Department of Psychiatry, Bakırköy Mental Health Research and Training State Hospital, Istanbul, Turkey.
Department of Psychiatry, Şişli Hamidiye Etfal Research and Training State Hospital, Istanbul, Turkey.
Exp Physiol. 2017 Oct 1;102(10):1264-1268. doi: 10.1113/EP086562. Epub 2017 Sep 2.
What is the central question of this study? The main goal of this study was, for the first time, to investigate the role of the serum osmolarity in bipolar disorder manic episode. What is the main finding and its importance? Our results demonstrate a diminished serum osmolarity in manic episode compared with healthy control subjects. This finding supports the hypothesis of a fluid and electrolyte imbalance during acute episodes. Decreased serum osmolarity might be a reflection of a relative haemodilution in mania. Imbalance of water and electrolyte homeostasis has been suggested to be associated with acute episodes of bipolar disorder. In this study, we aimed to investigate, for the first time, the serum osmolarity in bipolar disorder manic episode. A total of 68 bipolar inpatients in manic episode and 60 age- and sex-matched healthy control subjects were included in the study. Serum osmolarity was calculated from sodium (Na ), glucose and blood urea nitrogen (BUN) according to following formula: (2 × Na ) + (BUN/2.8) + (glucose/18). The significance level was accepted as P < 0.05. The serum osmolarity of manic patients was 295.34 ± 4.90 mosmol/l and that of the control group was 298.46 ± 5.33 mosmol/l. The serum osmolarity of the manic group was significantly lower than that of control subjects (P < 0.001). When we compared the components of serum osmolarity, a statistically significant difference was also observed between groups in terms of glucose (85.85 ± 12.25 mg/dl for manic, 92.95 ± 20.77 mg/dl for control subjects, P = 0.019) and Na (140.73 ± 2.06 mmol/l for manic, 142.06 ± 2.48 mmol/l for control subjects, P = 0.001). For BUN concentrations, there was no statistically significant difference between manic (25.50 ± 9.85 mg/dl) and control (26.61 ± 6.64 mg/dl) groups (P = 0.461). Our results demonstrate a diminished serum osmolarity in manic episode compared with healthy control subjects. This finding supports the hypothesis of a fluid and electrolyte imbalance during acute episodes. Decreased serum osmolarity might be a reflection of a relative haemodilution in mania. However, exploration of the role of fluid and electrolyte homeostasis and mechanisms of related hormones may contribute to a better understanding of the aetiology of bipolar disorder.
本研究的核心问题是什么？本研究的主要目的是首次探讨血清渗透压在双相情感障碍躁狂发作中的作用。主要发现及其重要性是什么？我们的研究结果表明，与健康对照组相比，躁狂发作患者的血清渗透压降低。这一发现支持了在急性发作期间存在体液和电解质失衡的假说。血清渗透压降低可能反映了躁狂症时的相对血液稀释。水和电解质平衡的失衡已被认为与双相情感障碍的急性发作有关。在这项研究中，我们旨在首次探讨双相情感障碍躁狂发作患者的血清渗透压。共有 68 名双相情感障碍躁狂发作患者和 60 名年龄和性别匹配的健康对照组纳入研究。血清渗透压根据以下公式由钠（Na+）、葡萄糖和血尿素氮（BUN）计算得出：（2×Na+）+（BUN/2.8）+（葡萄糖/18）。显著性水平设定为 P<0.05。躁狂患者的血清渗透压为 295.34±4.90mosmol/l，对照组为 298.46±5.33mosmol/l。躁狂组的血清渗透压明显低于对照组（P<0.001）。当我们比较血清渗透压的组成成分时，两组之间在葡萄糖（躁狂患者 85.85±12.25mg/dl，对照组 92.95±20.77mg/dl，P=0.019）和 Na+（躁狂患者 140.73±2.06mmol/l，对照组 142.06±2.48mmol/l，P=0.001）方面也观察到了统计学上的显著差异。对于 BUN 浓度，躁狂组（25.50±9.85mg/dl）和对照组（26.61±6.64mg/dl）之间没有统计学差异（P=0.461）。我们的研究结果表明，与健康对照组相比，躁狂发作患者的血清渗透压降低。这一发现支持了在急性发作期间存在体液和电解质失衡的假说。血清渗透压降低可能反映了躁狂症时的相对血液稀释。然而，探讨体液和电解质平衡的作用以及相关激素的机制可能有助于更好地理解双相情感障碍的病因。
