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.

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.

METHOD: 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.