Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte and Monocyte-to-Lymphocyte Ratio in Bipolar Disorder

Fusar-Poli, Laura; Natale, Antimo; Amerio, Andrea; Cimpoesu, Patriciu; Filioli, Pietro Grimaldi; Aguglia, Eugenio; Amore, Mario; Serafini, Gianluca; Aguglia, Andrea

doi:10.3390/brainsci11010058

Cited by 57 publications

(38 citation statements)

References 49 publications

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“…First, PLR appeared significantly increased in (hypo)mania without any differences between males and females. This is in line with previous reports [40,41], in which PLR was uniquely associated with (hypo)mania. Since no gender difference was observed in PLR values while considering only the (hypo)manic subgroup of bipolar patients, it is possible to hypothesize that PLR may represent the strongest biomarker of (hypo)mania among the considered inflammatory ratios, regardless of gender.…”

Section: Discussionsupporting

confidence: 93%

“…Our findings primarily confirm that several inflammatory ratios are consistently more elevated in (hypo)mania than MDE, further supporting the results of recent cross-sectional studies [39,40]. First, PLR appeared significantly increased in (hypo)mania without any differences between males and females.…”

Section: Discussionsupporting

confidence: 91%

“…These variables are derived from complete blood count (CBC), a low-cost and simple examination widespread in routine clinical practice [37]. According to recent studies, inflammatory ratios are significantly increased in BD [38], with higher values in (hypo)manic than MDE [39][40][41], thus representing potential state markers of this condition.…”

Section: Introductionmentioning

confidence: 99%

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Gender Differences in Complete Blood Count and Inflammatory Ratios among Patients with Bipolar Disorder

et al. 2021

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Background: Evidence suggested that inflammation may be involved in the etiopathogenesis of bipolar disorder (BD), a chronic psychiatric condition affecting around 2-3% of the general population. However, little is known regarding potential gender differences in peripheral biomarkers of BD, such as neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), and monocyte-to-lymphocyte (MLR) ratios. Methods: In total, 197 females and 174 males with BD in different phases (i.e., (hypo)mania, depression, euthymia) were recruited. A blood sample was drawn to perform a complete blood count (CBC). NLR, PLR, and MLR were subsequently calculated, and differences were computed according to the illness phase and gender. Results: PLR was consistently higher in (hypo)manic than depressed patients, in both males and females. No significant gender differences in PLR value were found when considering only (hypo)mania. Conversely, NLR was increased in (hypo)mania only among males, and gender differences were retrieved in the (hypo)manic subgroup. The findings related to MLR were only marginally significant. Higher platelets values were associated with (hypo)mania only in the female group. Basophils and eosinophils appeared gender- but not state-dependent. Conclusions: Our findings provide further evidence that increased PLR levels may be associated with (hypo)mania in bipolar patients, regardless of gender. Moreover, the usefulness of NLR as a peripheral biomarker of BD appeared limited to males while the role of platelets to females. As CBC represents a low-cost and easily accessible test, researchers should investigate in-depth its potential usefulness as a biomarker of BD and other psychiatric disorders.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Gender Differences in Complete Blood Count and Inflammatory Ratios among Patients with Bipolar Disorder

et al. 2021

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“…Conversely, Inanli et al (2019) showed that only MLR is increased in manic episodes versus depression in BD [ 34 ]. On the other hand, a recent study observed that all ratios (NLR, MLR, and PLR) were increased in mania compared to bipolar depression but it is worth mentioning that the studied sample was not controlled for possible major confounders such as pathological conditions or treatment with anti-inflammatory drugs [ 63 ]. Our results are in agreement with those in the literature regarding NLR, MLR, and PLR between mania and bipolar depression.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio, a Novel Inflammatory Marker, as a Predictor of Bipolar Type in Depressed Patients: A Quest for Biological Markers

Dionisie

Filip

Manea

et al. 2021

JCM

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(1) Background: Recent research suggests inflammation as a factor involved in the pathophysiology of mood disorders. Neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR), and systemic immune-inflammatory (SII) index ratios have been studied as peripheral markers of inflammation in bipolar and major depressive disorders. The purpose of this study is to comparatively analyze these inflammatory ratios among manic episodes of bipolar disorder, bipolar depression and unipolar depression. (2) Methods: 182 patients were retrospectively included in the study and divided into three groups: 65 manic patients, 34 patients with bipolar depression, and 83 unipolar depressive patients. White blood cells, neutrophils, monocytes, lymphocytes, and platelets were retrieved from the patients’ database. NLR, MLR, PLR, and SII index were calculated using these parameters. (3) Results: Patients with manic episodes had elevated NLR (p < 0.001), MLR (p < 0.01), PLR (p < 0.05), and SII index (p < 0.001) compared to unipolar depression and increased NLR (p < 0.05) and SII index (p < 0.05) when compared to bipolar depression. NLR (p < 0.01) and SII index (p < 0.05) were higher in the bipolar depression than unipolar depression. NLR is an independent predictor of the bipolar type of depression in depressive patients. (4) Conclusions: The results confirm the role of inflammation in the pathophysiology of mood disorders and suggest the ability of NLR as a marker for the differentiation of bipolar from unipolar depression.

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“… 8 In bipolar disorder, the NLR, PLR, and LMR were significantly higher in (hypo)manic than depressed individuals. 9 …”

Section: Discussionmentioning

confidence: 99%

Complete blood cell count-derived ratios can be useful biomarkers for neurological diseases

Novellino

Donato

Malara

et al. 2021

Int J Immunopathol Pharmacol

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Complete blood cell count-derived parameters such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) have recently shown to be highly sensitive biomarkers. Their usefulness has been proven as prognostic factors in several cancers, in the stratification of mortality in major cardiac events, as predictors and markers of infectious or inflammatory pathologies, and in many other conditions. Surprisingly, the study of these biomarkers in neurological diseases is somewhat limited. This paper aims to take stock of the data present in the literature regarding the complete blood cell count-derived ratios in this group of pathologies and to formulate a hypothesis, based on the most recent data concerning innate and acquired immunity, on which diseases of the nervous system could benefit in diagnostic and prognostic terms from the in-depth study of these new biomarkers.

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Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte and Monocyte-to-Lymphocyte Ratio in Bipolar Disorder

Cited by 57 publications

References 49 publications

Gender Differences in Complete Blood Count and Inflammatory Ratios among Patients with Bipolar Disorder

Gender Differences in Complete Blood Count and Inflammatory Ratios among Patients with Bipolar Disorder

Neutrophil-to-Lymphocyte Ratio, a Novel Inflammatory Marker, as a Predictor of Bipolar Type in Depressed Patients: A Quest for Biological Markers

Complete blood cell count-derived ratios can be useful biomarkers for neurological diseases

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