title: Total and differential white blood cell counts, high-sensitivity C-reactive protein, and cardiovascular risk in non-affective psychoses.
abstract: Schizophrenia is associated with increased cardiovascular disease morbidity and mortality. Schizophrenia is also associated with immune and inflammatory abnormalities, including aberrant blood levels of lymphocytes, cytokines and high-sensitivity C-reactive protein (hsCRP). The purpose of this study is to investigate the relationship between total and differential white blood cell (WBC) counts, hsCRP, and indices of cardiovascular disease risk in patients with schizophrenia and related non-affective psychoses. 108 inpatients and outpatients age 18-70 with non-affective psychoses and 44 controls participated in this cross-sectional study. Subjects had a fasting blood draw between 8 and 9am for glucose, lipids, total and differential WBC counts, and hsCRP. Vital signs and medical history were obtained. Patients with non-affective psychosis had significantly higher hsCRP levels than controls (p=0.04). In linear regression analyses, lymphocyte and monocyte counts were a significant predictor of the total-to-HDL cholesterol ratio in subjects with non-affective psychosis (p⩽0.02 for each). In binary logistic regression analyses, total WBC count was a significant predictor of an elevated 10-year estimated risk of myocardial infarction and cardiovascular disease in subjects with non-affective psychosis (p⩽0.03 for each). Associations between total and differential WBC counts and cardiovascular disease risk indices were stronger in males than females with non-affective psychosis. Our findings provide further evidence that measurement of total and differential WBC counts may be germane to the clinical care of patients with schizophrenia and related disorders, and support an association between inflammation and cardiovascular disease risk in these patients.
authors.affiliation: Department of Psychiatry and Health Behavior, Georgia Regents University, Augusta, GA, United States. Electronic address: brmiller@gru.edu.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Miller
authors.affiliation: Medical College of Georgia, Georgia Regents University, Augusta, GA, United States.
authors.forename: Prianka
authors.initials: P
authors.lastname: Kandhal
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.
authors.forename: Mark Hyman
authors.initials: MH
authors.lastname: Rapaport
authors.affiliation: Cancer Immunology, Inflammation and Tolerance Program, Georgia Regents University, Augusta, GA, United States.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mellor
authors.affiliation: Medical College of Georgia, Georgia Regents University, Augusta, GA, United States.
authors.forename: Peter
authors.initials: P
authors.lastname: Buckley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002097:C-Reactive Protein / Q000276:immunology*; D002318:Cardiovascular Diseases / Q000276:immunology / Q000378:metabolism; D016022:Case-Control Studies; D002784:Cholesterol / Q000378:metabolism; D008076:Cholesterol, HDL / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000276:immunology / Q000378:metabolism; D007958:Leukocyte Count; D016014:Linear Models; D016015:Logistic Models; D018655:Lymphocyte Count; D008297:Male; D024821:Metabolic Syndrome / Q000276:immunology / Q000378:metabolism; D008875:Middle Aged; D009000:Monocytes / Q000166:cytology; D009504:Neutrophils / Q000166:cytology; D011618:Psychotic Disorders / Q000276:immunology* / Q000378:metabolism; D012307:Risk Factors; D012559:Schizophrenia / Q000276:immunology* / Q000378:metabolism; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D002097:C-Reactive Protein; D002784:Cholesterol
keywords: C-reactive protein; Cardiovascular disease; Inflammation; Leukocytes; Lymphocytes; Monocytes; Neutrophils; Non-affective psychosis; Risk assessment; Schizophrenia