Longitudinal Assessment of Alterations in Peripheral Inflammatory Markers Over a Hospitalization Period in Patients with Schizophrenia

Year 2023, Volume: 33 Issue: 6, 763 - 767, 31.12.2023

Halil Ibrahim Ozturk , İmren Kurt , Oya Güçlü , Süleyman Dönmezler

https://doi.org/10.54005/geneltip.1328023

Abstract

Objective: To assess the effects of regular medication administration, diet, sleep, and physical activity provided by hospital care on inflammatory markers in schizophrenia patients. The primary hypothesis of our study is that the assembly of various factors, will reduce low-grade inflammation in a short period.
Materials and Methods: This retrospective longitudinal study involved 106 patients diagnosed with schizophrenia who met the exclusion and inclusion criteria. Inflammatory markers such as neutrophil-to-lymphocyte Ratios (NLR), monocyte-to-lymphocyte ratios (MLR), platelet-to-lymphocyte ratios (PLR), C-reactive protein-to-albumin ratios (CAR), and systemic immune inflammation indices (SII) were calculated at the time of hospital admission and after three weeks.
Results: The mean age of the participants was 39.0±13.1 years and the majority were male (n: 75). Reductions were observed in all inflammatory markers after three weeks. The CRP decreased from a median value of 2.6 (interquartile range (IQR): 1.1-5.3) to 1.90 (IQR: 0.85-3.30) (p=0.001, effect size=0.375). The CAR changed from 0.064 (IQR: 0.026-0.115) to 0.043 (IQR: 0.017-0.077) (p=0.005, effect size=0.371). The NLR demonstrated a significant reduction from 2.31 (IQR: 1.73-3.24) to 1.73 (IQR: 1.28-2.27) (p<0.001, effect size=0.647). The SII decreased from 634 (IQR: 425-870) to 470 (IQR: 321-645) (p<0.001, effect size=0.577). The PLR went down from 9.85 (IQR: 7.4-12.7) to 8.21 (IQR: 6.22-10.3) (p<0.001, effect size=0.547). Lastly, the MLR reduced from 0.297 (IQR: 0.221-0.378) to 0.258 (IQR: 0.195-0.319) (p<0.001, effect size=0.522).
Conclusion: This study underscores the influence of regular antipsychotic treatment and hospital care in reducing inflammation markers like NLR, MLR, PLR, SII, and CAR in schizophrenia patients. Future studies should explore the potential of markers like CAR and SII in detecting low-grade inflammation, and further probe into the role of sleep, nutrition, and physical activity, emphasising the paramount role of comprehensive hospital care.

Keywords

schizophrenia, low-grade inflammation, antipsychotics, systemic immune inflamattion index (SII), C-reaktive protein (CRP)- to-albumin ratio (CAR)

Şizofreni Hastalarında Hastaneye Yatış Sürecinde Periferik İnflamatuvar Belirteçlerdeki Değişimlerin Boylamsal Değerlendirmesi

Abstract

Amaç: Şizofreni hastalarında hastane bakımı ile sağlanan düzenli ilaç uygulaması, diyet, uyku ve fiziksel aktivitenin inflamatuar belirteçler üzerindeki etkilerini değerlendirmektir. Çalışmamızın temel hipotezi, hastane bakımının düşük dereceli inflamasyonu kısa sürede azaltacağıdır.
Gereç ve Yöntemler: Bu retrospektif boylamsal çalışmaya, dışlama ve dahil etme kriterlerini karşılayan şizofreni tanılı toplam 106 hasta dahil edildi. Nötrofil-lenfosit oranları (NLO), monosit-lenfosit oranları (MLO), trombosit-lenfosit oranları (TLO), C-reaktif protein-albumin oranları (CAO) ve sistemik immün inflamasyon indeksleri (Sİİ) gibi inflamatuar belirteçler hastaneye kabul sırasında ve üç hafta sonra hesaplanmıştır.
Bulgular: Katılımcıların yaş ortalaması 39,0±13,1 olup büyük çoğunluğu erkekti (n:75). Tüm inflamatuar belirteçlerde üç hafta sonra düşüş olduğu gözlendi. CRP, ortanca değeri 2,6'dan (çeyrekler arası aralık: 1,1-5,3) 1,90'a (çeyrekler arası aralık: 0,85-3,30) (p=0,001, etki büyüklüğü=0,375), CAO, 0.064'ten (çeyrekler arası aralık: 0.026-0.115) 0.043'e (çeyrekler arası aralık: 0.017-0.077) (p=0.005, etki büyüklüğü=0.371), NLO, 2.31'den (çeyrekler arası aralık: 1.73-3.24) 1.73'e (çeyrekler arası aralık: 1.28-2.27) (p<0.001, etki büyüklüğü=0.647), Sİİ, 634'ten (çeyrekler arası aralık: 425-870) 470'e (çeyrekler arası aralık: 321-645) (p<0.001, etki büyüklüğü=0.577), TLO, 9.85'ten (çeyrekler arası aralık: 7.4-12.7) 8.21'e (çeyrekler arası aralık: 6.22-10.3) (p<0.001, etki büyüklüğü=0.547) ve son olarak MLO, 0,297'den (çeyrekler arası aralık: 0,221-0,378) 0,258'e (çeyrekler arası aralık: 0,195-0,319) (p<0,001, etki büyüklüğü=0,522) düşmüş olduğu bulundu.
Sonuç: Bu çalışma, şizofreni hastalarında düzenli antipsikotik tedavi ve hastane bakımının NLO, MLO, TLO, Sİİ ve CAR gibi inflamasyon belirteçlerini azaltmadaki etkisinin altını çizmektedir. Gelecekteki çalışmalar, CAR ve SII gibi belirteçlerin düşük dereceli inflamasyonu tespit etme potansiyelini araştırmalı ve kapsamlı hastane bakımının önemli rollerinden düzenli uyku, beslenme ve fiziksel aktivitenin rolleri daha fazla araştırmalıdır.

Keywords

şizofreni, düşük dereceli inflamasyon, antipsikotikler, sistemik immün inflamasyon indeksi, C-reaktif protein (CRP) albumin oranı (CAR)

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