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

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
• glucose metabolism
• inflammation
• C-reactive protein

Acknowledgements

We thank Sharon Grevet, CT, Bachelor's Degree in languages from the University of Pennsylvania, for her English assistance.

Statement of interest

None to declare. She has no financial or other relationship relevant to the subject of this article.

Additional information

Funding

This study was supported by grants from the Instituto de Salud Carlos III [PI11/02493 and FIS PI14/02037) and from Fondos Europeos de Desarrollo Regional (FEDER). The sponsors had no involvement in the study design, collection, analysis, and interpretation of data, in the writing of the report, and in the decision to submit the article for publication.