Investigation of systemic immune-inflammation index, neutrophil/high-density lipoprotein ratio, lymphocyte/high-density lipoprotein ratio, and monocyte/high-density lipoprotein ratio as indicators of inflammation in patients with schizophrenia and bipolar disorder

Abstract

BackgroundThe systemic immune-inflammation index (SII), system inflammation response index (SIRI), neutrophil/high-density lipoprotein (HDL) ratio (NHR), lymphocyte/HDL ratio (LHR), monocyte/HDL ratio (MHR), and platelet/HDL ratio (PHR) have been recently investigated as new markers for inflammation. The purpose of this research is to use large-scale clinical data to discuss and compare the predictive ability of the SII, SIRI, NHR, LHR, MHR, and PHR in patients with schizophrenia (SCZ) and bipolar disorder (BD), to investigate potential biomarkers.Materials and methodsIn this retrospective, naturalistic, cross-sectional study, we collected the hematological parameter data of 13,329 patients with SCZ, 4,061 patients with BD manic episodes (BD-M), and 1,944 patients with BD depressive episodes (BD-D), and 5,810 healthy subjects served as the healthy control (HC) group. The differences in the SII, SIRI, NHR, LHR, MHR, and PHR were analyzed, and a receiver operating characteristic (ROC) curve was used to analyze the diagnostic potential of these parameters.ResultsCompared with the HC group, the values of the SII, SIRI, NHR, LHR, MHR, and PHR and the levels of neutrophils, monocytes, and triglycerides (TG) were higher in SCZ and BD groups, and levels of platelets, cholesterol (CHO), HDL, low-density lipoprotein (LDL), and apoprotein B (Apo B) were lower in SCZ and BD groups. Compared to the BD group, the values of the SIRI, lymphocytes, monocytes, and HDL were lower and the values of the SII, NHR, PHR, and platelet were higher in the SCZ group. In contrast to the BD-D group, the values of the SII; SIRI; NHR; and MHR; and levels of neutrophils, monocytes, and platelets were higher in the BD-M group, and the levels of CHO, TG, LDL, and Apo B were lower in the BD-M group. The MHR and NHR were predictors for differentiating the SCZ group from the HC group; the SIRI, NHR, and MHR were predictors for differentiating the BD-M group from the HC group; and the MHR was a predictor for differentiating the BD-D group from the HC group. The combination model of the indicators improved diagnostic effectiveness.ConclusionOur study highlights the role of systemic inflammation in the pathophysiology of SCZ, BD-M, and BD-D, the association between inflammation and lipid metabolism, and these inflammation and lipid metabolism indicators showed different variation patterns in SCZ, BD-D, and BD-M.

Predictive role of blood-based indicators in neuromyelitis optica spectrum disorders

“…This means that NMOSD patients with high MLR should prolong first-line therapy or receive second-line therapy earlier to prevent recurrence. Wang et al (2022) found that MLR was associated with the prognosis of acute ischemic stroke and speculated that MLR might be related to the level of inflammation. However, our results did not find significant changes in MLR levels in patients with NMOSD, suggesting abnormalities in the function, but not the number, of monocytes and lymphocytes in active NMOSD.…”

“…NLR, PLR and MLR were found to be associated with disease activity in polymyalgia rheumatica ( Jung et al, 2019 ). SII and SIRI were also significantly higher in patients with schizophrenia and bipolar disorder than in normal people ( Wei et al, 2022 ). During the COVID-19 epidemic, NLR, PLR, MLR, SII and SIRI all effectively predicted death ( Ghobadi et al, 2022 ).…”

The Predictive Value of Monocyte/High-Density Lipoprotein Ratio (MHR) and Positive Symptom Scores for Aggression in Patients with Schizophrenia

“…In 2021, Sahpolat et al first found significant differences in the MHR between patients with schizophrenia and healthy populations in a small sample study [ 37 ]. In 2022, Yanyan Wei et al recruited 13,329 patients with schizophrenia, 6005 patients with bipolar disorder and 5810 healthy people for a study, and subsequently found that the MHR could be used as a distinguishing factor between healthy people and SCZ patients [ 38 ]. Although it is true that there are relatively few inflammatory markers of this class in research on psychiatric disorders—which is in the exploratory phase—there are studies demonstrating the relationship of this class of indicators to psychiatric diseases.…”

The association between lymphocyte to high‐density lipoprotein ratio and depression: Data from NHANES 2015–2018

“…Moreover, lower serum HDL-C levels were associated with higher odds of having depression, and the immune/inflammatory response may contribute to lower serum HDL-C in depressive populations (Maes et al, 1997). Furthermore, the LHR was significantly associated with psychiatric diseases according to a previous study (Wei et al, 2022). Second, inflammatory and oxidative stress might be another reason contributing to the relationship between LHR and depression.…”