Sex-specific associations between Neutrophil-Percentage-to-Albumin Ratio(NPAR) and Neutrophil-to-Lymphocyte Ratio (NLR) with positive and negative symptoms in schizophrenia.
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Abstract
Background: Inflammatory markers such as the Neutrophil-Percentage-to-Albumin Ratio (NPAR) and Neutrophil-to-Lymphocyte Ratio (NLR) have been associated with psychiatric disorders. However, the role of sex differences in the association between these markers and symptoms severity in schizophrenia remains largely unexplored. Given that sex differences in immune response may influence the relationship between systemic inflammation and clinical symptoms, understanding these differences is crucial. This study aims to evaluate sex differences in the associations of NPAR and NLR with the severity of positive and negative symptoms in patients with schizophrenia.
Methods: This study retrospectively included 108 male and 109 female patients with schizophrenia of Han Chinese ethnicity who were admitted to our hospital between January 2023 and March 2025. Clinical data were collected and analyzed retrospectively. Venous blood samples were obtained to determine the neutrophil percentage, absolute neutrophil count, absolute lymphocyte count and albumin level. Based on these parameters, NPAR and NLR were calculated. We further examined the relationships between these inflammatory markers and symptom severity, assessed via the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS).
Results: Male and female patients with schizophrenia exhibited differences in the severity of positive and negative symptoms. In male patients, NLR was positively associated with positive symptoms (B = 2.53; p < 0.001), while in female patients, NPAR was positively associated with negative symptoms (B = 2.58; p < 0.001). Furthermore, significant interaction effects were observed between sex and inflammatory markers (NPAR and NLR), which influenced the severity of both positive and negative symptoms.
Conclusions: Our study suggests that NPAR and NLR are associated with the severity of schizophrenia symptoms and vary by sex, highlighting the importance of considering sex differences in clinical practice.
期刊介绍：
BMC Psychiatry is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of psychiatric disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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