Meta‐analysis of peripheral mean platelet volume in patients with mental disorders: Comparisons in depression, anxiety, bipolar disorder, and schizophrenia

Chen, Zhichao; Wang, Jing; Carru, Ciriaco; Sedda, Stefania; Nivoli, Alessandra Matilde; Li, Zhi

doi:10.1002/brb3.3240

Cited by 6 publications

(2 citation statements)

References 84 publications

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“…In a recent study, mean platelet component levels, serving as an indirect measure of platelet activation, demonstrated a significant reduction following administration of atypical antipsychotics, indicative of increased platelet aggregation. 9 However, this study included only 16 patients and did not General Psychiatry 20 and can be used as a surrogate biomarker of platelet activity because of the greater activity of larger platelets, exhibited significantly higher MPV levels in patients taking atypical antipsychotic drugs compared with those in drug-naïve patients. 10 Conversely, Lee et al found no significant MPV changes in 100 patients with schizophrenia receiving clozapine for 1 year.…”

Section: Main Findingsmentioning

confidence: 99%

New role of platelets in schizophrenia: predicting drug response

Zhang,

Zheng,

et al. 2024

Gen Psych

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BackgroundElevated platelet count (PLTc) is associated with first-episode schizophrenia and adverse outcomes in individuals with precursory psychosis. However, the impact of antipsychotic medications on PLTc and its association with symptom improvement remain unclear.AimsWe aimed to investigate changes in PLTc levels following antipsychotic treatment and assess whether PLTc can predict antipsychotic responses and metabolic changes after accounting for other related variables.MethodsA total of 2985 patients with schizophrenia were randomised into seven groups. Each group received one of seven antipsychotic treatments and was assessed at 2, 4 and 6 weeks. Clinical symptoms were evaluated using the positive and negative syndrome scale (PANSS). Additionally, we measured blood cell counts and metabolic parameters, such as blood lipids. Repeated measures analysis of variance was used to examine the effect of antipsychotics on PLTc changes, while structural equation modelling was used to assess the predictive value of PLTc on PANSS changes.ResultsPLTc significantly increased in patients treated with aripiprazole (F=6.00, p=0.003), ziprasidone (F=7.10, p<0.001) and haloperidol (F=3.59, p=0.029). It exhibited a positive association with white blood cell count and metabolic indicators. Higher baseline PLTc was observed in non-responders, particularly in those defined by the PANSS-negative subscale. In the structural equation model, PLTc, white blood cell count and a latent metabolic variable predicted the rate of change in the PANSS-negative subscale scores. Moreover, higher baseline PLTc was observed in individuals with less metabolic change, although this association was no longer significant after accounting for baseline metabolic values.ConclusionsPlatelet parameters, specifically PLTc, are influenced by antipsychotic treatment and could potentially elevate the risk of venous thromboembolism in patients with schizophrenia. Elevated PLTc levels and associated factors may impede symptom improvement by promoting inflammation. Given PLTc’s easy measurement and clinical relevance, it warrants increased attention from psychiatrists.Trial registration numberChiCTR-TRC-10000934.

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Section: Main Findingsmentioning

confidence: 99%

New role of platelets in schizophrenia: predicting drug response

Zhang,

Zheng,

et al. 2024

Gen Psych

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“…Additionally, MPV has gained interest as a biomarker in other systemic inflammatory or chronic disorders [3]. For example, disrupted MPV values have been linked to mental disorders [4], cardiovascular disease [5] and cancer [6].…”

Section: Introductionmentioning

confidence: 99%

Mean Platelet Volume Is Related to Cumulative Disease Damage in Patients with Systemic Lupus Erythematosus

Fernández-Cladera,

Hernández-Díaz,

García-González

et al. 2024

Life

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Mean platelet volume (MPV), which represents the average platelet size in femtoliters, has emerged as a reliable biomarker in several systemic and chronic disorders. However, its relationship with disease characteristics in large series of patients with systemic lupus erythematosus (SLE) has not been exhaustively studied to date. In the present work, we aimed to analyze how disease characteristics, including disease activity and cumulative damage, relate to MPV in a well-characterized series of SLE patients. In total, 179 patients with SLE and 181 age- and sex-matched healthy controls were recruited. Complete blood counts including MPV were assessed. Linear multivariable analysis was performed to evaluate the relationship between MPV and SLE disease characteristics, including composite scores of disease activity and damage. MPV was significantly lower in patients with SLE compared to controls after multivariable analysis (beta coefficient, −0.7 [95% confidence interval, −1.1 to −0.3)] fL, p < 0.001). Although the SLEDAI disease activity index was not related to MPV, the SLICC score measuring cumulative disease damage was significantly associated with lower MPV values after adjustment for covariates. Elements of the SLICC score that were associated with lower MPV levels were those pertaining to the kidney, peripheral vascular, and musculoskeletal manifestations of the disease. In conclusion, MPV is lower in patients with SLE compared to matched controls. This MPV downregulation is primarily due to the renal, peripheral vascular and musculoskeletal manifestations of the disease. MPV may represent a biomarker of accrual disease damage in SLE.

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Stress-Induced Hypercoagulability: Insights from Epidemiological and Mechanistic Studies, and Clinical Integration

von Känel

2024

Semin Thromb Hemost

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By integrating findings from comprehensive reviews, meta-analyses, and cutting-edge genetic studies, this article illuminates the significance of stress-induced hypercoagulability in clinical medicine. In particular, the findings from numerous prospective cohort studies indicate that stress and hemostatic factors of a hypercoagulable state are associated with increased incident risk and poor prognosis for atherosclerotic cardiovascular disease and venous thromboembolism. Mendelian randomization studies suggest that these associations are partially causal. The review synthesizes extensive research on the link between acute and chronic stress and hypercoagulability, outlining a potential pathway from stress to thrombosis risk. Consistent with the allostatic load concept, acute stress-induced hypercoagulability, initially adaptive, can turn maladaptive under chronic stress or excessive acute stress, leading to arterial or venous thrombotic events. Individuals with predisposing factors, including atherosclerosis, thrombophilia, or immobilization, may exhibit an increased risk of thrombotic disease during stress. Contextual sociodemographic characteristics, the stress experience, and coping resources additionally modulate the extent of stress-induced hypercoagulability. Research into the neuroendocrine, cellular, and molecular bases reveals how stress influences platelet activation coagulation and fibrinolysis. The activation of the sympathetic nervous system and the hypothalamic–pituitary–adrenal axis, along with vagal withdrawal, and the effects of catecholamines, cortisol, and vasopressin, are the central mechanisms involved. Hemoconcentration, inflammation, endothelial dysfunction, and thrombopoiesis additionally contribute to stress-induced hypercoagulability. Further research is needed to prove a causal link between chronic stress and hypercoagulability. This includes exploring its implications for the prevention and management of thrombotic diseases in stressed individuals, with a focus on developing effective psychosocial and pharmacological interventions.

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Meta‐analysis of peripheral mean platelet volume in patients with mental disorders: Comparisons in depression, anxiety, bipolar disorder, and schizophrenia

Cited by 6 publications

References 84 publications

New role of platelets in schizophrenia: predicting drug response

New role of platelets in schizophrenia: predicting drug response

Mean Platelet Volume Is Related to Cumulative Disease Damage in Patients with Systemic Lupus Erythematosus

Stress-Induced Hypercoagulability: Insights from Epidemiological and Mechanistic Studies, and Clinical Integration

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