Inflammatory Biomarkers and Bipolar Disorder: Neutrophil/Lymphocyte Ratio, Monocyte/Lymphocyte Ratio and Platelet/Lymphocyte Ratio

Jaewon Heo(허재원),Yunna Lee(이윤나) 대한생물치료정신의학회 2022 생물치료정신의학 Vol.28 No.3

목적:호중구/림프구 비율(NLR), 단핵구/림프구 비율(MLR) 및 혈소판/림프구 비율(PLR)은 염증의 표지자이다. 여러 연구에서 비율들과 양극성 장애의 중증도와의 관계를 평가했지만 상반되는 결과였다. 저자들은 이러한 염증 비율과 양극성 장애의 중증도 및 임상적 특징 사이의 관계를 조사했다. 방법:2010년 1월부터 2021년 8월까지 고신대학교 복음병원에 입원하였고 선정기준을 만족하는 양극성 장애 환자의 의무기록을 후향적으로 조사하였다. NLR, MLR, PLR은 온혈구계산에 따라 측정되었다. 중증도는 경조증/조증 삽화 환자에서 Young Mania Rating Scale (YMRS), 우울 삽화 환자에서 Hamilton Rating Scale for Depression (HAMD)로 평가되었다. 환자는 두 가지 임상적 특징인 현재의 정신병적 증상 및 자살 시도 과거력의 유무에 따라 분류되었다. 결과:선정된 181명의 대상자 중 123명이 여성이고 58명이 남성이었다. 더 높은 NLR 수치를 보인 환자군은 더 높은 HAMD 점수를 보였다(n=36, r=0.337, p=0.045). YMRS와 염증 표지자 사이에는 유의한 상관관계가 없었다. 이전 자살 시도가 있는 환자군은 이전 자살 시도가 없는 환자군보다 더 높은 PLR 수치를 보였다(N[SA+]=52, N[SA-]=129, p=0.035). 정신병적 특징에 따른 염증 비율의 수치에는 유의한 차이가 없었다. 결론:이 연구로 양극성 장애 우울에피소드의 중증도와 염증 표지자 사이의 상관 관계와 함께 양극성 장애에서 이전 자살 시도 과거력과 염증 표지자 사이의 가능한 상관 관계를 밝혀냈다. 앞으로 더 많은 대상자를 포함하는 잘 설계된 전향적 연구의 필요성이 시사된다. Objectives:Neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio (PLR) are indicators of inflammation. Several studies have evaluated their relationship with bipolar disorder severity, but the results are controversial. Here, we investigate the relationship between inflammatory ratios and the severity and clinical characteristics of bipolar disorder. Methods:We retrospectively reviewed the medical records of bipolar disorder patients who met the inclusion criteria and admitted to Kosin University Gospel Hospital between January 2010 and August 2021. NLR, MLR and PLR were measured according to the complete blood count. Severity was assessed by the Young Mania Rating Scale (YMRS) in hypo/manic episode patients, the Hamilton Rating Scale for Depression (HAMD) in depressive episode patients. Patients are grouped by presence of two clinical features, current psychotic features and history of suicide attempts. Results:181 subjects, of whom 123 were women and 58 men, were included. Subjects with higher NLR had higher HAMD scores (N=36, r=0.337, p=0.045). We found no significant correlation between YMRS and the inflammatory biomarkers. Patients with previous suicide attempts exhibited a greater PLR than those without previous suicide attempts (N[SA+]=52, N[SA-]=129, p=0.035). There was no significant difference in inflammatory ratios with respect to psychotic features. Conclusions:We found a possible correlation between the severity of bipolar depression and inflammatory indicators in the Korean population, in addition to correlation between previous suicidal attempt of bipolar disorder and inflammatory indicators. A well-designed prospective study involving a larger cohort is needed in the future.

조현병 중증도와 염증 표지자(호중구/림프구 비율, 단핵구/림프구 비율, 혈소판/림프구 비율)의 연관성

허재원,김호찬 대한생물치료정신의학회 2023 생물치료정신의학 Vol.29 No.3

Objectives: Neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio (PLR) are inflammatory biomarkers. Potential of these inflammatory biomarkers as state marker of schizophrenia severity is controversial. This study aimed to investigate the relationship between inflammatory biomarkers and schizophrenia severity. Methods: From January 2010 to June 2020, the medical records of schizophrenia patients admitted to Kosin University Gospel Hospital were retrospectively examined and 91 patients who met the inclusion criteria were selected as the subjects of the study. The Korean version of the Positive and Negative Syndrome Scale (PANSS-KV) was used to assess schizophrenia symptom severity and divided into PANSS-KV total score (PANSS-T), PANSS-KV positive syndrome subscale (PANSS-P), PANSS-KV negative syndrome subscale (PANSS-N), PANSS-KV general psychopathology subscale (PANSS-G). Results: In 91 subjects, 40 were male and 51 were female. We found no significant relationship between sex, age, number of hospitalization and NLR, MLR, PLR. Patients with higher NLR, MLR, PLR had higher PANSS-T scores. Positive correlation between NLR, MLR, PLR and PANSS-N, PANSS-G was demonstrated. There was no significant correlation between NLR, MLR, PLR and PANSS-P. Conclusions: We investigate the possibility of inflammatory biomarkers as state markers of schizophrenia symptom severity. A well-designed prospective study involving a larger cohort is needed in the future.

갑상선 유두암 재발의 예측 인자로서 혈중 호중구-림프구 비율의 임상적 유용성

한세웅,강상율,김선광,윤현조,정성후,Se Woong Han,Sang Yull Kang,Seon Kwang Kim,Hyun Jo Youn,Sung Hoo Jung 대한갑상선-내분비외과학회 2014 The Koreran journal of Endocrine Surgery Vol.14 No.4

Purpose: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of poor prognosis in patients with various types of cancer. To date, the utility of NLR for prediction of prognosis in thyroid cancer patients has not been studied. Therefore, the aim of our study was to determine whether NLR is associated with other prognostic factors of papillary thyroid carcinoma and predictive of recurrence. Methods: We conducted a retrospective review of 367 patients who underwent thyroidectomy for papillary thyroid carcinoma from January 2005 to December 2007. We measured the white blood cell count including neutrophil and lymphocyte within one month preoperatively. The NLR was defined as the absolute neutrophil count divided by absolute lymphocyte count. Logistic regression analysis was applied for comparison of NLR with other prognostic factors, including tumor size, lymph node metastasis, multiplicity, extrathyroidal invasion, and TNM stage. We also determined the cut-off value of NLR with a prediction for recurrence. Results: Median age of patients was 47 years (16∼86 years) and the rate of papillary thyroid microcarcinoma was 65.7% (241/367 cases). Median follow-up period was 1,841 days (506∼3,135 days). The median value of NLR was 1.68 (0.66∼6.36). NLR was not related to any other prognostic factors of papillary thyroid carcinoma. The cut-off value of NLR for prediction of recurrence was 1.73, where the sensitivity was 66.7% and specificity was 69.8%. Conclusion: Patients with NLR equal to or higher than 1.73 showed significantly higher recurrence of papillary thyroid carcinoma. Further validation study should be conducted for clinical use of NLR as a prognostic marker.

갑상선 유두암에서 혈중 호중구-림프구 비율의 임상적 의의

신영일(Yung il Shin),조자영(Ja Young Cho),이유미(Yu Mi Lee),성태연(Tae Yon Sung),윤종호(Jong Ho Yoon),정기욱(Ki Wook Chung),홍석준(Suck Joon Hong) 대한갑상선-내분비외과학회 2016 The Koreran journal of Endocrine Surgery Vol.16 No.2

Purpose: Neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammatory response, which is inexpensive, easily calculated, and known to show correlation with prognosis of cancer. The aim of this study was to evaluate the relationship between NLR and prognosis of papillary thyroid carcinoma. Methods: A total of 1,142 patients who underwent total thyroidectomy for papillary thyroid carcinoma between 1995∼2005 at Asan Medical Center were enrolled in this study. Patients were categorized according to two groups based on NLR and clinico-pathological variables and disease survival were compared between the two groups. Results: Median age of patients was 45.4 years, and the median follow-up period was 48 months. The cut-off value of NLR for prediction of disease-free survival (DFS) was 2. Comparison of DFS between two groups stratified by NLR (NLR ≤2, NLR>2) showed little statistical difference (P=0.48). After adjusting for risk (N stage), there was no significant difference according to N stage (N0: P=0.86, N1a: P=0.4, N1b: P=0.12). Conclusion: NLR did not show correlation with disease free survival of papillary thyroid carcinoma.