Background and purpose: Neuropeptide Y (NPY) has been reported to be involved in the pathophysiology of several cardiovascular disease processes and might contribute to the incidence of stroke, but the prognostic utility of circulating NPY after acute ischaemic stroke is unclear. This study aimed to prospectively examine the association between plasma NPY levels and adverse clinical outcomes after acute ischaemic stroke.Methods: Plasma NPY levels were measured in 3250 patients (2066 men and 1184 women) from the China Antihypertensive Trial in Acute Ischaemic Stroke. The primary outcome was the combination of death and major disability (modified Rankin Scale score ≥3) at 12 months after stroke onset, and secondary outcomes included major disability, death and cardiovascular events.Results: During the 12‐month follow‐up, 702 participants (21.6%) experienced major disability or died. After multivariable adjustment, odds ratio (95% confidence interval) for the highest quartile of NPY was 1.56 (1.19–2.04) for the primary outcome, compared to the lowest quartile. Each standard deviation (0.27 ng/mL) higher log‐transformed NPY was associated with an odds ratio (95% confidence interval) of 1.18 (1.07–1.30) for the primary outcome, 1.28 (1.15–1.42) for major disability. The addition of NPY to a conventional risk factors model improved risk prediction of the composite outcome of death and major disability (category‐free net reclassification index 8.82%, p = 0.040; integrated discrimination improvement 0.38%, p = 0.011).Conclusions: Elevated plasma NPY levels in the acute phase of ischaemic stroke were associated with increased risk of poor clinical outcomes after ischaemic stroke, suggesting that plasma NPY may be a potential prognostic biomarker for ischaemic stroke.

Background: Depression and anxiety are significant global health concerns, with systemic inflammation playing a critical role in their pathophysiology. Recent studies have highlighted the C-reactive protein to lymphocyte ratio (CLR) as a potential biomarker of inflammation that may be associated with these mental health conditions. However, the relationship between CLR and depression and anxiety, especially within a diverse population, remains underexplored.Methods: This study utilized data from the National Health and Nutrition Examination Survey (NHANES) (2015–2023) to examine the association between CLR and the prevalence of depression and anxiety. A total of 22,308 participants were included for depression analysis, and 16,138 participants were included for anxiety analysis. Depression was assessed using the PHQ-9, and anxiety was assessed through self-reported anxiety symptoms and medication use. CLR was calculated as the ratio of C-reactive protein to lymphocyte count, and logistic regression models were applied to analyze associations, adjusting for demographic and health-related variables.Results: Higher CLR levels were significantly associated with increased odds of depression (OR: 1.49; 95% CI: 1.25–1.78) and anxiety (OR: 1.13; 95% CI: 1.02–1.26) after full adjustment for confounders. Non-linear relationships were observed, with specific inflection points for both depression (CLR = 0.96) and anxiety (CLR = 0.88), beyond which the risk of mental health disorders increased sharply. Subgroup analyses revealed that younger individuals and those without hypertension showed stronger associations between CLR and depression.Conclusion: Elevated CLR is associated with an increased risk of depression and anxiety, suggesting the potential role of systemic inflammation in influencing mental health outcomes. CLR may serve as a useful biomarker for identifying populations at higher risk, underscoring the need for further research into early intervention strategies and targeted approaches to address systemic inflammation in mental health care.

Background: Soluble triggering receptor expressed on myeloid cells 2 (sTREM2) was reported to induce inflammatory responses, enhance microglial survival, and contribute to the development of neurodegenerative disorders. We aimed to prospectively investigate the association between plasma sTREM2 levels and poststroke depression (PSD). Methods: We measured plasma sTREM2 levels in 590 patients with ischemic stroke from 7 participating hospitals of the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke) trial. The 24‐item Hamilton Rating Scale for Depression was used to assess depression at 3 months after ischemic stroke onset, and PSD was defined as a score of ≥8. The predictive performance of sTREM2 was evaluated by calculating the net reclassification index and integrated discrimination improvement. Random forest regression model was used to assess the importance of sTREM2, clinical variables, and other potential biomarkers. Results: Of the 590 participants, 229 (38.8%) patients experienced PSD. The multivariable‐adjusted odds ratio for the highest quartile of sTREM2 compared with the lowest quartile was 1.98 (95% CI, 1.16–3.37) for PSD. Multiple adjusted spline regression analysis confirmed the linear dose–response relationship between sTREM2 levels and PSD ( P for linearity=0.037). The addition of sTREM2 to the conventional risk factors model improved risk reclassification for PSD, as shown by a category‐free net reclassification index of 19.3% ( P =0.03) and integrated discrimination improvement of 1.1% ( P =0.01). Furthermore, a random forest regression model suggested that sTREM2 was among the top 5 important indicators for PSD prediction. Conclusions: The present study demonstrated that elevated plasma sTREM2 levels were associated with an increased risk of PSD, suggesting that sTREM2 may be a promising prognostic biomarker for PSD. Registration: URL: https://clinicaltrials.gov ; Unique identifier: NCT01840072