中性粒细胞与淋巴细胞比率与双相情感障碍之间的关系：一项系统综述和荟萃分析

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry Pub Date : 2025-04-01 DOI:10.1016/j.ejpsy.2025.100308

Ling Gui , Haiyan Yu , Yuxin Wei , Qichao Huang , Yuyao Liu , Yixiao Fu

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引用次数: 0

摘要

目的中性粒细胞与淋巴细胞比率（NLR）是炎症和应激的系统性指标，与双相情感障碍（BD）的相关性不一致。本荟萃分析将调查NLR在bd中的诊断、预后和治疗相关性。方法系统搜索PubMed、Embase、Web of Science、PsycINFO和Cochrane图书馆，使用关键词“双相情感障碍”、“中性粒细胞”、“淋巴细胞”和“比率”，获得31项研究，通过纽卡斯尔-渥太华量表进行评估。通过敏感性分析、亚组分析和发表偏倚评估来探索异质性来源和结果稳定性。结果bd组NLR值显著高于健康对照组（HCs）(标准化平均差值[SMD] = 0.51, 95%可信区间[CI]: 0.40 ~ 0.62, p <；0.0001;优势比[OR] = 1.87, 95% CI: 1.27-2.74, p = 0.001)。双相躁狂症（BDM）与HC的相关性最为显著(SMD = 0.67, 95% CI: 0.57-0.76, p <；0.0001, i²= 47%)。此外，BDM患者的NLR高于双相抑郁症（BDD）和双相心境发作（BDE）患者(SMD = 0.22, 95% CI: 0.07-0.38, p = 0.04, I²= 42%；SMD = 0.31, 95% CI: 0.15 ~ 0.48, p = 0.0001, I²= 60%)。BDD与HC之间无显著差异（SMD = 0.30, 95% CI: -0.05 ~ 0.64, p = 0.09）。亚组分析显示，年龄可能影响NLR与BD之间的关系。结论NLR值在BD中升高，尤其是在BDM中。然而，BDD和HC之间的差异没有统计学意义。NLR可能是识别和评估双相障碍的有效生物标志物。

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Association between neutrophil-to-lymphocyte ratio and bipolar disorder: A systematic review and meta-analysis

Objective

The neutrophil-to-lymphocyte ratio (NLR), a systemic indicator of inflammation and stress, shows inconsistent associations with bipolar disorder (BD). This meta-analysis will investigate NLR's diagnostic, prognostic, and therapeutic relevance in BD.

Methods

A systematic search across PubMed, Embase, Web of Science, PsycINFO, and Cochrane Library, using key terms ‘bipolar disorder’, ‘neutrophils’, ‘lymphocytes’, and ‘ratio’ yielded 31 studies assessed via Newcastle-Ottawa Scale. Sensitivity analyses, subgroup analyses and publication bias assessments were conducted to explore heterogeneity sources and result stability.

Results

The NLR values in BDs were significantly higher than those in healthy controls (HCs) (standardized mean difference [SMD] = 0.51, 95 % confidence interval [CI]: 0.40–0.62, p < 0.0001; odds ratio [OR] = 1.87, 95 % CI: 1.27–2.74, p = 0.001). The association was most pronounced between bipolar mania (BDM) and HC (SMD = 0.67, 95 % CI: 0.57–0.76, p < 0.0001, I² = 47 %). Additionally, BDM exhibited higher NLR than bipolar depression (BDD) and bipolar patients in euthymic episode (BDE) (SMD = 0.22, 95 % CI: 0.07–0.38, p = 0.04, I² = 42 %; SMD = 0.31, 95 % CI: 0.15–0.48, p = 0.0001, I² = 60 %, respectively). No significant differences were observed between BDD and HC (SMD = 0.30, 95 % CI: -0.05–0.64, p = 0.09). Subgroup analyses suggested that age may influence the association between NLR and BD.

Conclusion

An elevated NLR value is found in BD, particularly in BDM. However, the difference between BDD and HC is not statistically significant. NLR may be a potent biomarker for the identification and evaluation of BD.

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来源期刊

European Journal of Psychiatry PSYCHIATRY-

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

43 days

期刊介绍： The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.