A retrospective comparative study: Novel diagnostical markers of inflammation and cardiovascular risk of bipolar disorder and manic episode

Abstract

Aim: The pan-immune inflammation value (PIV), inflammation burden index (IBI), atherogenic index of plasma (AIP), neutrophil/ high-density lipoprotein (HDL) ratio (NHR), lymphocyte/HDL ratio (LHR), monocyte/HDL ratio (MHR), and platelet/HDL ratio (PHR) have recently been investigated as novel inflammatory and cardiovascular markers. Our study aimed to compare these indices with the manic episode and remission period of bipolar disorder (BD) patients with controls and to investigate the relationship between these indices and the clinical characteristics of the patients and whether these indices can be biomarkers for the disease and manic episode.

Materials and Methods: In this retrospective observational study, we collected data from 66 patients in remission, 67 patients with manic episodes, and 70 controls. Differences in PIV, IBI, AIP, NHR, MHR, LHR, and PHR were investigated.  We performed logistic regression analysis to identify predictors of manic episodes, and the diagnostic potential of these parameters was evaluated using ROC curves.

Results: Significant differences were found between the three groups in NHR (p<0.001), MHR (p=0.001), LHR (p=0.013), AIP (p<0.001), PIV (p<0.001) and IBI (p<0.001). IBI (p<0.001) and PIV (p:0.001) were found to be positive predictors of manic episodes. ROC analysis showed that IBI (p<0.001) and PIV (p<0.001) can be used to define a manic episode; IBI (p<0.001), PIV (p<0.001) and AIP (p:0.001) can be used to define BD.

Conclusion: Given the inflammatory and atherogenic processes involved in the etiopathogenesis, the novel biomarkers PIV, IBI, and AIP may be promising therapeutic targets for BD. In addition, these biomarkers can be used as easily accessible, inexpensive clinical tools to predict illness and severity of manic episodes.