TY - JOUR
T1 - Inflammatory markers and their relationships with leptin and insulin from acute mania to full remission in bipolar disorder
AU - Tsai, Shang-Ying
AU - Chung, Kuo-Hsuan
AU - Wu, Jui-Yu
AU - Kuo, Chian Jue
AU - Lee, Hsin-Chien
AU - Huang, Shou-Hung
N1 - Funding Information:
Funding for this study was provided by National Science Council Grant (NSC95-2314-B-038-MY3) and Department of Health (DOH100-TD-B-111-003); the NSC and the DOH had not further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.
Funding Information:
This study was supported by grants from the National Science Council, Taiwan ( NSC95-2314-B-038-MY3 ) and Center of Excellence for Clinical Trial and Research in Neuroscience, Department of Health, Taiwan ( DOH100-TD-B-111-003 ). The authors thank Hui-Wen Lin, Ph.D. of the Biostatistics and Research Consultation Center, Taipei Medical University and Miss Yi-Lin Huang for statistical consultation and Miss Ying-Fang Wang for her assistance in data collection.
Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2012/1
Y1 - 2012/1
N2 - Background: Weight gain and increased production of leptin may be associated with immuno-modulation and insulin resistance in bipolar disorder. The links among inflammatory markers, leptin, and insulin of bipolar patients from acute mania to full remission remain unclear. Methods: Thirty-three healthy, bipolar I patients under 45 years of age were enrolled. We measured the circulating levels of high-sensitivity C-reactive protein (hs-CRP), anti-inflammatory mediators (interleukin-1 receptor antagonist [IL-1Ra] and soluble tumor necrosis factor receptor 1 [sTNF-R1]), leptin, and insulin during acute mania and subsequent partial and full remission. The results were compared with 33 age- and gender-matched healthy subjects. Results: The levels of IL-1Ra and hs-CRP of bipolar patients in both acute mania and partial remission were significantly higher than their levels of control subjects. The hs-CRP level of bipolar patients was also elevated in full remission. The elevation of IL-1Ra and hs-CRP levels in acute mania was independent of each other. They were also independent of the body mass index (BMI) and levels of leptin and insulin measurements. The levels of leptin were all positively associated with insulin levels in the normal subjects and bipolar patients in three phases. However, a significant relationship between leptin and immunoparameter was only seen in full remission with sTNF-R1 (r = 0.51). Furthermore, IL-1Ra was inversely correlated with sTNF-R1 (r = - 0.37, p <0.05) during partly remission, and while levels of IL-1Ra tended to normalize when patients remitted, levels of hs-CRP and sTNF-R1 showed the opposite trend. Conclusions: Activated inflammation was found in acute mania, as evidenced by high levels of IL-1Ra, hs-CRP, and sTNF-R1. The production of leptin may be more tightly linked to insulin than the immunomodulators. Chronic inflammation may exist in bipolar patients and is reflected by elevations of IL-1Ra and hs-CRP levels in acute mania and persistent higher hs-CRP in full remission.
AB - Background: Weight gain and increased production of leptin may be associated with immuno-modulation and insulin resistance in bipolar disorder. The links among inflammatory markers, leptin, and insulin of bipolar patients from acute mania to full remission remain unclear. Methods: Thirty-three healthy, bipolar I patients under 45 years of age were enrolled. We measured the circulating levels of high-sensitivity C-reactive protein (hs-CRP), anti-inflammatory mediators (interleukin-1 receptor antagonist [IL-1Ra] and soluble tumor necrosis factor receptor 1 [sTNF-R1]), leptin, and insulin during acute mania and subsequent partial and full remission. The results were compared with 33 age- and gender-matched healthy subjects. Results: The levels of IL-1Ra and hs-CRP of bipolar patients in both acute mania and partial remission were significantly higher than their levels of control subjects. The hs-CRP level of bipolar patients was also elevated in full remission. The elevation of IL-1Ra and hs-CRP levels in acute mania was independent of each other. They were also independent of the body mass index (BMI) and levels of leptin and insulin measurements. The levels of leptin were all positively associated with insulin levels in the normal subjects and bipolar patients in three phases. However, a significant relationship between leptin and immunoparameter was only seen in full remission with sTNF-R1 (r = 0.51). Furthermore, IL-1Ra was inversely correlated with sTNF-R1 (r = - 0.37, p <0.05) during partly remission, and while levels of IL-1Ra tended to normalize when patients remitted, levels of hs-CRP and sTNF-R1 showed the opposite trend. Conclusions: Activated inflammation was found in acute mania, as evidenced by high levels of IL-1Ra, hs-CRP, and sTNF-R1. The production of leptin may be more tightly linked to insulin than the immunomodulators. Chronic inflammation may exist in bipolar patients and is reflected by elevations of IL-1Ra and hs-CRP levels in acute mania and persistent higher hs-CRP in full remission.
KW - Bipolar mania
KW - C-reactive protein
KW - Insulin sensitivity
KW - Interleukin-1 receptor antagonist (IL-1Ra)
KW - Leptin
KW - Soluble tumor necrosis factor receptor 1 (sTNF-R1)
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U2 - 10.1016/j.jad.2011.08.022
DO - 10.1016/j.jad.2011.08.022
M3 - Article
C2 - 21962564
AN - SCOPUS:84857050654
SN - 0165-0327
VL - 136
SP - 110
EP - 116
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
IS - 1-2
ER -