School of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy.
School of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy.
Psychoneuroendocrinology. 2024 Oct;168:107134. doi: 10.1016/j.psyneuen.2024.107134. Epub 2024 Jul 25.
Schizophrenia spectrum disorders (SSDs) are associated with immune-inflammatory activation. Recently, complete blood count (CBC)-based inflammation indexes such as the neutrophil-to-lymphocyte ratio (NLR), the monocyte-to-lymphocyte ratio (MLR), and the platelet-to-lymphocyte ratio (PLR) have emerged as reproducible and cost-effective inflammation markers in mental disorders. In this study, we aimed at investigating the relationship of NLR, MLR, and PLR with symptom severity in people with SSDs, testing interactions with relevant clinical variables.
We included inpatients with SSDs aged 18-65 consecutively hospitalized from May 2020 to March 2024. Socio-demographic and clinical data were recorded. CBC-based ratios were estimated from routinely collected blood samples. Structural equation modelling (SEM) was performed to test relationships involving symptom severity constructs and CBC-based ratios, accounting for substance use disorder, antipsychotic treatment, and obesity.
Two hundred sixty-six participants met inclusion criteria. The SEM analysis uncovered a significant relationship of MLR with positive (coeff.: 0.19, p=0.048) and negative (coeff.: 0.27, p=0.004) symptoms, also showing a significant link of substance use disorder and antipsychotic treatment with symptom severity as well as of antipsychotic treatment with obesity.
Notwithstanding the cross-sectional design and the somewhat limited sample representativeness, this study showed a significant relationship between the MLR - but not the NLR or the PLR - and the severity of both positive and negative symptoms, testing at the same time the interactions with other clinical variables. Considering the insufficiency and inconsistency of data in this field, further research is needed to validate our findings and elucidate the underlying mechanisms driving the observed relationships between the MLR and SSD symptoms.
精神分裂症谱系障碍（SSDs）与免疫炎症激活有关。最近，基于全血细胞计数（CBC）的炎症指标，如中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）和血小板与淋巴细胞比值（PLR），已成为精神障碍中具有可重复性和成本效益的炎症标志物。在这项研究中，我们旨在研究 NLR、MLR 和 PLR 与 SSD 患者症状严重程度的关系，检验与相关临床变量的相互作用。
我们连续纳入了 2020 年 5 月至 2024 年 3 月期间住院的年龄在 18-65 岁的 SSD 住院患者。记录了社会人口统计学和临床数据。从常规采集的血液样本中估计基于 CBC 的比值。结构方程模型（SEM）用于测试涉及症状严重程度结构和基于 CBC 的比值的关系，同时考虑物质使用障碍、抗精神病药物治疗和肥胖。
266 名符合纳入标准的参与者。SEM 分析显示 MLR 与阳性（系数：0.19，p=0.048）和阴性（系数：0.27，p=0.004）症状显著相关，同时也显示物质使用障碍和抗精神病药物治疗与症状严重程度以及抗精神病药物治疗与肥胖之间存在显著关联。
尽管存在横断面设计和样本代表性有限的问题，但本研究显示 MLR 与阳性和阴性症状严重程度之间存在显著关系，同时检验了与其他临床变量的相互作用。考虑到该领域数据的不足和不一致性，需要进一步研究来验证我们的发现，并阐明驱动 MLR 与 SSD 症状之间观察到的关系的潜在机制。
