C-Reactive Protein/Albumin and Neutrophil/Albumin Ratios as Novel Inflammatory Markers in Patients with Schizophrenia
Open accessAbstract
Objective Peripheral biomarker studies in schizophrenia are insufficient to correspond to whether inflammatory markers are trait- or state-related. The main objective of this study was to compare novel biomarkers C-reactive protein/albumin ratio (CAR), neutrophil/albumin ratio (NAR), and complete blood count-derived inflammatory markers; neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), red-cell distribution width (RDW), and mean platelet volume (MPV) between patients with acutely exacerbated and remitted schizophrenia and healthy controls.Methods Anonymous data of a total of 618 patients with schizophrenia (179 in remission, 439 with acute exacerbation) and 445 psychiatrically and medically healthy subjects admitted to outpatient units were included. One-way ANOVA with Tukey’s HSD post-hoc test, Pearson’s correlation test, receiver operating characteristic analysis, and binomial logistic regression analysis were performed.Results CAR, NAR, NLR, PLR, MLR, RDW, MPV values were found higher in patients with schizophrenia than in healthy subjects. Except for NAR (p=0.007), none of the markers differed between acute exacerbation and remission. As a cut-off value of CAR, 0.388 differentiated patients with schizophrenia from controls (sensitivity 81%, specificity 81%). CAR, NAR, and MPV significantly predicted the diagnosis of schizophrenia.Conclusion CAR and NAR are reliable biomarkers of inflammation and a combination of inflammatory markers including CAR and NAR could be used to reflect the increased inflammatory status in schizophrenia, regardless of relapse or remission.
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Multiple pathophysiological biomarkers easily available by routine blood examinations are valuable for studying inflammatory processes and immune states in psychiatry.
“Previous studies demonstrated that multiple pathophysiological biomarkers, which are easily available by use of routine blood examinations, are valuable for the study of inflammatory processes and immune states in psychiatry.5,6”
From Albumin and Associated Biomarkers in Severe Neuropsychiatric Disorders: Acute-Phase Schizophrenia and Bipolar Disorder (2023) · cites this paper as [6]
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- Authors
- Balcioglu, Y. H., & Kirlioglu, S. S.
- Venue
- Psychiatry Investigation
- Publisher
- Korean Neuropsychiatric Association
- Published
- 2020-09-25
- Volume
- 17
- Issue
- 9
- Pages
- 902-910
- ISSN
- 1738-3684 (ISSN-L)
- 1976-3026
- PMC
- PMC7538240
- OpenAlex
- W3084224661
- Cited by
- 80
- References
- 60
- Citations by year
- 2026: 7 · 2025: 19 · 2024: 16 · 2023: 17 · 2022: 11 · 2021: 10
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Psychiatry Investigation (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Keywords
- schizophrenia, C-reactive protein to albumin ratio, inflammatory markers, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, red cell distribution width, mean platelet volume, acute exacerbation, remission, diagnostic prediction
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