Comparison of the complete blood count-derived inflammatory markers in bipolar patients with manic and mixed episodes

OBJECTIVES: We aimed to compare altered inflammatory status between patients with bipolar manic and mixed episodes through neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-tolymphocyte ratio (MLR) levels. BACKGROUND: NLR, PLR, and MLR are systemic inflammation biomarkers that have recently studied in bipolar disorder (BD) manic and depressive episodes. Immunological biomarker signature of mixed episodes and MLR levels in BD have less been studied. DESIGN AND SETTING: Our study included 48 bipolar patients in a mood episode (28 manic, 20 mixed) and 32 controls. Study-specifi c form including sociodemographic and clinical variables with laboratory fi ndings were fi lled for all participants. METHODS: Red cell distribution width (RDW), mean platelet volume (MPV) neutrophil, lymphocyte and platelet count, NLR, PLR, and MLR were recorded. RESULTS: PLR and MLR were found signifi cantly higher in bipolar patients compared to controls while NLR and MLR were signifi cantly higher in manic patients than in mixed patients. RDW was found higher in mixed episode compared to controls. CONCLUSIONS: One can interpret these findings as MLR would be considered as a novel state biomarker for bipolar mood episodes and greater inflammatory activation may be involved in mania rather than mixed episode (Tab. 2, Fig. 1, Ref. 35).