双相障碍患者骨代谢生化指标的研究：一项针对初诊、未用药患者的横断面研究。

Research on biochemical indexes of bone metabolism in bipolar disorder: A cross-sectional study with newly diagnosed, drug-naïve patients.

机构信息

National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.

Department of Ultrasound Dltrasound Diagnosis, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.

出版信息

J Psychiatr Res. 2022 Jul;151:197-204. doi: 10.1016/j.jpsychires.2022.04.015. Epub 2022 Apr 25.

DOI:10.1016/j.jpsychires.2022.04.015

PMID:35500447

Abstract

BACKGROUND

In recent years, the metabolic abnormalities associated with bipolar disorder (BD) have attracted people's attention. However, clinical studies on bone metabolism in individuals with BD are unavailable. This study was designed to assess biochemical indexes of bone metabolism and related influencing factors.

METHODS

We measured bone turnover markers (BTMs), including procollagen Ⅰ N-terminal propeptide (PⅠNP), osteocalcin (OC) and C-terminal cross-linking telopeptide of type I collagen (CTX-I), and index of calcium and phosphorus metabolism in 100 drug-naïve individuals with BD (DSM-5) and 91 healthy volunteers. Besides, sociodemographic and clinical assessment were collected. Between-group comparisons and within subgroup analysis were performed.

RESULTS

The PⅠNP (t = 3.715, p < 0.001), OC (t = 2.117, p = 0.036), parathyroid hormone (PTH, t = 3.877, p < 0.001), vitamin D (t = 2.065, p = 0.041), insulin (t = 4.208, p < 0.001) and insulin resistance (t = 2.888, p = 0.004) levels in the drug-naive BD group was significantly higher than those in the healthy control (HC) group. The level of calcium (t = -2.124, p = 0.035) in the drug-naive BD group was significantly lower than that of the HC group. But OC and vitamin D loses statistical significance after Bonferroni correction. However, there was no significant difference in the CTX-I level between the two groups. There are gender differences in the level of BMTs in individuals with BD, but this phenomenon was not found in the HC subgroup. It is shown that diagnosed BD, gender, age and BMI may affect the PINP levels through multiple linear regression analysis.

CONCLUSION

The biochemical indexes of bone metabolism in drug-naive individuals with BD were more active than that of the healthy controls in a sample from the Chinese Han nationality. The finding provides new evidence for our understanding of bone metabolism in individuals with BD.

摘要

背景

近年来，与双相障碍（BD）相关的代谢异常引起了人们的关注。然而，目前尚缺乏关于 BD 患者骨代谢的临床研究。本研究旨在评估骨代谢的生化指标及相关影响因素。

方法

我们测量了 100 例未经药物治疗的 BD 患者（DSM-5）和 91 名健康志愿者的骨转换标志物（BTMs），包括Ⅰ型前胶原 N 端前肽（PⅠNP）、骨钙素（OC）和Ⅰ型胶原 C 端交联肽（CTX-I），以及钙磷代谢指标。此外，还收集了社会人口学和临床评估资料。对组间比较和亚组内分析进行了分析。

结果

与健康对照组相比，未经药物治疗的 BD 组的 PⅠNP（t=3.715，p<0.001）、OC（t=2.117，p=0.036）、甲状旁腺激素（PTH，t=3.877，p<0.001）、维生素 D（t=2.065，p=0.041）、胰岛素（t=4.208，p<0.001）和胰岛素抵抗（t=2.888，p=0.004）水平显著升高。未经药物治疗的 BD 组的钙水平（t=-2.124，p=0.035）显著低于健康对照组。但经 Bonferroni 校正后，OC 和维生素 D 的差异无统计学意义。然而，两组之间 CTX-I 水平无显著差异。BD 患者的 BTM 水平存在性别差异，但在健康对照组亚组中未发现这种现象。多元线性回归分析显示，确诊 BD、性别、年龄和 BMI 可能通过多种途径影响 PINP 水平。