McIntyre Roger S, Nguyen Ha T, Soczynska Joanna K, Lourenco Maria Teresa C, Woldeyohannes Hanna O, Konarski Jakub Z
Department of Psychiatry and Pharmacology, University of Toronto, ON, Canada.
Dialogues Clin Neurosci. 2008;10(2):203-13. doi: 10.31887/DCNS.2008.10.2/rsmcintyre.
It is well established that individuals with bipolar disorder are differentially affected by substance-related as well as medical disorders (ie, cardiometabolic disorders, respiratory disorders, neurological disorders, and infectious diseases). Emerging evidence indicates that some comorbid conditions (eg, diabetes mellitus) in bipolar individuals may be subserved by overlapping neurobiological networks. Disturbances in glucocorticoid/insulin signaling and immunoinflammatory effector systems are points of pathophysiological commonality between bipolar disorder and "stress-sensitive" medical disorders. Subphenotyping bipolar disorder as a function of comorbidity and temporality of onset may provide an opportunity for refining disease pathophysiological models and developing innovative disease-modifying therapies.
众所周知，双相情感障碍患者受到物质相关疾病以及躯体疾病（即心脏代谢疾病、呼吸系统疾病、神经系统疾病和传染病）的影响存在差异。新出现的证据表明，双相情感障碍患者的一些共病状况（如糖尿病）可能由重叠的神经生物学网络所介导。糖皮质激素/胰岛素信号传导和免疫炎症效应系统的紊乱是双相情感障碍与“应激敏感”躯体疾病之间病理生理学的共同之处。根据共病情况和发病时间对双相情感障碍进行亚分型，可能为完善疾病病理生理模型和开发创新的疾病修正疗法提供机会。
