Duygudurumla İlişkili ve Duygudurumla İlişkili Olmayan Psikozlarda Nötrofil-Lenfosit Oranının (NLR) Karşılaştırılması

Year 2024, Volume: 34 Issue: 5, 624 - 628, 31.10.2024

Beyazit Garip , Begüm Oğur , Şükran Tekin , Öykü İnanç

https://doi.org/10.54005/geneltip.1413078

Abstract

Amaç: İltihaplı belirteçler, özellikle yükselmiş NLR seviyesi, sistemik iltihabın bilinen göstergeleridir ve psikozu anlamak için pratik araçlar olarak önerilmiştir. Bu çalışmanın birincil amacı, hem duygusal hem de duygusal olmayan psikozda nötrofil, lenfosit ve monosit sayıları ve bunların türetilmiş oranları (NLR, MLR, PLR) dahil olmak üzere kan parametrelerini araştırmaktır. Bu araştırma, psikozun patofizyolojik temellerini aydınlatmada bu biyobelirteçlerin potansiyel rolüne ışık tutmayı ve tanı ve tedavi yaklaşımlarını bilgilendirebilecek içgörüler sunmayı amaçlamaktadır.
Materyaller ve Yöntemler: Bu retrospektif vaka kontrol çalışması, şizofreni (SCH), ilk epizod psikoz (FEP) ve bipolar bozukluk (BD) tanısı konmuş hastalara odaklanmıştır. 2016’dan 2021’e kadar olan dijital tıbbi kayıtlar retrospektif olarak analiz edildi. Çalışmaya toplam 437 hasta dahil edildi ve üç gruba ayrıldı: şizofreni (n = 199), ilk atak psikoz (n = 127) ve bipolar bozukluk (n = 111) ve daha önce psikiyatrik bozukluğu olmayan bireylerden oluşan sağlıklı bir kontrol (HC) grubu (n = 200).
Sonuçlar: Bu çalışmada, şizofreni (SCH) ve bipolar bozukluk (BP) hastalarında nötrofil ve lenfosit sayılarında önemli artışlar gözlemledik. Tersine, monosit sayıları SCH hastalarında kontrol grubuna kıyasla önemli ölçüde azaldı. Özellikle, nötrofil-lenfosit oranı (NLR), ilk atak psikoz (FEP) hastalarında kontrollere kıyasla önemli ölçüde yüksekti. Ayrıca, çalışma grupları arasında monosit-lenfosit oranı (MLR) ve trombosit-lenfosit oranı (PLR) açısından istatistiksel olarak anlamlı bir fark bulunmamıştır (her karşılaştırma için p > 0,05).
Sonuç: Çalışmamız, ilk epizod psikoz (FEP) hastalarında yüksek nötrofil-lenfosit oranına (NLR) dikkat çekerek, NLR’nin psikotik bozuklukların akut ve kronik evrelerini ayırt etme potansiyeli olduğunu göstermektedir. Ancak, bazı önceki çalışmaların aksine, bipolar bozukluk (BP) hastaları ve kontroller arasında anlamlı bir NLR farkı bulamadık. Psikiyatrik bozukluklarda inflamasyon belirteçlerinin rolünü tam olarak anlamak için daha fazla prospektif araştırmaya ihtiyaç vardır.

Keywords

Psikoz, Bipolar, NLR, MLR, PLR

Comparative Study of Inflammatory Markers in Schizophrenia, FirstEpisode Psychosis, and Bipolar Disorder

Abstract

Objective: An elevated level of NLR level is defined as an indicator of systemic inflammation, and it is stated that it can be used as an effective tool in navigating psychosis. The aim of the present study is to explore the blood parameters such as neutrophil, lymphocyte, and monocyte and their ratios (NLR, MLR, PLR) in both affective and non-affective psychosis.
Materials and Methods: This is a retrospective case-control study conducted on schizophrenia(Sch), first-episode psychosis(FEP), and bipolar disorder(BD). Digital medical records were retrospectively analyzed between 2016 to 2021. The total number of patients recruited for this study is 437. Patients were divided into 3 groups which are schizophrenia (n:199), FEP (n:127), and Bipolar Disorder (n:111). The healthy control (HC) group (n:200) was selected who had never been diagnosed with any psychiatric disorders.
Results: In this study, no difference was found between the patient groups in terms of substance use (Chi-square= 5.008; p= 0.082), platelet count was lower in SCH patients and no difference was found between the other groups in terms of platelet count. There was no statistical difference between the study groups in terms of lymphocyte, neutrophil, and monocyte counts and their ratios (NLR, MLR, PLR) (p>0.05 for each).
Conclusion: In contrast to the previous findings, we did not show any significant differences in NLR, MLR, and PLR levels in both affective and non-affective psychosis. To better understand the pathophysiology of psychosis, it might be more suitable to conduct a clinical trial with drug-naive FEP patients in a prospective manner.

Keywords

Psychosis, Bipolar, NLR, MLR, PLR

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