Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan.
Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
BMC Psychiatry. 2024 Oct 11;24(1):679. doi: 10.1186/s12888-024-06105-3.
Cardiovascular disease (CVD) is the leading cause of excessive and premature mortality in patients with bipolar disorder (BD). Despite immune cells participating considerably in the pathogenesis of CVD, limited data are available regarding leukocyte phenotypes in patients with BD and CVD. This study aimed to evaluate associations between circulating leukocyte subset and CVD among patients with BD.
A total of 109 patients with BD-I and cardiologist-confirmed CVD diagnosis (i.e., case) were matched with 109 BD-I patients without CVD (i.e., control) according to the age (± 2 years), sex, and date of most recent psychiatric admission because of acute mood episode (± 2 years). Leukocyte subset data were retrieved from complete blood count tests performed on the next morning after the most recent acute psychiatric admission.
During the most recent acute psychiatric hospitalization, circulating monocyte counts in the case group were significantly higher than those in the age- and sex-matched controls (p = 0.020). In addition, monocyte-lymphocyte ratios (MLRs) in the case group were significantly higher than those in the control group (p = 0.032). Multiple logistic regression showed that together with serum levels of uric acid and manic symptoms, circulating monocyte counts (95% CI, OR: 1.01-1.05) and MLRs (95% CI, OR: 1.01-1.09) were significantly associated with CVD in patients with BD, respectively.
Monocyte activation in an acute manic episode may play a critical role in the pathogenesis of CVD among patients with BD. Future research is required to investigate markers of monocyte activation and indices of cardiovascular structure and function across the different mood states of BD.
心血管疾病（CVD）是双相障碍（BD）患者过度和过早死亡的主要原因。尽管免疫细胞在 CVD 的发病机制中起重要作用，但关于 BD 和 CVD 患者白细胞表型的数据有限。本研究旨在评估循环白细胞亚群与 BD 患者 CVD 之间的关联。
根据年龄（±2 岁）、性别和最近因急性情绪发作而入院的日期（±2 岁），共对 109 例 BD-I 患者和心脏病专家确诊的 CVD 诊断患者（即病例）与 109 例无 CVD 的 BD-I 患者（即对照）进行匹配。白细胞亚群数据从最近一次急性精神病住院后次日早晨进行的全血细胞计数检查中获得。
在最近一次急性精神病住院期间，病例组的循环单核细胞计数明显高于年龄和性别匹配的对照组（p=0.020）。此外，病例组的单核细胞-淋巴细胞比值（MLR）明显高于对照组（p=0.032）。多变量逻辑回归显示，除了尿酸水平和躁狂症状外，循环单核细胞计数（95%CI，OR：1.01-1.05）和 MLR（95%CI，OR：1.01-1.09）与 BD 患者的 CVD 显著相关。
急性躁狂发作时单核细胞的激活可能在 BD 患者 CVD 的发病机制中起关键作用。需要进一步研究来研究 BD 不同情绪状态下的单核细胞激活标志物和心血管结构与功能的指标。
