Effects of metabolic syndrome and obesity on suicidality in individuals with bipolar disorder

Stenzel, Christoph; Dalkner, Nina; Unterrainer, ­Human-Friedrich; Birner, Armin; Bengesser, Susanne; Fellendorf, Frederike T.; Fink, Andréas; Fleischmann, Eva; Lenger, Melanie; Maget, Alexander; Platzer, Martina; Queissner, Robert; Schönthaler, Elena; Tmava-Berisha, Adelina; Reininghaus, Eva

doi:10.1016/j.jad.2022.05.062

Cited by 5 publications

(3 citation statements)

References 55 publications

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“…Several additional inflammatory factors, such as specific chemokines (MCP-1, fractalkine), glial factors (GFAP, S100B), or lipid-derived mediators such as endocannabinoids, and neurodegeneration-related molecules such as neurofilament light chain, neurogranin and β-amyloid peptide isoforms (Aβ42, Aβ40, Aβ38) and their fragments could be promising biomarkers in patients with BD in relation to prospective clinical outcomes, such as those of neuronal injury, cognitive deficits and risk of dementia [ 93 ]. Recent studies have also evaluated non-coding RNA expression, sexual hormones, oxidative stress (uric acid, bilirubin, albumin) and metabolic biomarkers (metabolic syndrome, overweight/obesity, thyroid and liver function) in predicting BD and suicidality in individuals with bipolar disorder [ 94 , 95 , 96 , 97 , 98 ]. In addition, big data of cerebral blood flow and structural and functional connectivity using magnetic resonance imaging are becoming useful tools for actual practice in psychiatry [ 99 , 100 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Value of Inflammatory and Neurotrophic Biomarkers in Bipolar Disorder: A Systematic Review and Meta-Analysis

et al. 2022

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Bipolar disorder (BD) is a multifactorial chronic psychiatric disease highly defined by genetic, clinical, environmental and social risk factors. The present systematic review and meta-analysis aimed to examine the relationship between inflammatory and neurotrophic factors and clinical, social and environmental factors involved in the development and the characterization of BD. Web of Science, PubMed, PsycINFO, Scopus and Science Direct were searched by two independent reviewers. The systematic review was registered in PROSPERO (CRD42020180626). A total of 51 studies with 4547 patients with a diagnosis of BD were selected for systematic review. Among them, 18 articles were included for meta-analysis. The study found some evidence of associations between BDNF and/or inflammatory factors and different stressors and functional and cognitive impairment, but limitations prevented firm conclusions. The main finding of the meta-analysis was a negative correlation between circulating levels of BDNF and depression severity score (standardized mean difference = −0.22, Confidence Interval 95% = −0.38, −0.05, p = 0.01). Evidence indicates that BDNF has a role in the depressive component of BD. However, the poor consistency found for other inflammatory mediators clearly indicates that highly controlled studies are needed to identity precise biomarkers of this disorder.

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Section: Discussionmentioning

confidence: 99%

Clinical Value of Inflammatory and Neurotrophic Biomarkers in Bipolar Disorder: A Systematic Review and Meta-Analysis

et al. 2022

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“…Com relação ao TB em indivíduos obesos, a fluência verbal mostra-se mais prejudicada, e a frequência de episódios depressivos e maníacos é mais acentuada. Além disso, portadores de TB significativamente acima do peso apresentam maior risco de ideação e comportamento suicida (STENZEL et al, 2022).…”

Section: O Binômio Obesidade-tbunclassified

Transtorno bipolar e obesidade: Correlações fisiopatológicas

Bueno¹,

Centa²,

Assolini³

et al. 2023

Ciências Da Saúde E Suas Descobertas Científicas

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A obesidade, doença metabólica de origem multifatorial, é um problema de saúde pública que, a longo prazo, pode agravar patologias secundárias ao adoecimento. O Transtorno Bipolar (TB) é um transtorno crônico que causa extremas mudanças de humor, cujas manifestações são verificadas em estados de mania, hipomania, depressão e estados mistos. Evidências recentes sugerem que a obesidade e o TB compartilham um vínculo comum ao afetar regiões subcorticais e estruturas do sistema límbico, já que as anormalidades estruturais do transtorno são mais graves em pacientes com Índice de Massa Corporal (IMC) elevado, fator que prejudica o domínio cognitivo e a fluência verbal. Exames comparativos de neuroimagem revelam alterações no corpo caloso, na substância branca do lobo frontal e na substância cinzenta das áreas corticais cingulada e temporal, além de reduções volumétricas da amígdala e desregulação do sistema de recompensa dopaminérgico. Alterações em neurotrofinas, como o Fator Neurotrófico Derivado do Cérebro (BDNF), também são verificadas em relação ao ganho de peso, dado que sua desregulação em regiões hipotalâmicas resulta em comportamento hiperfágico. Observa-se que as correlações fisiopatológicas do binômio obesidade-TB podem resultar em implicações e repercussões negativas para a saúde dos pacientes.

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“…It is not surprising that low total serum bilirubin levels were proposed as a risk factor for different neurological and psychiatric disorders including BD [ 27 ]. In the same way, obesity concomitant with over-inflammation has led some authors to argue that metabolic syndrome and the related metabolic biomarkers may be related to suicide attempts in BD but so far, available data are inconsistent [ 28 ]. Similarly, even though it has been suggested that chronically elevated cortisol levels, resulting from a pro-inflammatory state can potentially be associated with suicidal behavior, the findings appear inconsistent [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

Which Clinical and Biochemical Parameters Are Associated with Lifetime Suicide Attempts in Bipolar Disorder?

et al. 2022

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Introduction: Bipolar Disorder (BD) is a disabling condition with suicidal behavior as one of the most common adverse outcomes. The purpose of the present research is to investigate the relationship between lifetime suicide attempts and the clinical factors/biochemical parameters in a large sample of bipolar patients. Methods: A total of 561 patients, consecutively hospitalized for BD in Milan and Monza (Italy), were recruited. Data about the demographic and clinical variables, as well as the values of blood analyses, were collected. The groups identified according to the presence/absence of lifetime suicide attempts were compared using univariate analyses. Then, three preliminary binary logistic regressions and a final logistic regression model were performed to identify the clinical and biochemical parameters associated with lifetime suicide attempts in BD. Results: Lifetime suicide attempts in BD were predicted by a longer duration of untreated illness (DUI) (p = 0.005), absence of lifetime psychotic symptoms (p = 0.025), presence of poly-substance use disorders (p = 0.033), comorbidity with obesity (p = 0.022), a last mood episode of manic polarity (p = 0.044), and lower bilirubin serum levels (p = 0.002); higher total cholesterol serum levels showed a trend toward statistical significance (p = 0.058). Conclusions: BD patients with lifetime suicide attempts present unfavorable clinical features. Some specific biochemical characteristics of bipolar patients may represent potential markers of suicidal behavior and need to be better investigated to identify new targets of treatment in the framework of personalized medicine. These preliminary findings have to be confirmed by further studies in different clinical settings.

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Effects of metabolic syndrome and obesity on suicidality in individuals with bipolar disorder

Cited by 5 publications

References 55 publications

Clinical Value of Inflammatory and Neurotrophic Biomarkers in Bipolar Disorder: A Systematic Review and Meta-Analysis

Clinical Value of Inflammatory and Neurotrophic Biomarkers in Bipolar Disorder: A Systematic Review and Meta-Analysis

Transtorno bipolar e obesidade: Correlações fisiopatológicas

Which Clinical and Biochemical Parameters Are Associated with Lifetime Suicide Attempts in Bipolar Disorder?

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