title: Total and differential white blood cell counts, inflammatory markers, adipokines, and the metabolic syndrome in phase 1 of the clinical antipsychotic trials of intervention effectiveness study.
abstract: OBJECTIVE
  The metabolic syndrome is highly prevalent in patients with schizophrenia, and is associated with a state of chronic, low-grade inflammation. We investigated relationships between total and differential white blood cell (WBC) counts, inflammatory markers, adipokines and the metabolic syndrome in patients with schizophrenia.
  
  
  METHODS
  For subjects with available data from the baseline/screening visit of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial, WBC counts, inflammatory markers, and adipokines were investigated as predictors of the metabolic syndrome (and its components), using linear and binary logistic regression models, controlling for potential confounding effects of age, sex, race, smoking, fasting status, alcohol, and illicit drug use.
  
  
  RESULTS
  After controlling for potential confounders, blood CRP, interleukin-6, and leptin were significant predictors of all five individual components of the metabolic syndrome (as both continuous and categorical outcome measures). Furthermore, total WBC (OR=2.31, 95% CI 1.58-3.41, p<0.01) and lymphocyte (OR=2.51, 95% CI 1.75-3.60, p<0.01) counts were the strongest predictors of current metabolic syndrome.
  
  
  CONCLUSIONS
  Our findings provide the strongest evidence to date that measurement of total and differential WBC counts are germane to the clinical care of patients with schizophrenia, and that inflammation and adipokines are associated with metabolic disturbance in these patients.
authors.affiliation: Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States.
authors.forename: Neil
authors.initials: N
authors.lastname: Mori
authors.affiliation: Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: McEvoy
authors.affiliation: Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States. Electronic address: brmiller@gru.edu.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Miller
mesh_terms: D054392:Adipokines / Q000097:blood; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D062313:Databases, Pharmaceutical; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D012559:Schizophrenia / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D055105:Waist Circumference
chemical_list: D054392:Adipokines; D014150:Antipsychotic Agents
keywords: Adiponectin; C-reactive protein; Inflammation; Interleukin-6; Leptin; Metabolic syndrome; Schizophrenia; WBC