C-Reactive Protein/Albumin and Neutrophil/Albumin Ratios as Novel Inflammatory Markers in Patients with Schizophrenia

Abstract

Objective Peripheral biomarker studies in schizophrenia are insufficient to correspond to whether inflammatory markers are trait- or state-related. The main objective of this study was to compare novel biomarkers C-reactive protein/albumin ratio (CAR), neutrophil/albumin ratio (NAR), and complete blood count-derived inflammatory markers; neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), red-cell distribution width (RDW), and mean platelet volume (MPV) between patients with acutely exacerbated and remitted schizophrenia and healthy controls.Methods Anonymous data of a total of 618 patients with schizophrenia (179 in remission, 439 with acute exacerbation) and 445 psychiatrically and medically healthy subjects admitted to outpatient units were included. One-way ANOVA with Tukey’s HSD post-hoc test, Pearson’s correlation test, receiver operating characteristic analysis, and binomial logistic regression analysis were performed.Results CAR, NAR, NLR, PLR, MLR, RDW, MPV values were found higher in patients with schizophrenia than in healthy subjects. Except for NAR (p=0.007), none of the markers differed between acute exacerbation and remission. As a cut-off value of CAR, 0.388 differentiated patients with schizophrenia from controls (sensitivity 81%, specificity 81%). CAR, NAR, and MPV significantly predicted the diagnosis of schizophrenia.Conclusion CAR and NAR are reliable biomarkers of inflammation and a combination of inflammatory markers including CAR and NAR could be used to reflect the increased inflammatory status in schizophrenia, regardless of relapse or remission.

Association Between Plasma Homocysteine Levels and Cognitive Deficits in Han Chinese Patients with Schizophrenia across Age Groups

“…It is among the top 10 global causes of disability 1 . Biomarkers, such as homocysteine (Hcy), kynurenic acid, C-reactive protein, and triiodothyronine, have been shown to be potential risk factors for schizophrenia [2][3][4][5] . Hcy interacts with NMDA receptors, induces apoptosis, triggers oxidative stress, injures mitochondrial function and leads to vascular damage, which played an essantial role in the occurrence and development of schizophrenia 6 .…”

Associations of C-Reactive Protein, Free Triiodothyronine, Thyroid Stimulating Hormone and Creatinine Levels with Agitation in Patients with Schizophrenia: A Comparative Cross-Sectional Study

“…Moreover, A recent study examined C-reactive protein to albumin ratio (CAR), which is considered more sensitive in representing inflammatory status, in both clinically exacerbated and remitted schizophrenia patients. 46 Hence, a study is needed to further explore the relationship between CAR and agitation in first-episode and drug-naïve schizophrenia.…”

Pathophysiological correlates of schizophrenia and incidental cerebral periventricular leukomalacia through a patient

“…abnormalities and ventricular enlargement (11,14,15). All of the abovementioned findings suggest that the causality between PVL and schizophrenia cannot be solely attributed to a neurostructural abnormalityschizophrenia nexus, and that the shared multifactorial etiology including neuroinflammation that leads to both pathologies, should be comprehensively examined to provide a deeper appreciation of the underpinnings of the involvement of impaired neurodevelopmental processes in the schizophrenia etiopathogenesis.…”