High neutrophil-lymphocyte ratio in schizophrenia independent of infectious and metabolic parameters

Yüksel, Rabia Nazik; Ertek, İrem Ekmekçi; Dikmen, Asiye Uğraş; Göka, Erol

doi:10.1080/08039488.2018.1458899

Cited by 53 publications

(33 citation statements)

References 36 publications

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“…). In a sensitivity analysis, after removing two studies , χ 2 was not significant (χ 2 = 19.84, I 2 = 29.4%, P = 0.14), with a similar, significant effect size (SMD = 0.29, 95% CI 0.18–0.40, P < 0.01). There was no evidence of publication bias in the associated funnel plot and Egger's test ( P = 0.18) (see Fig.…”

Section: Resultsmentioning

confidence: 91%

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Meta‐analysis of total and differential white blood cell counts in schizophrenia

Jackson

Miller

2019

Acta Psychiatr Scand

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analysis of total and differential white blood cell counts in schizophrenia. Objective: Schizophrenia is associated with alterations in blood inflammatory markers, including cytokines. Total white blood cell (WBC) count is a marker of low-grade inflammation. We conducted a meta-analysis of total and differential WBC counts in patients with schizophrenia. Method: Articles were identified through a systematic search of PsycINFO, Pub Med, Web of Science, and the associated references. Data were analyzed using a random effects approach. Results: Twenty-four studies met the inclusion criteria. Blood total WBC, monocytes, and neutrophils were significantly higher in schizophrenia vs. controls with small-to-medium effect sizes (standardized mean difference [SMD] = 0.39-0.53, P < 0.01 for each). In first-episode psychosis compared with controls, neutrophils and monocytes were significantly increased with similar effect sizes (SMD = 0.40-0.41, P ≤ 0.01 for each), and there was a trend for higher total WBC (SMD = 0.46, P = 0.05). Conclusions: Consistent with studies of other inflammatory markers, we found evidence for increased total and differential WBC counts in schizophrenia. Our results complement other studies of WBC counts in schizophrenia. These findings are relevant to the pathophysiology and potentially the treatment of schizophrenia.

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Section: Resultsmentioning

confidence: 91%

“…Subsequently, 50 articles were selected for further evaluation. After review by both authors, 24 studies (27 samples) met the inclusion/exclusion criteria . Figure summarizes the study selection process.…”

Section: Methodsmentioning

confidence: 99%

Meta‐analysis of total and differential white blood cell counts in schizophrenia

Jackson

Miller

2019

Acta Psychiatr Scand

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“…The cut-off value of CAR found in our study was 0.388 with a sensitivity of 81% and a specificity of 81%, and 0.885 as a cut-off value for NAR had lower sensitivity and specificity. To date, few studies have reported cut-off levels of peripheral inflammatory biomarkers such as NLR [ 55 ], IL-6 [ 56 ], and the high sensitivity-CRP/IL-10 ratio [ 57 ]; however; insufficient power of sensitivity and/or specificity for these markers were denoted. Despite there still existing copious room for research to appreciate its diagnostic use, our finding suggests that CAR, as an inflammatory biomarker, may be used to support the diagnosis of schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

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

Balcıoğlu

Kırlıoğlu

2020

Psychiatry Investig

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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.

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“…24 Two studies investigating NLR in schizophrenia found NRL remained elevated when controlling for metabolic syndrome and lifestyle factors. 8,25 What cut-off should we use for NLR? Table 4 summarises the three studies designed to define normal NLR.…”

Section: The Effect Of Medical Comorbidities On Nlrmentioning

confidence: 99%

Neutrophil–lymphocyte ratio – a simple, accessible measure of inflammation, morbidity and prognosis in psychiatric disorders?

Zulfic

Weickert

et al. 2020

Australas Psychiatry

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Objective: A narrative review to describe the utility of the neutrophil-lymphocyte ratio (NLR) as an inflammatory marker in psychiatric and non-psychiatric disorders and to discuss the potential role of NLR in psychiatric research. Conclusions: NLR is inexpensive and readily available using division of two measures obtained on routine blood testing. NLR is elevated in a number of psychiatric disorders. It can predict morbidity and mortality in a wide range of non-psychiatric conditions, but this has not been confirmed in psychiatric conditions. It can be calculated in large, pre-existing datasets to investigate clinical correlates of inflammatory processes. NLR may have a future role in identifying patients with an inflammatory phenotype who could benefit from adjunctive anti-inflammatory medications.

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High neutrophil-lymphocyte ratio in schizophrenia independent of infectious and metabolic parameters

Abstract: NLR levels are high in schizophrenia independent of metabolic parameters according to the results. So, it can be considered that inflammatory processes may play a role in the etiology of the disease.

Cited by 53 publications

References 36 publications

Meta‐analysis of total and differential white blood cell counts in schizophrenia

Meta‐analysis of total and differential white blood cell counts in schizophrenia

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

Neutrophil–lymphocyte ratio – a simple, accessible measure of inflammation, morbidity and prognosis in psychiatric disorders?

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