Background: Several inflammatory hypotheses have been suggested to explain the etiopathogenesis of bipolar disorder (BD) and its different phases. Neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), and monocyte-to-lymphocyte (MLR) ratios have been proposed as potential peripheral biomarkers of mood episodes. Methods: We recruited 294 patients affected by BD, of which 143 were experiencing a (hypo)manic episode and 151 were in a depressive phase. A blood sample was drawn to perform a complete blood count. NLR, PLR, and MLR were subsequently calculated. A t-test was performed to evaluate differences in blood cell counts between depressed and (hypo)manic patients and a regression model was then computed. Results: Mean values of neutrophils, platelets, mean platelet volume, NLR, PLR, and MLR were significantly higher in (hypo)manic than depressed individuals. Logistic regression showed that PLR may represent an independent predictor of (hypo)mania. Conclusions: Altered inflammatory indexes, particularly PLR, may explain the onset and recurrence of (hypo)manic episodes in patients with BD. As inflammatory ratios represent economical and accessible markers of inflammation, further studies should be implemented to better elucidate their role as peripheral biomarkers of BD mood episodes.

中文翻译：

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双相情感障碍中的中性粒细胞与淋巴细胞，血小板与淋巴细胞和单核细胞与淋巴细胞之比

背景：已经提出了几种炎症假说来解释躁郁症（BD）及其不同阶段的病因。中性粒细胞与淋巴细胞（NLR），血小板与淋巴细胞（PLR）和单核细胞与淋巴细胞（MLR）的比率已被提议作为情绪发作的潜在外周生物标志物。方法：我们招募了294例受BD影响的患者，其中143例经历了（低）躁狂发作，而151例处于抑郁期。抽取血样进行全血细胞计数。随后计算NLR，PLR和MLR。一个牛逼-测试用于评估抑郁症患者和低躁狂患者之间血细胞计数的差异，然后计算回归模型。结果：（低）躁狂患者中的中性粒细胞，血小板，平均血小板体积，NLR，PLR和MLR的平均值显着高于抑郁者。Logistic回归表明，PLR可能代表躁狂症的一个独立预测因子。结论：炎症指数的改变，特别是PLR的改变，可以解释BD患者躁狂发作的发生和复发。由于炎症比率代表了经济的，可及的炎症标志物，因此应进行进一步的研究，以更好地阐明其作为BD情绪发作的外围生物标志物的作用。