基于高密度脂蛋白的炎症指标和脂质比率在年轻精神分裂症患者中的临床及诊断价值

Clinical and Diagnostic Value of High-Density Lipoprotein-Based Inflammatory Indices and Lipid Ratios in Young Adults with Schizophrenia.

作者信息

Chen Liling, Zheng Cunqing, Luan Honglin, Chen Xinyuan

机构信息

Department of Clinical Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, People's Republic of China.

Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, People's Republic of China.

出版信息

J Inflamm Res. 2024 Sep 14;17:6363-6374. doi: 10.2147/JIR.S473528. eCollection 2024.

DOI:10.2147/JIR.S473528

PMID:39296645

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11410031/

Abstract

PURPOSE

This study aimed to assess High-density Lipoprotein (HDL)-based Inflammatory Indices and lipid profile changes in antipsychotic-naive first-episode schizophrenia (AN-FES) patients, chronic schizophrenia (CS) patients, and explore the clinical and predictive value of these parameters for schizophrenia.

PATIENTS AND METHODS

The study cohort included 52 AN-FES patients, 46 CS patients, and 52 healthy controls (HCs), with an average age of 24 years. Upon admission, patients underwent complete blood count and lipid profile analyses. Various ratios were calculated, including neutrophil-to-HDL (NHR), monocyte-to-HDL (MHR), lymphocyte-to-HDL (LHR), and platelet-to-HDL (PHR), as well as lipid ratios like triglycerides/HDL, non-HDL/HDL, total cholesterol/HDL, and low-density lipoprotein/HDL. For the AN-FES group, these evaluations were repeated after two months of treatment with atypical antipsychotics. Statistical analyses included correlation analysis, Receiver Operating Characteristic (ROC) curve analysis, and univariate and multivariate regression.

RESULTS

Compared to HCs, CS patients exhibited significantly higher MHR and NHR values, while AN-FES patients showed elevated levels of PHR, MHR, and NHR. No significant differences were observed in LHR or lipid ratios across the three groups. In the AN-FES cohort, MHR correlated positively with neutrophil counts, and NHR with monocyte counts. Additionally, white blood cell counts were positively associated with both MHR and NHR. Following treatment, NHR levels decreased, whereas TG/HDL ratios increased, with MHR and PHR remaining elevated. ROC analysis highlighted NHR as the most diagnostically valuable parameter (AUC = 0.799), with 86.5% specificity at an optimal cutoff of 3.534, outperforming MHR and PHR. Regression analyses recognized NHR (OR=2.225) as an independent risk factor for schizophrenia, even after adjusting for confounders.

CONCLUSION

HDL-based inflammatory indices, particularly NHR, may serve as valuable diagnostic and prognostic markers in young adults with schizophrenia, even though significant alterations in lipid ratios were not observed in this demographic.

摘要

目的

本研究旨在评估首次发作未使用抗精神病药物的精神分裂症（AN-FES）患者和慢性精神分裂症（CS）患者基于高密度脂蛋白（HDL）的炎症指标及血脂谱变化，并探讨这些参数对精神分裂症的临床及预测价值。

患者与方法

研究队列包括52例AN-FES患者、46例CS患者和52例健康对照者（HCs），平均年龄24岁。入院时，患者接受全血细胞计数和血脂谱分析。计算了各种比值，包括中性粒细胞与HDL比值（NHR）、单核细胞与HDL比值（MHR）、淋巴细胞与HDL比值（LHR）和血小板与HDL比值（PHR），以及血脂比值，如甘油三酯/HDL、非HDL/HDL、总胆固醇/HDL和低密度脂蛋白/HDL。对于AN-FES组，在使用非典型抗精神病药物治疗两个月后重复进行这些评估。统计分析包括相关性分析、受试者操作特征（ROC）曲线分析以及单因素和多因素回归分析。

结果

与HCs相比，CS患者的MHR和NHR值显著更高，而AN-FES患者的PHR、MHR和NHR水平升高。三组在LHR或血脂比值方面未观察到显著差异。在AN-FES队列中，MHR与中性粒细胞计数呈正相关，NHR与单核细胞计数呈正相关。此外，白细胞计数与MHR和NHR均呈正相关。治疗后，NHR水平下降，而TG/HDL比值升高，MHR和PHR仍升高。ROC分析突出显示NHR是最具诊断价值的参数（AUC = 0.799），在最佳截断值为3.534时特异性为86.5%，优于MHR和PHR。回归分析认为NHR（OR = 2.225）是精神分裂症的独立危险因素，即使在调整混杂因素后也是如此。