Development of weighted factors of systemic inflammation based on hematological coefficients in patients with mental disorders

Background. In recent decades, there has been increasing recognition that mental disorders, from stress-related and affective disorders to schizophrenia spectrum disorders, are associated with a state of low-grade systemic inflammation. A large number of calculated hematological coefficients (CHCs) have been proposed for its assessment, since they are calculated on the basis of a standard complete blood count and are widely available as an adjunct to diagnostic proce-dures and for stratifying patients based on inflammatory load. However, to identify minimal deviations, simultaneous integration of several indicators may be necessary. The creation of weighted unifying measures can maximize the con-sideration of information on inflammatory activity and improve the reliability of its assessment. Objective. To develop and evaluate the stability of weighted factors of systemic inflammation based on a set of standard CHCs. Materials. The study involved 185 patients (70 men and 115 women aged 18-72 years) undergoing inpatient treatment at the Federal State Budgetary Institution “V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology” with diagnoses according to ICD-10: organic, including symptomatic, mental disorders (F0) ‒ n=7, schizophrenia, schizotypal and delusional disorders (F2) ‒ n=127, mood disorders [affective disorders] (F3) ‒ n=39, other mental disorders due to brain damage and dysfunction and to physical disease (F06) ‒ n=12. For each participant, 12 SIHC were calculated based on a complete blood count. Methods. The sample was randomized into training (n=130) and test (n=55) parts. To identify latent factors in the training set, principal component analysis (PCA) was used. Weighted indicators were formed based on factor loadings. To test the reproducibility of the PCA model, a repeated analysis was performed on the test set. The correlation coefficient of the factors was estimated by the Pearson correlation coefficient. Results. The In-nate Inflammatory Response factor combined the blood leukocyte shift index according to N.I. Yabluchansky (BLSI), the neutrophil-to-lymphocyte ratio (NLR), and Aggregate Index of Systemic Inflammation (AISI). The Adaptive Immu-noreactive Response factor included the immunoreactivity index (IRI) and the lymphocyte-to-monocyte ratio (LMR). The factor structure was reproduced on the test sample (explained variance 64.2%), statistically significant (r=0.95-0.99, p<0.001) correlations between the values of the training and test samples were found. Discussion. The identified factors are consistent with the concept of the dual nature of the immune response in the pathogenesis of mental disorders. The innate inflammatory response factor reflects the acute phase of inflammation and myeloid activity, while the adaptive immunoreactive response factor indicates a specific lymphocytic response associated with the chronic course of the in-flammatory process. The results confirm the clinical significance of complex hematological indices for patient stratifica-tion and also allow us to consider integrated hematological coefficients as potential markers of neuroinflammatory pro-cesses. Conclusion. The study proposes balanced measures for the combined assessment and study of systemic inflam-matory processes based on standard hematological coefficients. The analysis revealed a reproducible structure character-izing the two components of the immune response.