Blood Viscosity and Inflammation in First-Episode and Acute Exacerbations of Schizophrenia: A Case-Control Study with Healthy Controls

Yasin Hasan BALCIOĞLU, Hasan GÖKÇAY , Ümit Haluk YEŞİLKAYA , Mustafa Nuray NAMLI
2023 September - 60 (3)


• First-episode schizophrenia (FES) is closely linked with
decreased blood viscosity (BV).
• Initial schizophrenia episode shows higher
proinflammatory state than relapses.
• Blood viscosity is decreased in first episode and relapses
of schizophrenia.
• BV and inflammation link to cardiovascular risks in
psychoses via distinct pathways.


Introduction: Elevated proinflammatory status and alterations in
blood flow, both of which are associated with the pathophysiology of
schizophrenia, may be linked with an increased risk of cardiovascular
diseases. However, such a relationship at different acute stages of
schizophrenia has not been evaluated. We aimed to examine whether
blood viscosity and systemic inflammatory status varied between firstepisode
schizophrenia (FES) and acute exacerbations of schizophrenia.
Methods: Fifty-two patients with FES, 69 schizophrenia patients with
acute exacerbation (S-AE) and 56 healthy controls (HC) were included
in the study. Whole blood viscosity (WBV) was calculated according to
de Simone’s formula at low and high shear rates (LSR and HSR). Systemic
immune-inflammation index (SII) and systemic inflammatory response
index (SIRI) were calculated from hemogram screening data at admission.
Results: When adjusted for age, WBV at both LSR and HSR were
significantly decreased in both FES and S-AE groups compared to HCs.
Systemic inflammatory response index was significantly higher in FES
patients than in the S-AE and HC groups. Total cholesterol (TC) and WBV
at HSR were correlated in patients. Total cholesterol predicted WBV at
LSR in patients with FES whereas other independent variables including
age and SIRI did not.
Conclusion: Both first and subsequent episodes of schizophrenia
are associated with reduced blood viscosity. Increased inflammatory
status may not fully explain such a relationship. Extrapolation of
hemorheological characteristics in schizophrenia may help to stratify
cardiovascular risk and reflect the pathophysiological process in the
early and later stages of schizophrenia.
Keywords: Blood viscosity, cardiovascular risk, first-episode
schizophrenia, inflammation, schizophrenia