Pradeep Johnson Ruben, Acharya Mithun Sadashiva, Radhakrishnan Rajiv, Srinivasan Krishnamachari
Department of Psychiatry, St John's Medical College Hospital, Bengaluru, India.
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
Prim Care Companion CNS Disord. 2019 Jul 25;21(4):19m02448. doi: 10.4088/PCC.19m02448.
The evidence linking schizophrenia and total and unconjugated bilirubin is primarily from retrospective studies. To overcome this limitation, we conducted a prospective study of total and unconjugated bilirubin levels of patients diagnosed with schizophrenia or bipolar affective disorder.
Serum total and unconjugated bilirubin levels were compared between patients diagnosed with schizophrenia (n = 50) and bipolar affective disorder (n = 43) (ICD-10 criteria) admitted to an inpatient psychiatric unit of a tertiary hospital in India. The study was conducted between October 2013 and July 2015.
The median serum levels (mg/dL) of total and unconjugated bilirubin were significantly higher (P = .027 and P = .004, respectively) among patients with schizophrenia compared to those with bipolar affective disorder. Analysis of covariance revealed that unconjugated bilirubin was significantly higher (P = .029) in patients with schizophrenia compared to those with bipolar affective disorder, even after controlling for the effects of age, sex, and medications.
In this prospective study, serum levels of unconjugated bilirubin were significantly higher in patients with schizophrenia compared to patients with bipolar affective disorder. The findings suggest that serum unconjugated bilirubin could be a potential marker for schizophrenia. However, the results need to be replicated in a larger sample including patients living in the community.
将精神分裂症与总胆红素及非结合胆红素联系起来的证据主要来自回顾性研究。为克服这一局限性，我们对诊断为精神分裂症或双相情感障碍的患者的总胆红素及非结合胆红素水平进行了一项前瞻性研究。
比较了印度一家三级医院住院精神科病房收治的诊断为精神分裂症（n = 50）和双相情感障碍（n = 43）（依据国际疾病分类第十版标准）的患者的血清总胆红素及非结合胆红素水平。该研究于2013年10月至2015年7月进行。
与双相情感障碍患者相比，精神分裂症患者的血清总胆红素及非结合胆红素的中位数水平（mg/dL）显著更高（分别为P = 0.027和P = 0.004）。协方差分析显示，即使在控制了年龄、性别和药物的影响后，精神分裂症患者的非结合胆红素仍显著高于双相情感障碍患者（P = 0.029）。
在这项前瞻性研究中，与双相情感障碍患者相比，精神分裂症患者的血清非结合胆红素水平显著更高。研究结果表明血清非结合胆红素可能是精神分裂症的一个潜在标志物。然而，这些结果需要在包括社区患者在内的更大样本中进行重复验证。
