Association between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and C-reactive protein levels and metabolic status in patients with a bipolar disorder

World J Biol Psychiatry. 2022 Jul;23(6):464-474. doi: 10.1080/15622975.2021.2013089. Epub 2022 Jan 12.

Abstract

Objectives: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and C-Reactive Protein (CRP) are markers of inflammation that are elevated in bipolar disorder (BD) and are also related to a higher risk of metabolic syndrome (MetS). This study aimed at investigating for the first time the association between NLR, PLR, and CRP and the metabolic status in BD.

Methods: We assessed the association between biomarkers and the metabolic status: number of metabolic risk factors, presence of MetS, insulin sensitivity (Quantitative Insulin Sensitivity Check Index, QUICKI) and insulin resistance (Homeostatic Model Assessment for Insulin Resistance, HOMA-IR index), in a sample of 219 outpatients with BD.

Results: 25.9% of the sample met the criteria for MetS. High levels of CRP were found in 12% of the sample. Older age, low PLR, high NLR, and high CRP levels significantly predicted a higher number of MetS risk factors (p < 0.001). Older age and low PLR were associated with a greater likelihood of developing MetS (p = 0.007).

Conclusions: Although further studies are needed to replicate and validate these findings, inflammatory biomarkers as CRP, PLR and NLR could be useful tools to identify patients with a BD at risk for a metabolic adverse outcome.

Keywords: Bipolar affective disorder; C-reactive protein; glucose metabolism; inflammation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers
  • Bipolar Disorder*
  • C-Reactive Protein / analysis
  • Humans
  • Insulin Resistance*
  • Lymphocytes
  • Metabolic Syndrome*
  • Neutrophils / chemistry
  • Platelet Count
  • Retrospective Studies

Substances

  • C-Reactive Protein
  • Biomarkers