Mansur Rodrigo B, Rizzo Lucas B, Santos Camila M, Asevedo Elson, Cunha Graccielle R, Noto Mariane N, Pedrini Mariana, Zeni Maiara, Cordeiro Quirino, McIntyre Roger S, Brietzke Elisa
Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada.
Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Department of Psychiatry, Clinic for Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.
J Psychiatr Res. 2016 Mar;74:63-9. doi: 10.1016/j.jpsychires.2015.12.003. Epub 2015 Dec 12.
Replicated evidence indicates that individuals with BD are differentially affected by metabolic comorbidities and that its occurrence is a critical mediator and/or moderator of BD outcomes. This study aimed to explore the role of adipokines on bipolar disorder (BD) course and its relationship with metabolic comorbidities (i.e. type 2 diabetes mellitus, obesity). We measured plasma levels of adiponectin and leptin, as well as anthropometric and metabolic parameters of 59 patients with BD and 28 healthy volunteers. Our results showed that, in female participants, adiponectin was lower in individuals with BD, relative to healthy controls (p = 0.017). In the BD population, adiponectin levels were correlated with fasting glucose (r = -0.291, p = 0.047), fasting insulin (r = -0.332, p = 0.023), C-peptide (r = 0.040, p = 0.040), homeostatic model assessment-insulin resistance (r = -0.411, p = 0.004), HDL (r = 0.508, p < 0.001), VLDL (r = -0.395, p = 0.005) and triglycerides (r = -0.310, p = 0.030). After adjustment for age, gender and BMI, individuals with BD and low adiponectin levels (i.e. < 7.5 μg/ml), had a higher number of mood episodes (p < 0.001), lower number of psychiatric hospitalizations (p = 0.007), higher depressive symptoms (p < 0.001) and lower levels of functioning (p = 0.020). In conclusion, adiponectin levels, either directly or as a proxy of metabolic dysfunction, is independently associated with an unfavorable course of illness in BD.
重复的证据表明，双相情感障碍（BD）患者受代谢合并症的影响存在差异，且代谢合并症的发生是BD预后的关键调节因素和/或中介因素。本研究旨在探讨脂肪因子在双相情感障碍病程中的作用及其与代谢合并症（即2型糖尿病、肥胖症）的关系。我们测量了59例BD患者和28名健康志愿者的血浆脂联素和瘦素水平，以及人体测量和代谢参数。我们的结果显示，在女性参与者中，BD患者的脂联素水平低于健康对照组（p = 0.017）。在BD患者群体中，脂联素水平与空腹血糖（r = -0.291，p = 0.047）、空腹胰岛素（r = -0.332，p = 0.023）、C肽（r = 0.040，p = 0.040）、稳态模型评估-胰岛素抵抗（r = -0.411，p = 0.004）、高密度脂蛋白（HDL）（r = 0.508，p < 0.001）、极低密度脂蛋白（VLDL）（r = -0.395，p = 0.005）和甘油三酯（r = -0.310，p = 0.030）相关。在调整年龄、性别和体重指数（BMI）后，BD患者且脂联素水平较低（即< 7.5 μg/ml）的患者，情绪发作次数更多（p < 0.001），精神科住院次数更少（p = 0.007），抑郁症状更严重（p < 0.001），功能水平更低（p = 0.020）。总之，脂联素水平，无论是直接还是作为代谢功能障碍的指标，都与BD的不良病程独立相关。
