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    Relationship between the Visceral Adiposity Index and neutrophil/lymphocyte ratio in patients with bipolar disorder
    (Edizioni Minerva Medica, 2021) Sahin, Sengul K.; Simsek, Lutfiye; Aksoy, Perihan G.; Elboga, Gulcin; Altindag, Abdurrahman; Keskek, Sakir O.
    BACKGROUND: Metabolic syndrome, visceral obesity, and increased inflammation are common in patient with bipolar disorder. However, the relationship between inflammation and obesity in patients with bipolar disorder is not clear. Obesity is associated with increased inflammation. Visceral adipose tissue - the fat tissue that secretes cytokines and adipokines - plays a more important role than the total fat content and Body Mass Index (BMI) in obesity. In this study, we aimed to determine: 1) the Visceral Adiposity Index (VAI) to assess the visceral adipose tissue in patients in remission with bipolar disorder, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) to assess subclinical inflammation; 2) the incidence of visceral adipose dysfunction (VAD) in the patients based on VAI cut-off values; and 3) the relationship between inflammation (based on NLR and PLR) and VAI in patients with bipolar disorder. METHODS: Seventy-eight patients with euthymic bipolar disorder (patient group) and 78 healthy individuals (control group) were included in this study. Anthropometric measurements (waist circumference, height, weight, and BMI), triglyceride and high-density lipoprotein (HDL) levels of the participants were recorded. Moreover, VAI, NLR, and PLR were calculated. RESULTS: VAI was significantly higher in the patient group than in the control group. According to the age-adjusted VAI cut-off values for metabolic syndrome risk, 40 patients (51%) (VAI=4.58+2.17) had VAD. There was no significant difference in NLR between the patient and control group (P=0.578), while PLR was significantly lower in the patient group than in the control group (P<0.001). Moreover, there was no significant difference in NLR (P=0.15) and PLR (P=0.35) between patients with and without VAD. CONCLUSIONS: NLR and PLR may be indicative of the absence of subclinical inflammation during the euthymic period of bipolar disorder. The absence of a relationship between VAI and NLR/PLR may support the presence of VAD in patients in remission, irrespective of inflammation.