Comparison of Monocyte/High-Density Lipoprotein Cholesterol Ratio Between Patients with First-Episode and Chronic Schizophrenia

Q: What are the key findings of this study?

Schizophrenia was associated with significantly higher monocyte-to-HDL cholesterol ratios in both first-episode (17.5 ± 4.6) and chronic (19.4 ± 6.6) patients compared to healthy controls (10.9 ± 2.2).

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Schizophrenia (n=143). Intervention: Schizophrenia vs. Healthy controls. Primary outcome: Monocyte-to-high-density lipoprotein ratio (MHR) (p=<0.001).

Q: What does this research mean for the field?

Patients with both first-episode and chronic schizophrenia exhibit significantly higher monocyte-to-HDL cholesterol ratios compared to healthy controls, with no significant difference between the two illness stages. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Q: What question did this study set out to answer?

To evaluate the monocyte/high-density lipoprotein cholesterol ratio as a systemic inflammatory marker in patients with first-episode schizophrenia and chronic schizophrenia compared with healthy controls.

Yusuf Çokünlü; Ali Metehan Çalışkan; Kamile Yücel

doi:10.30733/std.2025.01930

September 14, 2026Selçuk Tıp DergisiOpen Access

Comparison of Monocyte/High-Density Lipoprotein Cholesterol Ratio Between Patients with First-Episode and Chronic Schizophrenia

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Key result

Schizophrenia linked to markedly higher monocyte-to-HDL ratios in both first-episode and chronic patients versus controls.

P<0.001
n=143

Key Points

To evaluate the monocyte/high-density lipoprotein cholesterol ratio as a systemic inflammatory marker in patients with first-episode schizophrenia and chronic schizophrenia compared with healthy controls.
Retrospective review of 143 male participants, comprising 38 patients with first-episode schizophrenia (FES), 65 patients with chronic schizophrenia (CS), and 40 healthy controls (HC).
Calculated MHR by dividing monocyte count (10³/µL) by HDL-C level (mg/dL) obtained from recorded routine laboratory blood tests.
Evaluated group differences using one-way ANOVA, ANCOVA adjusted for age, post hoc Tukey tests, and Pearson correlation analyses with clinical variables.
Mean MHR levels were significantly higher in both FES (17.5 ± 4.6) and CS (19.4 ± 6.6) groups compared to HC (10.9 ± 2.2; F = 34.02, p < 0.001), remaining significant after age adjustment (p < 0.001).
No statistically significant difference in MHR was observed between FES and CS patients (mean difference 1.9; post hoc p > 0.05).
Compared with controls, both FES and CS groups exhibited significantly higher monocyte counts (0.7 ± 0.1 vs 0.7 ± 0.1 vs 0.5 ± 0.1 × 10³/µL; F = 17.82, p < 0.001) and lower HDL-C levels (41.7 ± 9.4 vs 38.3 ± 7.7 vs 50.8 ± 6.5 mg/dL; F = 31.19, p < 0.001).

Study Design

Type

Observational (n=143)

Multicenter

No

Structured PICO

P

Population

143 male participants, including 38 with first-episode schizophrenia, 65 with chronic schizophrenia, and 40 healthy controls, evaluated retrospectively for inflammatory markers.

C

Comparator

Healthy male individuals matched for age and smoking status, with no history of psychiatric or systemic illnesses.

O

Outcome

Monocyte-to-high-density lipoprotein cholesterol ratio (MHR)surrogate

Main Result

p-value: p=<0.001

The monocyte-to-HDL cholesterol ratio is significantly elevated in patients with first-episode and chronic schizophrenia compared to healthy controls, supporting its potential utility as a biomarker for inflammatory activation in this population.

Limitations

Retrospective design may introduce potential selection bias.
Healthy control group was recruited from individuals attending routine health examinations, introducing potential health-seeking bias.
Potential confounding factors such as physical activity, dietary habits, and socioeconomic status were not systematically recorded.
Included only male participants, limiting generalizability to female patients.
Absence of standardized psychopathology severity scales.
Retrospective design
Only male participants included
Lack of direct inflammatory mediator measurements
No scale for episode severity
Age differences between groups

Implication

Should not yet change practice; leaves open MHR as a potential inflammatory biomarker in schizophrenia.

Abstract

Amaç: Literatürde ilk atak (İEŞ) ve kronik (KŞ) şizofreni hastalarında yeni bir inflamasyon belirteci olduğu gösterilen monosit/yüksek yoğunluklu lipoprotein oranını (MHO) araştırmaktır. Gereç ve Yöntemler: Çalışmaya 38 IEŞ hastası, 65 KŞ hastası ve 40 sağlıklı kontrol (SK) dahil edildi. Kan parametrelerinin retrospektif incelemeleri, veri tabanı ve ilgili kayıtlar kullanılarak gerçekleştirilmiştir. MHO'yu belirlemek için monosit sayısı HDL-K düzeyine bölünmüştür. Bulgular: Monosit düzeyleri önemli ölçüde daha yüksekken, trombosit ve HDL-K düzeyleri hem İEŞ hem de KŞ gruplarında sağlıklı kontrollere kıyasla önemli ölçüde daha düşüktü. MHO düzeyleri hem İEŞ hem de KŞ hastalarında sağlıklı kontrollere kıyasla önemli ölçüde daha yüksekti, ancak iki gurup arasında istatistiksel olarak anlamlı bir fark tespit edilmedi. Korelasyon analizleri, MHO ile belirli klinik değişkenler arasında birkaç mütevazı ilişki olduğunu gösterdi, ancak hastalık süresi veya hastaneye yatışla ilgili değişkenlerle tutarlı bir ilişki gözlemlenmedi. Sonuç: Bu çalışmanın bulguları, şizofreni hastalarında MHO'nun önemli ölçüde arttığını göstermekte ve şizofreninin inflamatuar aktivasyonla ilişkili olduğu görüşünü desteklemektedir. Bu sonuçlar, MHO'nun şizofrenide gözlenen inflamatuar değişikliklerle ilişkili olabileceğini düşündürmektedir.

Discussion

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Cite This Study

Çokünlü et al. (2026) conducted an observational in Schizophrenia (n=143). Schizophrenia vs. Healthy controls was evaluated on Monocyte-to-high-density lipoprotein ratio (MHR) (p=<0.001). Schizophrenia was associated with significantly higher monocyte-to-HDL cholesterol ratios in both first-episode (17.5 ± 4.6) and chronic (19.4 ± 6.6) patients compared to healthy controls (10.9 ± 2.2).

synapsesocial.com/papers/6aabb68c5f706d05830e50c9 https://doi.org/10.30733/std.2025.01930

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Comparison of Monocyte/High-Density Lipoprotein Cholesterol Ratio Between Patients with First-Episode and Chronic Schizophrenia

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Comparison of Monocyte/High-Density Lipoprotein Cholesterol Ratio Between Patients with First-Episode and Chronic Schizophrenia

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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