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Background <p>Patients with acute schizophrenia (SCZ) exhibit elevated composite inflammatory markers. Although age at onset is known to be associated with clinical progression and treatment response, its relationship with systemic inflammatory indices during acute episodes remains unclear. This study aimed to investigate the association between age at onset and commonly used composite inflammatory markers in patients with acute SCZ, with stratification by age group and gender.</p> Methods <p>A total of 443 patients with acute SCZ (205 males, 238 females; mean age 41.37 ± 12.14 years) and 366 healthy controls (103 males, 263 females; mean age 49.43 ± 16.46 years) were enrolled. Demographic data and blood parameters were collected, and composite inflammatory markers were calculated, including the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune inflammation value (PIV).</p> Results <p>Among male patients aged 20–39 years, those with early-onset (EO) SCZ had significantly lower PLR, SII, and PIV levels than non-EO patients, and EO was identified as an independent influencing factor for PLR (<i>P</i> = 0.02, B = − 26.10, β = −0.25, 95% CI −48.34 to − 3.87). In female patients of the same age group, no significant differences in composite inflammatory markers were observed between EO and non-EO groups (all <i>P</i> &gt; 0.05). Among male patients aged 40–59 years, NLR levels differed significantly across the EO, intermediate-onset (IO), and late-onset (LO) subgroups (<i>P</i> &lt; 0.05); however, age at onset was not an independent influencing factor for NLR (<i>P</i> &gt; 0.05). In female patients of this age group, no significant differences in composite inflammatory markers were found among the three onset-age subgroups (all <i>P</i> &gt; 0.05).</p> Conclusion <p>The association between age at onset and composite inflammatory markers in patients with acute SCZ varies significantly across different age groups and gender, highlighting the importance of stratified analyses in future studies.</p>

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Heterogeneity of composite inflammatory markers in acute schizophrenia: stratification by age, gender, and age at onset

  • 期刊论文

  • 发表日期：

    2026年5月19日

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  • Yali Zheng,
  • Haijie Yuan,
  • Huangling Gao,
  • Jianping Jiang,
  • Quanfeng Zhu

摘要

Background

Patients with acute schizophrenia (SCZ) exhibit elevated composite inflammatory markers. Although age at onset is known to be associated with clinical progression and treatment response, its relationship with systemic inflammatory indices during acute episodes remains unclear. This study aimed to investigate the association between age at onset and commonly used composite inflammatory markers in patients with acute SCZ, with stratification by age group and gender.

Methods

A total of 443 patients with acute SCZ (205 males, 238 females; mean age 41.37 ± 12.14 years) and 366 healthy controls (103 males, 263 females; mean age 49.43 ± 16.46 years) were enrolled. Demographic data and blood parameters were collected, and composite inflammatory markers were calculated, including the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune inflammation value (PIV).

Results

Among male patients aged 20–39 years, those with early-onset (EO) SCZ had significantly lower PLR, SII, and PIV levels than non-EO patients, and EO was identified as an independent influencing factor for PLR (P = 0.02, B = − 26.10, β = −0.25, 95% CI −48.34 to − 3.87). In female patients of the same age group, no significant differences in composite inflammatory markers were observed between EO and non-EO groups (all P > 0.05). Among male patients aged 40–59 years, NLR levels differed significantly across the EO, intermediate-onset (IO), and late-onset (LO) subgroups (P < 0.05); however, age at onset was not an independent influencing factor for NLR (P > 0.05). In female patients of this age group, no significant differences in composite inflammatory markers were found among the three onset-age subgroups (all P > 0.05).

Conclusion

The association between age at onset and composite inflammatory markers in patients with acute SCZ varies significantly across different age groups and gender, highlighting the importance of stratified analyses in future studies.