Kennedy Kody G, Islam Alvi H, Grigorian Anahit, Fiksenbaum Lisa, Mitchell Rachel H B, McCrindle Brian W, MacIntosh Bradley J, Goldstein Benjamin I
Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Pharmacology, University of Toronto, Toronto, ON, Canada.
Acta Psychiatr Scand. 2021 Jun;143(6):513-525. doi: 10.1111/acps.13278. Epub 2021 Feb 16.
Abnormal blood lipid levels are common in bipolar disorder (BD) and correlate with mood symptoms and neurocognition. However, studies have not examined the lipid-brain structure association in BD or youth.
This study examined low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), triglycerides, and total cholesterol (TC) levels in relation to brain structure utilizing T1-weighted images, among participants ages 13-20 with BD (n = 55) and healthy controls (HC; n = 47). General linear models investigated group differences in the association of lipids with anterior cingulate cortex (ACC), hippocampus, and inferior parietal lobe structure, controlling for age, sex, body mass index, and intracranial volume. For significant associations, post hoc within-group analyses were undertaken. Exploratory vertex-wise analyses further investigated group differences in the lipid-brain structure association.
There were significant group differences in the association of LDL-C (β = -0.29 p = 0.001), and TC (β = -0.21 p = 0.016), with hippocampal volume, and triglycerides with ACC volume (β = -0.25 p = 0.01) and area (β = -0.26 p = 0.004). Elevated lipids were associated with smaller brain structure to a significantly greater extent in BD vs HC. Post hoc analyses revealed that elevated LDL-C (β = -0.27 p = 0.007) and reduced HDL-C (β = 0.24 p = 0.01) were associated with smaller hippocampal volume in the BD group. Exclusion of BD second-generation antipsychotic users did not alter these results. Vertex-wise analyses further showed that elevated lipids were associated with smaller brain structure to a significantly greater extent in BD vs HC, across the cortex.
Elevated lipids are associated with smaller brain structure in BD. Research evaluating lipid-brain structure associations prospectively and whether lipid optimization has salutary effects on brain structure is necessary.
血脂异常在双相情感障碍（BD）中很常见，且与情绪症状和神经认知相关。然而，尚未有研究探讨BD或青少年中血脂与脑结构的关联。
本研究利用T1加权图像，在13至20岁的BD患者（n = 55）和健康对照者（HC；n = 47）中，检测低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）、甘油三酯和总胆固醇（TC）水平与脑结构的关系。一般线性模型研究了脂质与前扣带回皮质（ACC）、海马体和顶下叶结构关联中的组间差异，并对年龄、性别、体重指数和颅内体积进行了控制。对于显著关联，进行了事后组内分析。探索性逐顶点分析进一步研究了脂质与脑结构关联中的组间差异。
LDL-C（β = -0.29，p = 0.001）、TC（β = -0.21，p = 0.016）与海马体体积的关联，以及甘油三酯与ACC体积（β = -0.25，p = 0.01）和面积（β = -0.26，p = 0.004）的关联存在显著组间差异。与HC相比，BD患者中脂质升高与脑结构较小的关联程度显著更高。事后分析显示，BD组中LDL-C升高（β = -0.27，p = 0.007）和HDL-C降低（β = 0.24，p = 0.01）与较小的海马体体积相关。排除使用第二代抗精神病药物的BD患者并未改变这些结果。逐顶点分析进一步表明，与HC相比，BD患者中脂质升高与整个皮质脑结构较小的关联程度显著更高。
BD患者中脂质升高与脑结构较小相关。有必要前瞻性地研究脂质与脑结构的关联，以及脂质优化是否对脑结构有有益影响。
