RPR) is increasingly studied as a marker of chronic inflammation in physical illness and mental illness [32, 33].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [32] Arora S, Patro S, Nath P, Arora S. Red cell distribution width(RDW) to platelet ratio (RPR): A novel marker in early prediction of severity of Acute Pancreatitis. J Assoc Physicians India. 2020;68(1):88–98.

      Not checked in the free run.

    • cites [33] Bahrami A, Khorasanchi Z, Sadeghnia HR, Tayefi M, Avan A, Ferns GA, Bahrami-Taghanaki H, Ghayour-Mobarhan M. Depression in adolescent girls: Relationship to serum vitamins a and E, immune response to heat shock protein 27 and systemic inflammation. J Affect Disord. 2019;252:68–73. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    PDW is a marker of inflammation in diabetic nephropathy, irritable bowel disease, and coronary heart disease.

    “PDW has been introduced as a marker of inflammation in diabetic nephropathy [18], irritable bowel disease [19], and coronary heart disease [20].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [18] Atak BM, Duman TT, Aktas G, Kocak MZ, Savli H. Platelet distribution width is associated with type 2 diabetes mellitus and diabetic nephropathy and neuropathy. National Journal of Health Sciences. 2018;3(3):95–8. source

      Not checked in the free run.

    • cites [19] Aktas G, Duman T, Atak B, Kurtkulagi O, Bilgin S, Basaran E, Demirkol M, Kosekli M. Irritable bowel syndrome is associated with novel inflammatory markers derived from hemogram parameters. Family Medicine & Primary Care Review. 2020;22(2):107–10. source

      Not checked in the free run.

    • cites [20] Sincer I, Mansiroglu AK, Erdal E, Cosgun M, Aktas G, Gunes Y. Could platelet distribution width predict coronary collateral development in stable coronary artery disease? North Clin Istanb. 2020;7(2):112–7.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    A post hoc analysis using the Bonferroni correction was utilized to correct for multiple comparisons.

    “A post hoc analysis that used the Bonferroni correction analysis to correct for multiple comparisons was utilized to identify the differences between groups.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    PAR was originally studied in cancer and is considered a clinical indicator of inflammatory status.

    “The platelet to albumin ratio (PAR) was originally studied in cancer and is considered as a clinical indicator of inflammatory status [36].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] Guo M, Sun T, Zhao Z, Ming L. Preoperative Platelet to Albumin Ratio Predicts Outcome of Patients with Non-Small-Cell Lung Cancer. Ann Thorac Cardiovasc Surg. 2021;27(2):84–90. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Blood sample measurements were performed by laboratory technicians who were blinded to the diagnosis of diseases.

    “Blood sample measurements were performed in the laboratory of the Beijing HuiLongGuan Hospital or Jining Psychiatric Hospital by laboratory technicians who were blinded to the diagnosis of diseases.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Abnormalities of the 5-HT receptor in platelets may suggest deficiency of the 5-HT receptor in the central nervous system.

    “Previous studies have found that the abnormalities of the 5-HT receptor in platelets may suggest deficiency of the 5-HT receptor in the central nervous system [10, 11].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [10] Goubau C, Buyse GM, Di Michele M, Van Geet C, Freson K. Regulated granule trafficking in platelets and neurons: a common molecular machinery. Eur J Paediatr Neurol. 2013;17(2):117–25. source

      Not checked in the free run.

    • cites [11] Izzi B, Tirozzi A, Cerletti C, Donati MB, de Gaetano G, Hoylaerts MF, Iacoviello L, Gialluisi A. Beyond haemostasis and thrombosis: platelets in depression and its co-morbidities. INT J MOL SCI. 2020;21(22):1–10. source

      Not checked in the free run.

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  • The authors state this as an assumption.

    Most patients included in the study were in the acute phase of the disease.

    “we assumed that most of the patients included in our study were in the acute phase of the disease.”

  • The paper relies on this without support.

    Platelet parameters derived from the complete blood count are simple, readily available, low-cost and reproducible biomarkers of inflammation.

    “These platelet parameters derived from the CBC are simple, readily available, low-cost and reproducible biomarkers of inflammation.”

  • The paper relies on this without support.

    The clinical diagnoses of MDD and BD used in the study are accurate.

    “the retrospective design of the study did not allow us to conduct a structured psychiatric interview”

  • The paper relies on this without support.

    Treatment status does not confound the observed differences in platelet parameters between patients and controls.

    “the study did not take into account the effects of treatment, which may affect the levels of the parameters.”

  • The paper relies on this without support.

    Confounding factors such as smoking, diet, and body mass index do not explain the observed differences in platelet parameters.

    “some confounding factors may influence the levels of platelet parameters, and we were not able to control for some factors in the present study, such as smoking, diet, and body mass index.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Nonsignificant differences assigned a significant P threshold

    Minor

    The results call the PLR, SII and PAR differences nonsignificant while stating P < 0.05, which the paper defines as statistically significant. Table 1 reports P values above 0.05 for all three.

  • Conflicting female counts for BD depressive episodes

    Minor

    The text gives 823 females in the BD depressive episodes group, whereas Table 4 gives 828.

  • MDD sex predictor does not meet the stated P threshold

    Minor

    The text assigns P < 0.001 to all five MDD regression indicators, but Table 7 reports P = 0.008 for sex. Sex remains significant under the paper's 0.05 threshold.

3 of 3

Cites

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Cited by

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Related

Authors
Wei, Y., Feng, J., Ma, J., Chen, D., Xu, H., Yin, L., & Chen, J.
Affiliations
  • Peking University (CN)
  • Beijing Tongren Hospital (CN)
Corresponding author
Chen, Jingxu
ORCID
Venue
BMC Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2022-02-25
Volume
22
Issue
1
Pages
150-150
ISSN
1471-244X (ISSN-L)
DOI
10.1186/s12888-022-03775-9
PMC
PMC8874305
OpenAlex
W4214744136
Semantic Scholar
586fd3fa346454dbadefc2d6cc998a64a6cb9bea
Cited by
48
References
61
Citations by year
2026: 7 · 2025: 11 · 2024: 15 · 2023: 11 · 2022: 4
FWCI
4.29
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Greater South Information System
Funders
  • LongYue Project of Beijing Huilongguan Hospital (LY202101)
  • Beijing Municipal Hospital Scientific Research and Cultivation Program ((PX2022079))
  • Capital Foundation of Medicine Research and Development (2018-3-2132)
Topics
  • Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords
platelet indices, mood disorders, major depressive disorder, bipolar disorder, systemic inflammation, mean platelet volume, platelet distribution width, plateletcrit, systemic immune-inflammation index, platelet-to-lymphocyte ratio, platelet-to-albumin ratio, red cell distribution width, inflammatory markers, manic episodes, depressive episodes, Chinese patients
MeSH terms
Mania, Albumins, China, Cross-Sectional Studies, Depressive Disorder, Major, Major Depressive Disorder, Humans, Inflammation, Retrospective Studies, Mood Disorders

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

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