Neutrophil-Lymphocyte Ratio, Monocyte-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Manic Episode Patients with Bipolar Disorder


Abstract views: 451 / PDF downloads: 231

Authors

DOI:

https://doi.org/10.58600/eurjther.20232902-1574.y

Keywords:

bipolar disorder, Inflammatory Marker, neutrophil-to-lymphocyte ratio, monocyte, platelets-to-lymphocytes ratio

Abstract

Objective: Inflammation is one of several etiopathological mechanisms contributing to bipolar disorder. Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) are relatively cheap hematological parameters recommended to measure the level of inflammation. In this study, the NLR, MLR, and PLR values of the same patients during manic and euthymic periods were compared to a healthy control group.

Methods: This retrospective study was conducted on inpatients with bipolar disorder manic episodes at the University Faculty of Medicine psychiatry clinic. Ninety-nine patients with manic episodes of bipolar disorder and age and gender-matched 101 volunteers without prior psychiatric illness were included in the study. Neutrophil, lymphocyte, monocyte, and platelet counts during the disease period were recorded, and NLR, MLR, and PLR values were calculated from these values. Similar hematological parameters of the same patients in the euthymic period after discharge were compared.

Results: Patients with manic episodes were shown to have significantly higher neutrophil, platelet, NLR, MLR, and PLR levels than the control group (p<0.001). Monocyte count was significantly lower in manic episode patients compared to controls (p<0.001). Neutrophil and monocyte counts were significantly lower during the euthymic period compared to the control group, while NLR, MLR, and PLR levels were higher (p<0.001).

Conclusions: The fact that NLR, MLR, and PLR are higher in BD patients compared to the healthy control group in both manic and euthymic periods indicates that they can be used as trait biomarkers.

Metrics

Metrics Loading ...

References

Kessing LV, González-Pinto A, Fagiolini A, et al. (2021)DSM-5 and ICD-11 criteria for bipolar disorder: Implications for the prevalence of bipolar disorder and validity of the diagnosis -A narrative review from the ECNP bipolar disorders network. Eur Neuropsychopharmacol. 47:54-61. https://doi.org/10.1016/j.euroneuro.2021.01.097

Miller JN, Black DW (2020) Bipolar Disorder and Suicide: a Review. Curr Psychiatry Rep. 22(2):6. https://doi.org/10.1007/s11920-020-1130-0

Fountoulakis KN, Yatham LN, Grunze H, et al. (2020) The CINP Guidelines on the Definition and Evidence-Based Interventions for Treatment-Resistant Bipolar Disorder. Int J Neuropsychopharmacol. 23(4):230-256. https://doi.org/10.1093/ijnp/pyz064

Vieta E, Berk M, Schulze TG, et al. (2018 ) Bipolar disorders. Nat Rev Dis Primers. 4:18008. https://doi.org/10.1038/nrdp.2018.8

Akbayram S, Gokcen C, Karadag M (2020) Increased of platelet indices in patients with attention deficit/hyperactivity disorder. Psychiatry Behav. Sci. 10:86-89. https://doi.org/10.5455/PBS.20190912052825

Quintero M, Stanisic D, Cruz G, Pontes JGM, Costa TBBC, Tasic L (2019) Metabolomic Biomarkers in Mental Disorders: Bipolar Disorder and Schizophrenia. Adv Exp Med Biol. 1118:271-293. https://doi.org/10.1007/978-3-030-05542-4_14

Fries GR, Walss-Bass C, Bauer ME, Teixeira AL (2019) Revisiting inflammation in bipolar disorder. Pharmacol Biochem Behav. 177:12-19. https://doi.org/10.1016/j.pbb.2018.12.006

Marazziti D, Torrigiani S, Carbone MG, et al. (2022) Neutrophil/Lymphocyte, Platelet/Lymphocyte, and Monocyte/Lymphocyte Ratios in Mood Disorders. Curr Med Chem. 29(36):5758-5781. https://doi.org/10.2174/0929867328666210922160116

Mazza MG, Lucchi S, Tringali AGM, Rossetti A, Botti ER, Clerici M (2018) Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: A meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 84(Pt A):229-236. https://doi.org/10.1016/j.pnpbp.2018.03.012

Özdin S, Sarisoy G, Böke Ö (2017) A comparison of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in schizophrenia and bipolar disorder patients - a retrospective file review. Nord J Psychiatry. 71(7):509-512. https://doi.org/10.1080/08039488.2017.1340517

Kulacaoglu F, Yıldırım YE, Aslan M, İzci F (V) Neutrophil to lymphocyte and monocyte to high-density lipoprotein ratios are promising inflammatory indicators of bipolar disorder. Nord J Psychiatry. 77(1):77-82. https://doi.org/10.1080/08039488.2022.2116106

Inanli I, Aydin M, Çaliskan AM, Eren I (2019) Neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, and mean platelet volume as systemic inflammatory markers in different states of bipolar disorder. Nord J Psychiatry. 73(6):372-379. https://doi.org/10.1080/08039488.2019.1640789

Wei Y, Feng J, Ma J, Chen D, Chen J (2022) Neutrophil/lymphocyte, platelet/lymphocyte and monocyte/lymphocyte ratios in patients with affective disorders. J Affect Disord. 309:221-228. https://doi.org/10.1016/j.jad.2022.04.092

Bulut NS, Yorguner N, Çarkaxhiu Bulut G (2021) The severity of inflammation in major neuropsychiatric disorders: comparison of neutrophil-lymphocyte and platelet-lymphocyte ratios between schizophrenia, bipolar mania, bipolar depression, major depressive disorder, and obsessive compulsive disorder. Nord J Psychiatry. 75(8):624-632. https://doi.org/10.1080/08039488.2021.1919201

Yang S, Li S (2022) Development of prognostic predictive model with neutrophil-lymphocyte ratio (NLR) in patients with gastric signet ring carcinoma. Medicine (Baltimore). 101(1):e28043. https://doi.org/10.1097/MD.0000000000028043

Ge YL, Zhang HF, Zhang Q, et al. (2019) Neutrophil-to-Lymphocyte Ratio in Adult Community-Acquired Pneumonia Patients Correlates with Unfavorable Clinical Outcomes. Clin Lab. 65(5). https://doi.org/10.7754/Clin.Lab.2018.181042

Wang L, Song Q, Wang C, et al. (2019) Neutrophil to lymphocyte ratio predicts poor outcomes after acute ischemic stroke: A cohort study and systematic review. J Neurol Sci. 406:116445. https://doi.org/10.1016/j.jns.2019.116445

Ye Z, Ai X, Liao Z, You C, Cheng Y (2019) The prognostic values of neutrophil to lymphocyte ratio for outcomes in chronic obstructive pulmonary disease [published correction appears in Medicine (Baltimore). Medicine (Baltimore). 98(28):e16371. https://doi.org/10.1097/MD.0000000000016371

Dong CH, Wang ZM, Chen SY (2018) Neutrophil to lymphocyte ratio predict mortality and major adverse cardiac events in acute coronary syndrome: A systematic review and meta-analysis. Clin Biochem. 52:131-136. https://doi.org/10.1016/j.clinbiochem.2017.11.008

Zulfic Z, Weickert CS, Weickert TW, Liu D, Myles N, Galletly C (2020) Neutrophil-lymphocyte ratio - a simple, accessible measure of inflammation, morbidity and prognosis in psychiatric disorders?. Australas Psychiatry. 28(4):454-458. https://doi.org/10.1177/1039856220908172

Melo MCA, Garcia RF, de Araújo CFC, Abreu RLC, de Bruin PFC, de Bruin VMS (2019) Clinical significance of neutrophil-lymphocyte and platelet-lymphocyte ratios in bipolar patients: An 18-month prospective study. Psychiatry Res. 271:8-14. https://doi.org/10.1016/j.psychres.2018.10.077

Özdin S, Usta MB (2021) A comparison of inflammatory markers in manic and euthymic states of bipolar disorder. Nord J Psychiatry. 75(2):124-129. https://doi.org/10.1080/08039488.2020.1807048

Dadouli K, Janho MB, Hatziefthimiou A, et al. (2022)Neutrophil-to-Lymphocyte, Monocyte-to-Lymphocyte, Platelet-to-Lymphocyte Ratio and Systemic Immune-Inflammatory Index in Different States of Bipolar Disorder. Brain Sci. 12(8):1034. https://doi.org/10.3390/brainsci12081034

Gan Z, Wu X, Liao Y, et al. (2019) The association between low-grade inflammation and the clinical features of bipolar disorder in Han Chinese population. Psychoneuroendocrinology. 101:286-294. https://doi.org/10.1016/j.psyneuen.2018.12.239

Dargél AA, Roussel F, Volant S, et al. (2018) Emotional hyper-reactivity and cardiometabolic risk in remitted bipolar patients: a machine learning approach. Acta Psychiatr Scand. 138(4):348-359. https://doi.org/10.1111/acps.12901

Magalhães PV, Dean OM, Bush AI, et al. (2013 ) A preliminary investigation on the efficacy of N-acetyl cysteine for mania or hypomania. Aust N Z J Psychiatry. 47(6):564-568. https://doi.org/10.1177/0004867413481631

Arabzadeh S, Ameli N, Zeinoddini A, et al. (2015) Celecoxib adjunctive therapy for acute bipolar mania: a randomized, double-blind, placebo-controlled trial. Bipolar Disord. 17(6):606-614. https://doi.org/10.1111/bdi.12324

Rosenblat JD, McIntyre RS (2017) Bipolar Disorder and Immune Dysfunction: Epidemiological Findings, Proposed Pathophysiology and Clinical Implications. Brain Sci. 7(11):144. https://doi.org/10.3390/brainsci7110144

Downloads

Published

2023-05-22

How to Cite

İmre, O., & Güldeste Yılmaz, İkbal V. (2023). Neutrophil-Lymphocyte Ratio, Monocyte-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Manic Episode Patients with Bipolar Disorder: . European Journal of Therapeutics, 29(2), 110–115. https://doi.org/10.58600/eurjther.20232902-1574.y

Issue

Section

Original Articles