Wenyuan Liu ¹ Hongyu Zheng ² Xiaofei Wen ² Longxing Liu ¹ Yue Yang ¹ Hui Zhong ^1*

• ¹ Anhui Medical University, Hefei, China
• ² Anhui Mental Health Center, Hefei, Anhui Province, China

Background: Depression and suicidal behavior are associated with proinflammatory status in adults. However, differences in inflammatory levels among adolescents with depression at different suicide risk levels are unclear, and the connection between anti-inflammatory factors, which serve as vital for the immune system, and suicide needs to be explored.This study recruited 111 adolescent patients with depression aged 13-18 and 23 healthy controls. Patients were divided into three subgroups according to suicidal ideation within the past week and history of suicide attempts. Severity of depression, suicidal ideation, and suicide risk were assessed using the Hamilton Depression Scale-17 (HAMD-17) and the Chinese version of the Beck Suicide Ideation Scale (BSI-CV). Plasma levels of IL-6, TNF-α, IFN-γ, IL-1β, and IL-10 in all participants were measured.Results: Plasma levels of IL-6, TNF-α, IFN-γ, and IL-10 differed between the suicide risk subgroups, and the differences remained significant after controlling for severity of depressive symptoms using covariance analysis. Pairwise comparison indicated that plasma levels of these four cytokines in the high suicide risk group were higher than those in the low suicide risk group (all p<0.05), among which the level of IL-10 was significantly higher than that in the medium and low risk groups. IL-10 was positively correlated with the total score of the HAMD-17, BSI-CV, and suicidal ideation; the other four cytokines were also somewhat correlated with suicidal ideation (all p<0.05). IL-10 correlated positively with these four pro-inflammatory factors. Multiple linear regression analysis showed that IL-10 levels significant were associated with BSI-CV and HAMA-17 total scores. In binary logistic regression, after controlling for depressive symptoms, gender, age, BMI, and duration of illness: IL-10 level remained a risk factor for suicidal behavior (OR = 3.224, 95% CI 1.571-6.619 p = 0.001).Adolescents with different suicide risk levels differed in plasma levels of pro-inflammatory factors and the anti-inflammatory factor IL-10. These differences were independent of depressive symptoms; high IL-10 levels may be a risk factor for suicidal behavior in depressed patients. Further research is needed to explore the relationship between anti-inflammatory factors and suicide.