The Predictive Value of Monocyte/High-Density Lipoprotein Ratio (MHR) and Positive Symptom Scores for Aggression in Patients with Schizophrenia

Abstract

Background and Objectives: Schizophrenia with aggression often has an inflammatory abnormality. The monocyte/high-density lipoprotein ratio (MHR), neutrophil/high-density lipoprotein ratio (NHR), platelet/high-density lipoprotein ratio (PHR) and lymphocyte/high-density lipoprotein ratio (LHR) have lately been examined as novel markers for the inflammatory response. The objective of this study was to assess the relationship between these new inflammatory biomarkers and aggression in schizophrenia patients. Materials and Methods: We enrolled 214 schizophrenia inpatients in our cross-sectional analysis. They were divided into the aggressive group (n = 94) and the non-aggressive group (n = 120) according to the Modified Overt Aggression Scale (MOAS). The severity of schizophrenia was assessed using the Positive and Negative Syndrome Scale (PANSS). The numbers of platelets (PLT), neutrophils (NEU), lymphocytes (LYM), monocytes (MON) and the high-density lipoprotein (HDL) content from subjects were recorded. The NHR, PHR, MHR and LHR were calculated. We analyzed the differences between those indexes in these two groups, and further searched for the correlation between inflammatory markers and aggression. Results: Patients with aggression had higher positive symptom scores (p = 0.002). The values of PLT, MON, MHR and PHR in the aggressive group were considerably higher (p < 0.05). The NHR (r = 0.289, p < 0.01), LHR (r = 0.213, p < 0.05) and MHR (r = 0.238, p < 0.05) values of aggressive schizophrenia patients were positively correlated with the total weighted scores of the MOAS. A higher MHR (β = 1.529, OR = 4.616, p = 0.026) and positive symptom scores (β = 0.071, OR = 1.047, p = 0.007) were significant predictors of aggression in schizophrenia patients. Conclusions: The MHR and the positive symptom scores may be predictors of aggressive behavior in schizophrenia patients. The MHR, a cheap and simple test, may be useful as a clinical tool for risk stratification, and it may direct doctors’ prevention and treatment plans in the course of ordinary clinical care.

Construction and verification of aggressive behavior risk prediction model in stable patients with schizophrenia

“…The results of this study showed that aggressive behavior were positively correlated with positive symptoms and childhood traumas in patients with schizophrenia, corroborated by prior investigations [ 31 , 32 ]. Per the assessment, positive manifestations in patients with schizophrenia included delusions, muddled thinking, bizarre behavior, and cognitive inconsistencies, all of which greatly affect how they interpret reality, resulting in extreme frustration, varying mood swings, increased arousal levels, and challenges in controlling actions, ultimately leading to aggressive behavior [ 33 ].…”

Investigation of the Monocyte to High Density Lipoprotein Ratio as an Inflammatory Marker in Schizophrenia

“…More recently, research has conducted on peripheral blood leucocytes (monocytes, lymphocytes and neutrophils) and lipoproteins (low density lipoproteins, high density lipoproteins) as inexpensive and readily obtainable markers of inflammation in schizophrenia, particularly in assessing the risk of cardiovascular morbidity in such patients. 9 A novel marker indicating subclinical inflammation is monocyte to high density lipoprotein ratio (MHR). In several systemic diseases such as artery disease, cancer and auto-immune disorders MHR has been examined and high values have been linked to increased disease severity, treatment resistance and worse prognosis.…”