Elevated lipids are associated with reduced regional brain structure in youth with bipolar disorder

Abstract

Objective 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. Methods 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. Results 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. Conclusion 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.

Investigation of systemic immune-inflammation index, neutrophil/high-density lipoprotein ratio, lymphocyte/high-density lipoprotein ratio, and monocyte/high-density lipoprotein ratio as indicators of inflammation in patients with schizophrenia and bipolar disorder

“…In line with our results, a lower HDL cholesterol level had been reported in SCZ and BD patients in previous studies. Some research studies have found that reduced HDL levels were associated with smaller hippocampal volume and cognitive deficits in BD patients ( 53 ). Lower levels of HDL cholesterol are correlated with an increased vulnerability to oxidative damage to lipids, proteins, and DNA, and increased immune–inflammatory responses ( 53 ).…”

“…Some research studies have found that reduced HDL levels were associated with smaller hippocampal volume and cognitive deficits in BD patients ( 53 ). Lower levels of HDL cholesterol are correlated with an increased vulnerability to oxidative damage to lipids, proteins, and DNA, and increased immune–inflammatory responses ( 53 ). Furthermore, our results showed that lipid profiles had correlations with neutrophils, lymphocytes, monocytes, and platelets, suggesting a link between lipid metabolism and inflammation.…”

Metabolomic biomarkers related to non-suicidal self-injury in patients with bipolar disorder

“…Results showed that sphingolipids and glycerolipids were increased, whereas glycerophospholipids were decreased, in serum samples from patients with BD. Moreover, studies also showed that elevated lipid level is associated with smaller brain structures in patients with BD (37). Future research is needed to verify the changes in the HDL levels of BD patients compared with those of healthy individuals and the speci c mechanisms of lipid changes in the pathogenesis of BD.…”

Specific metabolic syndrome components predict cognition and social functioning in people with type 2 diabetes mellitus and severe mental disorders

“…MetS is currently considered a major risk factor for the development of chronic diseases that involve high morbimortality, such as T2DM and SMI, 53 and therefore, early detection and 56 The recent development of lifestyle psychiatry is gaining momentum. 57 Lifestyle modifications reportedly have a positive impact on symptom severity and neurocognitive function for individuals with SMI, 58,59 which goes beyond their known efficacy to treat metabolic comorbidities. Moreover, the negative impact of several MetS components on cognition might be prevented with nutritional and dietary interventions specifically designed to improve cognition in individuals with SMI and T2DM.…”