Liu Zhihua, Lv Dali, Li Jianfeng, Li Fuwei, Zhang Yanhua, Liu Yongjie, Gao Chao, Qiu Yafeng, Ma Jun, Zhang Ruiling
Department of Psychiatry, The Fourth People's Hospital of Nanyang, Nanyang, Henan, China.
Department of Psychiatry, The Fifth People's Hospital of Luoyang, Luoyang, Henan, China.
Front Psychiatry. 2024 Sep 3;15:1431350. doi: 10.3389/fpsyt.2024.1431350. eCollection 2024.
Inflammation is associated with the pathophysiology of schizophrenia. The blood markers for systemic inflammation include neutrophil-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), lymphocyte-monocyte ratio (LMR), system inflammation response index (SIRI), and platelet-lymphocyte ratio (PLR). However, these inflammation markers and their relationships with clinical phenotypes among Han Chinese patients with first-episode adolescent-onset schizophrenia (AOS) is unclear. This investigation aimed to elucidate the impact of inflammation on Han Chinese AOS patients as well as the association of blood-based inflammation markers with clinical symptoms.
Altogether, 203 Han Chinese individuals participated in this study, 102 first-episode AOS patients and 101 healthy controls. The assessment of inflammatory indices was based on complete blood cell count. Furthermore, schizophrenia-related clinical symptoms were evaluated using the five-factor model of the Positive and Negative Syndrome Scale (PANSS).
In Han Chinese first-episode AOS patients, levels of SIRI, PLR, SII, and NLR were significantly increased (), while LMR decreased () compared to healthy controls. Furthermore, multivariate logistic regression showed that LMR, NLR, SII, and SIRI (all p < 0.05) were independently associated with AOS. Moreover, Receiver operating characteristics assessment indicated that NLR, SIRI, LMR, and SII could effectively distinguish AOS patients from healthy controls. Their areas under the curves were 0.734, 0.701, 0.715, and 0.730 (all ). In addition, Correlation analysis revealed that LMR was negatively correlated with the PANSS total, negative, and cognitive factor scores (all ); NLR was positively correlated with the cognitive factor score (); SII was negatively correlated with the positive factor score and positively with the negative and cognitive factor scores (all ); SIRI was positively correlated with the PANSS total and cognitive factor scores (all ).
This research established the involvement of peripheral blood inflammatory markers (LMR, NLR, SII, and SIRI) with the clinical manifestations and pathophysiology of schizophrenia, and these can serve as screening tools or potential indices of the inflammatory state and AOS symptoms severity.
炎症与精神分裂症的病理生理学相关。全身炎症的血液标志物包括中性粒细胞与淋巴细胞比值（NLR）、全身免疫炎症指数（SII）、淋巴细胞与单核细胞比值（LMR）、全身炎症反应指数（SIRI）和血小板与淋巴细胞比值（PLR）。然而，这些炎症标志物及其与汉族首发青少年期精神分裂症（AOS）患者临床表型的关系尚不清楚。本研究旨在阐明炎症对汉族AOS患者的影响以及基于血液的炎症标志物与临床症状的关联。
共有203名汉族个体参与本研究，其中102例首发AOS患者和101例健康对照。炎症指标的评估基于全血细胞计数。此外，使用阳性和阴性症状量表（PANSS）的五因素模型评估精神分裂症相关的临床症状。
与健康对照相比，汉族首发AOS患者的SIRI、PLR、SII和NLR水平显著升高（），而LMR降低（）。此外，多因素逻辑回归显示LMR、NLR、SII和SIRI（均p<0.05）与AOS独立相关。此外，受试者工作特征评估表明NLR、SIRI、LMR和SII能够有效区分AOS患者和健康对照。它们的曲线下面积分别为0.734、0.701、0.715和0.730（均）。此外，相关性分析显示LMR与PANSS总分、阴性和认知因子得分均呈负相关（均）；NLR与认知因子得分呈正相关（）；SII与阳性因子得分呈负相关，与阴性和认知因子得分呈正相关（均）；SIRI与PANSS总分和认知因子得分呈正相关（均）。
本研究证实外周血炎症标志物（LMR、NLR、SII和SIRI）与精神分裂症的临床表现和病理生理学有关，这些标志物可作为炎症状态和AOS症状严重程度的筛查工具或潜在指标。
