Lipid and Glycemic Profiles in Patients with Bipolar Disorder: Cholesterol Levels Are Reduced in Mania

Abstract

Background and Objectives: Bipolar disorder (BD) is a severe mental condition with a lifetime prevalence estimated around 2% among the general population. Due to risk factors, etiological mechanisms, and the chronic use of psychotropic medications, people with BD are frequently affected by medical comorbidities, such as metabolic syndrome (MetS), associated with altered blood levels of glucose, cholesterol, and triglycerides. Moreover, the lipid concentration may be associated with the severity of psychiatric symptoms. Materials and Methods: Five hundred and forty-two in- and outpatients (418 affected by BD and 124 affected by schizophrenia) were recruited in two Italian university hospitals. A blood examination assessing the fasting glucose, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides was performed. Results: No significant differences were found in the lipid and glycemic profiles between patients with BD and schizophrenia. When considering only the BD sample, we found that patients experiencing a manic episode had significantly lower total cholesterol, HDL, and LDL than euthymic patients. Moreover, the total and LDL cholesterol levels were significantly lower in (hypo)manic than depressed patients. Mood episodes did not influence the triglyceride and glucose levels in our sample. Conclusions: Clinicians should pay attention to blood cholesterol levels in patients with BD, as differences in concentrations may predispose them to severe medical conditions and can be associated with the onset of mood episodes.

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 the SCZ, BD-M, and BD-D groups, the BD-D group showed the highest CHO, LDL, and Apo B, followed by the SCZ group; the BD-M group showed the lowest CHO, LDL, and Apo B; furthermore, the SCZ group showed the lowest HDL. Several reports had identified lower cholesterol levels in BD manic patients than in the euthymic phase or BD depressive patients ( 51 ), which was in line with our results. Cholesterol is a principal component of the cell membrane and plays an important role in synaptic functions, and the depletion of cholesterol may induce the alteration of brain signaling, with effects on several neurotransmission systems ( 48 , 52 ).…”

Gender Differences in Complete Blood Count and Inflammatory Ratios among Patients with Bipolar Disorder

“…BD represents a leading cause of burden worldwide and contributes significantly to premature death [2]. Subjects with BD are at high risk of presenting with co-occurrent psychiatric illnesses, including alcohol and substance use disorders [3][4][5], as well as serious medical comorbidities [3,[6][7][8][9][10]. Moreover, suicide risk is up to 30 times higher in individuals with BD than the general population, with one in four to five subjects attempting suicide lifetime [11,12].…”

Effect of Probiotic Supplements on Oxidative Stress Biomarkers in First-Episode Bipolar Disorder Patients: A Randomized, Placebo-Controlled Trial

“…It has been found that BPD patients experiencing a manic episode had significantly lower total cholesterol, high-density lipoprotein (HDL), and LDL than euthymic patients. The BPD patients have significantly lower total cholesterol and LDL levels in (hypo)manic than depressed patients ( Fusar-Poli et al, 2020 ), indicating a greater oxidative stress in manic episode. As such, the decreased oxidation of LDL was related to the alleviation of manic symptoms in BPD.…”