Association of serum HMGB1 and TLR4 levels with early-onset post-stroke depression in type 2 diabetes: a prospective cohort study

To explore the relationship between HMGB1 and TLR4 in early-onset post-stroke depression (PSD) among patients with type 2 diabetes mellitus (T2DM). A cohort of 100 patients diagnosed with T2DM and AIS, admitted to the First Affiliated Hospital of Henan Medical University from January to August 2024, was selected for this study. Based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, as well as scores from the Hamilton Depression Rating Scale-17 (HAMD-17), participants were categorized into either a non-PSD group or a PSD group. Logistic regression analysis was utilized to identify risk factors associated with early-onset PSD, while Receiver Operating Characteristic (ROC) curve analysis assessed the diagnostic performance of HMGB1 and TLR4 in predicting PSD among T2DM patients. Univariate analysis revealed statistically significant differences in fasting blood glucose levels, serum TLR4 concentrations, and serum HMGB1 levels between both groups (p < 0.05). Logistic regression indicated that both TLR4 and HMGB1 serve as independent and significant risk factors for early-onset PSD in individuals with T2DM. The results from ROC curve analysis demonstrated that the area under the curve (AUC) values for HMGB1, TLR4, and their combined predictive capacity regarding early-onset PSD were 0.786 (95% CI: 0.676-0.897), 0.893 (95% CI: 0.802-0.984), and 0.902 (95% CI: 0.816-0.989). Elevated serum levels of TLR4 and HMGB1 may be correlated with early-onset PSD in patients suffering from T2DM.