The Combined Predictive Value of LHR, NLR, and Platelet Count for First-Episode Schizophrenia

Objective To investigate the predictive value of the combination of lymphocyte-to-high-density lipoprotein ratio (LHR), neutrophil-to-lymphocyte ratio (NLR), and platelet count for patients with first-episode schizophrenia (FES). Methods A retrospective analysis was performed on 181 inpatients with FES admitted to Zhenjiang Mental Health Center between January 2015 and February 2025.189 participants, including staff members who underwent health check-ups at the same center from July 2024 to November 2025, were prospectively recruited as the healthy control group. Both groups underwent fasting blood cell analysis. Univariate analysis, binary Logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were employed to assess the predictive efficacy of the combined use of LHR, NLR, and platelet count for FES. Results Univariate analysis revealed that white blood cell count, neutrophil count, monocyte count, platelet count, high-density lipoprotein (HDL), neutrophil-to-high-density lipoprotein ratio (NHR), LHR, platelet-to-lymphocyte ratio (PLR), NLR, and systemic immune-inflammation index (SIRI) were statistically significant influencing factors associated with FES (all P  < 0.05) when comparing the FES group with the healthy control group. Binary Logistic regression analysis further identified platelet count, LHR, and NLR as independent predictors of FES relative to healthy controls (all P  < 0.05). The ROC curve analysis demonstrated that the combination of platelet count, LHR, and NLR yielded an area under the curve (AUC) of 0.863 for predicting FES. Conclusion The combination of, LHR, NLR and platelet count exhibits favorable predictive performance for FES, suggesting its potential as a biomarker for early identification of this population.