Ischemia-modified albumin: a unique marker of global metabolic risk in schizophrenia and mood disorders

Figures & data

Table 1. Socio-demographic and clinical characteristics of the groups (BD: Bipolar Disorder, UD: Unipolar depression, SZ: Schizophrenia, HC: Healthy Control).

		BD (n = 32)	UD (n = 32)	SZ (n = 28)	HC (n = 34)	F / χ^2	p
Age*		33.34 ± 1.13	33.91 ± 8.56	33.61 ± 10.02	30.62 ± 7.26	0.88	0.453
Gender [Women]		15 (%46.9)	16 (%50)	13 (%46.4)	20 (%58.8)	1.30	0.730
Education*		12.00 ± 3.30	11.84 ± 3.68	10.29 ± 3.93	12.59 ± 2.95	2.40	0.071
Age at Onset*		22.84 ± 7.46	29.38 ± 8.12	21.59 ± 3.96		6.01	0.004
Duration of the Disease**		109.00 ± 97.54	59.97 ± 59.27	140.78 ± 111.00		11.26	<0.001
Waist Circumference		99.06 ± 11.83	93.00 ± 6.68	95.32 ± 10.83	89.35 ± 6.89	7.39	0.001
BMI		28.04 ± 5.05	25.07 ± 3.57	25.53 ± 5.62	24.56 ± 3.33	3.91	0.011
Systolic tension		120.47 ± 13.34	116.25 ± 11.07	112.14 ± 9.57	114.85 ± 11.51	2.77	0.044
Diastolic tension		77.34 ± 7.83	70.31 ± 7.06	70.00 ± 7.57	71.32 ± 8.82	6.03	0.001
Pulse rate		85.10 ± 12.64	74.03 ± 15.99	83.46 ± 18.70	78.18 ± 8.32	3.85	0.010
YMRS		1.45 ± 3.18
HDRS		9.03 ± 9.07	10.71 ± 9.62
SAPS				9.04 ± 9.56
SANS				18.80 ± 17.52
Number of Hospitalizations		3.10 ± 4.87	0.19 ± 0.64	1.71 ± 1.74		7.27	0.001
Number of Episodes	Depressive	2.46 ± 4.30	4.00 ± 1.41			0.30	0.742
	Manic	2.19 ± 3.93
	Total	7.54 ± 6.50
Smokers (%)		13 (%40.6)	15 (%46.9)	10 (%35.7)	9 (%26.5)	3.14	0.370
Chlorpromazine Equivalents		317.27 ± 279.46	163.12 ± 207.57	347.41 ± 203.77		1.27	0.289
Drugs N (%)	Antipsychotics^¥	23 (%71.9)	7 (%21.9)	28 (%100)		75.73	<0.001
	Antidepressants	7 (%21.9)	31 (%96.9)	6 (%21.4)		76.93	<0.001
	Mood Stabilizers^§	29 (%90.6)	2 (%6.3)	2 (%7.1)		92.63	<0.001

One-way ANOVA and Chi-square Test. Post-hoc comparisons: Age at onset: BD < UD, p = 0.001, SZ < UD, p < 0.001; Duration of the Disease: UD < SZ, p = 0.005; Waist circumference: HC < BD, p = 0.001; BMI: UD < BD, p = 0.010; HC < BD, p = 0.042 Number of hospitalizations: UD < BD, p = 0.007; UD < SZ, p < 0.001; Pulse rate, UD < BD, p = 0.020; Systolic tension: SZ < BD, p = 0.041; Diastolic tension: HC < BD, p = 0.027; UD < BD, p = 0.002; SZ < BD, p = 0.003. BD: Bipolar Disorder, UD: Unipolar depression, SZ: Schizophrenia, HC: Healthy Control.

*Years.

**Months.

^¥2 patients in the BD group, 3 patients in the UD group and 5 patients in the SZ group were on typical antipsychotics.

^§7 patients were on lithium, 14 patients were on valproate, and 8 patients were on lamotrigine in the BD group. 1 patient was on valproate, and 1 patient was on lamotrigine in the UD group. 1 patient was on valproate and 1 was on topiramate in the SZ group.

Table 2. Biochemical variables of the groups.

	BD (n = 32)	UD (n = 32)	SZ (n = 28)	HC (n = 34)	F / χ^2	p
IMA	0.54 ± 0.16 (29.6%)	0.51 ± 0.14 (27.5%)	0.53 ± 0.15 (28.3%)	0.44 ± 0.09 (20.5%)	3.04	0.032
Albumin	3.99 ± 0.23 (5.8%)	3.93 ± 0.26 (6.6%)	3.87 ± 0.31 (8.0%)	3.93 ± 0.26 (6.6%)	1.21	0.311
TAS	1.42 ± 0.15 (10.6%)	1.44 ± 0.21 (14.6%)	1.45 ± 0.18 (12.4%)	1.33 ± 0.13 (9.8%)	2.75	0.045
TOS	4.40 ± 1.81 (41.1%)	3.66 ± 1.42 (38.8%)	3.83 ± 0.95 (24.8%)	3.47 ± 1.56 (45.0%)	2.33	0.077
TAS / TOS	0.38 ± 0.16 (42.1%)	0.43 ± 0.12 (27.9%)	0.40 ± 0.13 (32.5%)	0.46 ± 0.19 (41.3%)	1.46	0.228
Cholesterol	178.81 ± 44.78 (25.0%)	193.61 ± 36.89 (19.1%)	181.63 ± 31.29 (17.2%)	168.09 ± 34.01 (20.2%)	2.53	0.060
Triglyceride	128.84 ± 76.61 (59.5%)	150.00 ± 95.11 (63.4%)	154.00 ± 129.89 (84.3%)	125.30 ± 59.67 (47.6%)	0.749	0.525
WBC	6611.78 ± 2074.23 (31.4%)	7109.38 ± 2522.72 (35.5%)	7795.93 ± 2289.27 (29.4%)	7059.71 ± 1962.31 (27.8%)	1.41	0.244
Neutrophil	3832.53 ± 1502.41 (39.2%)	4132.53 ± 1509.33 (36.5%)	5204.04 ± 1699.19 (32.7%)	4323.28 ± 1574.98 (36.4%)	4.04	0.009
Lymphocyte	2198.88 ± 846.19 (38.5%)	2394.38 ± 1887.35 (78.8%)	2073.59 ± 603.88 (29.1%)	2259.59 ± 636.39 (28.2%)	0.40	0.750
Neutrophil / Lymphocyte	1.95 ± 1.03 (52.8%)	2.05 ± 1.05 (51.2%)	2.58 ± 0.72 (27.9%)	2.00 ± 0.80 (40.0%)	2.86	0.040
Hemoglobin	14.63 ± 1.80 (12.3%)	14.93 ± 1.56 (10.4%)	15.06 ± 1.46 (9.7%)	14.31 ± 1.48 (10.3%)	1.39	0.250
Hematocrit	43.19 ± 5.72 (13.2%)	44.25 ± 4.70 (10.6%)	44.78 ± 4.62 (10.3%)	41.92 ± 4.57 (10.9%)	2.05	0.111
Platelet	232.81 ± 91.18 (39.2%)	243.91 ± 76.02 (31.2%)	249.00 ± 58.90 (23.7%)	245.53 ± 71.54 (29.1%)	0.26	0.853

One-way ANOVA. Means ± SD (coefficient of variation %) are reported. Post-hoc comparisons IMA: HC < BD, p = 0.048, HC < SZ, p = 0.059; Neutrophil: BD < SZ, p = 0.007 and Neutrophil / Lymphocyte ratio, BD < SZ, p = 0.045; TAS was not significantly different between the groups in the post-hoc comparison. Partial eta-squared coefficient for IMA was 0.71, for TAS was 0.64, for neutrophil 0.92 and for neutrophil/lymphocyte 0.67. IMA: Ischemia-modified albumin, TAS: Total Antioxidant Status, TOS: Total Oxidant Status: WBC: White Blood Cell.

Table 3. Predictors of IMA levels in the groups.

Model		Unstandardized coefficients		Standardized coefficients	t	p	F	Adjusted R^2
		β	SE	β
BD^1	WBC	<0.001	<0.001	−0.43	−2.26	0.034	5.09	0.15
UD^2	Pulse rate	0.003	0.002	0.39	2.16	0.040	4.67	0.12
SZ^3	TOS	0.114	0.027	0.679	4.24	<0.001	17.97	0.44
HCs^4	Systolic tension	−0.04	0.002	−0.46	−2.54	0.018	6.47	0.18

¹Bipolar disorder.

²Unipolar depression.

³Schizophrenia.

⁴Healthy controls.

Stepwise linear regression analyses were performed separately in the groups. Dependent variable: IMA; Independent variables: Waist circumference, BMI, Systolic tension, diastolic tension, pulse rate, cholesterol, triglyceride, TAS, TOS, TAS/TOS ratio, WBC, neutrophil, lymphocyte, Neutrophil/lymphocyte ratio. Albumin was added to the independent variables in the second step of the regression analysis to control the effect of albumin levels to IMA levels. In the second step regression models were not significant in all groups [BD F = 1.67, p = 0.220; UD F = 1.16, p = 0.403; SZ F = 1.43, p = 0.327; HCs F = 0.60, p = 0.822]. Second step analysis showed that significance in the first step depended on albumin levels in the groups.