Relationship between neutrophil/lymphocyte ratio with oxidative stress and psychopathology in patients with schizophrenia

Figures & data

Table 1 Sociodemographic characteristics of the patients and the control group

	Patient group (n=64)	Control group (n=61)	P-value
Age range (years)	18–76	18–71	0.752
Age, mean ± SD	40.17±11.3	40.90±14.19
Sex, n (%)			0.858
Female	28 (43.8)	28 (46)
Male	36 (56.2)	33 (54)
Marital status, n (%)			0.006*
Single	31 (48.43)	14 (22.95)
Divorced, separated	11 (15.63)	10 (16.39)
Married	22 (35.94)	37 (60.66)
Education, n (%)			0.169
Literate	8 (12.5)	9 (14.7)
Primary school	20 (31.24)	13 (21.3)
Secondary school, high school	22 (34.38)	16 (26.2)
University	14 (21.88)	23 (33.7)
Smoking, n (%)			0.473
Yes	25 (39)	28 (45.9)
No	39 (61)	33 (54.1)
Duration of disease (years), mean ± SD	12±7.32	NA	NA
Drug therapy, n (%)		NA	NA
Atypical antipsychotic	33 (51.56)
Typical antipsychotic	12 (21.75)
Typical/atypical antipsychotic	19 (26.68)
Type of schizophrenia, n (%)		NA	NA
Paranoid	46 (71.87)
Disorganized	7 (9.37)
Undifferentiated	5 (7.81)
Residual	6 (10.94)

Notes:

* Correlation is significant at the 0.05 level (two-tailed). Fisher’s exact test, Pearson chi-square test, and Student’s t-test were used.

Abbreviations: NA, not applicable; SD, standard deviation.

Table 2 Comparison of neutrophils, lymphocytes, NLR, TAS, TOS, OSI, PON1, T.thl, and T.thl/OSI ratio between the control group and patients with schizophrenia

	Patient group (n=64), mean ± SD	Control group (n=61), mean ± SD	P-value
Neutrophils (%)	66.3±7.7	54.5±7.9	<0.001*
Lymphocytes (%)	24.78±7.00	35.12±8.37	<0.001*
NLR	3.10±1.68	1.67±0.54	<0.001*
TAS (mmol/L)	1.97±0.34	1.82±0.36	0.018*
TOS (μmol/L)	12.32±10.12	5.69±1.76	<0.001*
OSI	6.83±6.85	4.63±8.69	0.118
PON1 (U/L)	38.75±20.98	36.07±28.18	0.546
T.thl (μmol/L)	442.29±53.24	555.39±23.29	<0.001*
T.thl/OSI ratio	100.09±52.76	187.20±60.43	<0.001*
PANSS-negative subscale	17.6±5.1
PANSS-positive subscale	17.0±4.1
PANSS-total subscale	71.6±17.7

Notes:

* Correlation is significant at the 0.05 level (two-tailed). Mann–Whitney U-test and Student’s t-test were used.

Abbreviations: NLR, neutrophil/lymphocyte ratio; OSI, oxidative stress index; PANSS, Positive and Negative Syndrome Scale; PON1, paraoxonase; TAS, total antioxidant status; TOS, total oxidative status; T.thl, total thiol.

Table 3 Relationship between PANSS and leukocyte, lymphocyte, NLR, TAS, TOS, OSI, PON1, T.thl values, and T.thl/OSI ratio

	PANSS-negative subscale		PANSS-positive subscale		PANSS-total subscale
	r	P-value	r	P-value	r	P-value
Neutrophils (%)	0.071	0.576	0.255	0.042*	0.301	0.016*
Lymphocytes (%)	−0.106	0.406	−0.291	0.020*	−0.286	0.022*
NLR	0.163	0.197	0.179	0.156	0.251	0.045*
TAS	0.158	0.212	0.009	0.943	−0.097	0.444
TOS	0.118	0.352	0.196	0.121	0.173	0.172
OSI	0.060	0.636	0.134	0.293	0.213	0.091
PON1	0.108	0.397	0.039	0.758	0.044	0.730
T.thl	0.067	0.599	0.037	0.769	−0.180	0.156
T.thl/OSI ratio	0.090	0.481	−0.264	0.035*	−0.286	0.022*

Notes:

* Correlation is significant at the 0.05 level (two-tailed). Pearson and Spearman correlation analyses were used.

Abbreviations: NLR, neutrophil/lymphocyte ratio; OSI, oxidative stress index; PANSS, Positive and Negative Syndrome Scale; PON1, paraoxonase; TAS, total antioxidant status; TOS, total oxidative status; T.thl, total thiol.

Table 4 The relationship between NLR and T.thl/OSI ratios in the patient and control groups

	Patients T.thl/OSI ratio		Controls T.thl/OSI ratio
	r	P-value	r	P-value
NLR	−0.340	0.006*	0.040	0.758

Notes:

* Correlation is significant at the 0.05 level (two-tailed). Pearson and Spearman correlation analyses were used.

Abbreviations: NLR, neutrophil/lymphocyte ratio; OSI, oxidative stress index; T.thl, total thiol.

Table 5 Comparison of NLR and T.thl/OSI values with other parameters in patients with schizophrenia

	NLR		T.thl/OSI ratio
	r	P-value	r	P-value
TAS	−0.014	0.913	0.256	0.041*
TOS	0.361	0.003*	−685	<0.001*
PON1	0.168	0.185	0.118	0.353
T.thl	−0.021	0.868	0.416	0.001*
OSI	0.307	0.014*	−0.678	<0.001*

Notes:

* Correlation is significant at the 0.05 level (two-tailed). Pearson and Spearman correlation analyses were used.

Abbreviations: NLR, neutrophil/lymphocyte ratio; OSI, oxidative stress index; PON1, paraoxonase; TAS, total antioxidant status; TOS, total oxidative status; T.thl, total thiol.

Figure 1 ROC analysis of schizophrenic patients versus controls.

Abbreviations: NLR, neutrophil/lymphocyte ratio; OSI, oxidative stress index; PON1, paraoxonase; ROC, receiver operating characteristic; TAS, total antioxidant status; TOS, total oxidative status; T.thl, total thiol.

Table 6 ROC analysis data of NLR, TAS, TOS, PON1, T.thl, OSI, and T.thl/OSI ratio parameters

Biomarker	Area under curve	Cut-off level	Sensitivity (%)	Specificity (%)	+ LR	− LR
NLR	0.855	1.98	76.56	77.05	3.34	0.30
OSI	0.771	3.35	71.87	73.77	2.74	0.38
PON1	0.578	NA	NA	NA	NA	NA
TAS	0.652	1.99	48.44	86.89	3.69	0.59
TOS	0.866	5.9	81.25	75.41	3.30	0.25
T.thl	0.952	496.85	90.62	100.00	NA	0.094
T.thl/OSI ratio	0.865	137.46	78.12	86.89	5.96	0.25

Notes: + LR = positive likelihood ratio, − LR = negative likelihood ratio.

Abbreviations: NA, not applicable; NLR, neutrophil/lymphocyte ratio; OSI, oxidative stress index; PON1, paraoxonase; ROC, receiver operating characteristic; TAS, total antioxidant status; TOS, total oxidative status; T.thl, total thiol.