Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Eur Child Adolesc Psychiatry. 2024 Apr;33(4):1113-1120. doi: 10.1007/s00787-023-02237-1. Epub 2023 May 26.
Appetite hormone dysregulation may play a role in the pathomechanisms of bipolar disorder and chronic irritability. However, its association with executive dysfunction in adolescents with bipolar disorder and those with disruptive mood dysregulation disorder (DMDD) remains unclear. We included 20 adolescents with bipolar disorder, 20 adolescents with DMDD, and 47 healthy controls. Fasting serum levels of appetite hormones, including leptin, ghrelin, insulin, and adiponectin were examined. All participants completed the Wisconsin Card Sorting Test. Generalized linear models with adjustments for age, sex, body mass index, and clinical symptoms revealed that patients with DMDD had elevated fasting log-transformed insulin levels (p = .023) compared to the control group. Adolescents with DMDD performed worse in terms of the number of tries required to complete tasks associated with the first category (p = .035), and adolescents with bipolar disorder performed worse in terms of the number of categories completed (p = .035). A positive correlation was observed between log-transformed insulin levels and the number of tries required for the first category (β = 1.847, p = .032). Adolescents with DMDD, but not those with bipolar disorder, were more likely to exhibit appetite hormone dysregulation compared to healthy controls. Increased insulin levels were also related to executive dysfunction in these patients. Prospective studies should elucidate the temporal association between appetite hormone dysregulation, executive dysfunction, and emotional dysregulation.
食欲激素失调可能在双相情感障碍和慢性易激惹的发病机制中起作用。然而，其与双相情感障碍和破坏性心境失调障碍（DMDD）青少年的执行功能障碍之间的关系尚不清楚。我们纳入了 20 名双相情感障碍青少年、20 名 DMDD 青少年和 47 名健康对照者。检测了空腹血清食欲激素水平，包括瘦素、胃饥饿素、胰岛素和脂联素。所有参与者都完成了威斯康星卡片分类测试。经过年龄、性别、体重指数和临床症状调整的广义线性模型显示，与对照组相比，DMDD 患者的空腹 log 转化胰岛素水平升高（p=0.023）。DMDD 青少年在完成与第一类相关任务所需的尝试次数方面表现更差（p=0.035），而双相情感障碍青少年在完成的类别数量方面表现更差（p=0.035）。log 转化胰岛素水平与第一类所需的尝试次数之间存在正相关（β=1.847，p=0.032）。与健康对照组相比，DMDD 青少年而不是双相情感障碍青少年更可能出现食欲激素失调。这些患者的胰岛素水平升高也与执行功能障碍有关。前瞻性研究应阐明食欲激素失调、执行功能障碍和情绪失调之间的时间关联。
