Turan Cetin, Kesebir Sermin, Süner Ozgür
Erenköy Mental and Neurological Disease Training and Research Hospital, Sinan Ercan C. N: 29 Kadıköy, İstanbul, Turkey.
Erenköy Mental and Neurological Disease Training and Research Hospital, Sinan Ercan C. N: 29 Kadıköy, İstanbul, Turkey.
J Affect Disord. 2014 Jul;163:76-80. doi: 10.1016/j.jad.2014.03.052. Epub 2014 Apr 12.
In bipolar patients, the rate of mortality from cardiovascular diseases is two-fold higher than that in other psychiatric disorders. The risk of cardiovascular diseases was found to be associated with some cellular adhesion molecules: Intracellular adhesion molecule (ICAM), vascular cell adhesion molecule (VCAM) and E-selectin. The aim of this study was to compare ICAM, VCAM and E-selectin levels at first manic episode and subsequent remission period, and to investigate the presence of a relationship between adhesion molecules levels and clinical and metabolic variables.
In line with this purpose, 50 patients diagnosed with mania according to DSM IV-TR criteria, who had their first episode were evaluated consecutively. The control group consisted of 50 healthy individuals without any history of psychiatric admission and treatment, matched with the manic patients in terms of age, gender, BMI and smoking status. For the confirmation of subsequent remission period (n=40), Young Mania Rating Scale and Hamilton Depression Rating Scale were used. In three groups plasma ICAM, VCAM and E-selectin, fasting blood glucose, total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride levels were measured and compared.
ICAM and VCAM levels were found to be higher in first manic episode than those in subsequent remission and healthy individuals. A weak correlation was found between ICAM levels and YMRS scores in manic patients. In first manic episode, a weak correlation was found between ICAM and total cholesterol and LDL cholesterol levels and a weak correlation was found between ICAM, VCAM and E-selectin levels and BMI.
In the present study, which is the first investigation of proinflammatory and prothrombotic state, which is defined as a risk for metabolic syndrome and cardiovascular disease, in bipolar disorder, ICAM and VCAM levels were found to be higher in first episode mania than those in subsequent remission and healthy individuals. As the study group included first episode mani cases, there was no effect of chronic psychotropic use. Probable risk of cardiovascular disease, reflected by increased ICAM and VCAM levels is already present in bipolar patients at the onset of the disease. In addition, ICAM and VCAM levels increasing in manic episode, return to normal in the subsequent remission period.
在双相情感障碍患者中，心血管疾病的死亡率比其他精神障碍患者高出两倍。研究发现心血管疾病的风险与一些细胞粘附分子有关：细胞间粘附分子（ICAM）、血管细胞粘附分子（VCAM）和E-选择素。本研究的目的是比较首次躁狂发作期和随后缓解期的ICAM、VCAM和E-选择素水平，并调查粘附分子水平与临床及代谢变量之间是否存在关联。
为此，根据DSM-IV-TR标准对50例首次发作且被诊断为躁狂症的患者进行了连续评估。对照组由50名无精神科住院和治疗史的健康个体组成，在年龄、性别、体重指数和吸烟状况方面与躁狂症患者相匹配。为确认随后的缓解期（n = 40），使用了青年躁狂评定量表和汉密尔顿抑郁评定量表。测量并比较了三组患者的血浆ICAM、VCAM和E-选择素、空腹血糖、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯水平。
发现首次躁狂发作期的ICAM和VCAM水平高于随后缓解期及健康个体。在躁狂症患者中，ICAM水平与YMRS评分之间存在弱相关性。在首次躁狂发作期，ICAM与总胆固醇和低密度脂蛋白胆固醇水平之间存在弱相关性，ICAM、VCAM和E-选择素水平与体重指数之间存在弱相关性。
在本研究中，这是对双相情感障碍中被定义为代谢综合征和心血管疾病风险的促炎和促血栓形成状态的首次调查，发现首次发作躁狂症患者的ICAM和VCAM水平高于随后缓解期及健康个体。由于研究组包括首次发作躁狂症病例，因此不存在长期使用精神药物的影响。双相情感障碍患者在疾病发作时就已存在由ICAM和VCAM水平升高所反映的心血管疾病潜在风险。此外，躁狂发作期升高的ICAM和VCAM水平在随后的缓解期恢复正常。
