The association between neuroendocrine/glucose metabolism and clinical outcomes and disease course in different clinical states of bipolar disorders
ObjectiveThe treatment of bipolar disorder (BD) remains challenging. The study evaluated the impact of the hypothalamic–pituitary–adrenal (HPA) axis/hypothalamic–pituitary-thyroid (HPT) axis and glucose metabolism on the clinical outcomes in patients with bipolar depression (BD-D) and manic bipolar...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1275177/full |
| _version_ | 1797347911359528960 |
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| author | Xu Zhang Xu Zhang Yaling Zhou Yuexin Chen Yuexin Chen Shengnan Zhao Bo Zhou Bo Zhou Xueli Sun |
| author_facet | Xu Zhang Xu Zhang Yaling Zhou Yuexin Chen Yuexin Chen Shengnan Zhao Bo Zhou Bo Zhou Xueli Sun |
| author_sort | Xu Zhang |
| collection | DOAJ |
| description | ObjectiveThe treatment of bipolar disorder (BD) remains challenging. The study evaluated the impact of the hypothalamic–pituitary–adrenal (HPA) axis/hypothalamic–pituitary-thyroid (HPT) axis and glucose metabolism on the clinical outcomes in patients with bipolar depression (BD-D) and manic bipolar (BD-M) disorders.MethodsThe research design involved a longitudinal prospective study. A total of 500 BD patients aged between 18 and 65 years treated in 15 hospitals located in Western China were enrolled in the study. The Young Mania Rating Scale (YMRS) and Montgomery and Asberg Depression Rating Scale (MADRS) were used to assess the BD symptoms. An effective treatment response was defined as a reduction in the symptom score of more than 25% after 12 weeks of treatment. The score of symptoms was correlated with the homeostatic model assessment of insulin resistance (HOMA-IR) index, the HPA axis hormone levels (adrenocorticotropic hormone (ACTH) and cortisol), and the HPT axis hormone levels (thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free triiodothyronine (fT3), and free thyroxine (fT4)).ResultsIn the BD-M group, the YMRS was positively correlated with baseline T4 (r = 0.349, p = 0.010) and fT4 (r = 0.335, p = 0.013) and negatively correlated with fasting insulin (r = −0.289, p = 0.013). The pre-treatment HOMA-IR was significantly correlated with adverse course (p = 0.045, OR = 0.728). In the BD-D group, the baseline MADRS was significantly positively correlated with baseline fT3 (r = 0.223, p = 0.032) and fT4 (r = 0.315, p = 0.002), while baseline T3 (p = 0.032, OR = 5.071) was significantly positively related to treatment response.ConclusionThe HPT axis and glucose metabolism were closely associated with clinical outcomes at 12 weeks in both BD-D and BD-M groups. If confirmed in further longitudinal studies, monitoring T3 in BD-D patients and HOMA-IR for BD-M could be used as potential treatment response biomarkers. |
| first_indexed | 2024-03-08T11:55:47Z |
| format | Article |
| id | doaj.art-ce5805b4ce544f15b6cafc5f928c945a |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-03-08T11:55:47Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-ce5805b4ce544f15b6cafc5f928c945a2024-01-24T04:21:14ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402024-01-011510.3389/fpsyt.2024.12751771275177The association between neuroendocrine/glucose metabolism and clinical outcomes and disease course in different clinical states of bipolar disordersXu Zhang0Xu Zhang1Yaling Zhou2Yuexin Chen3Yuexin Chen4Shengnan Zhao5Bo Zhou6Bo Zhou7Xueli Sun8Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaKey Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, ChinaThe Fourth People’s Hospital of Chengdu, Chengdu, ChinaSichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaKey Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, ChinaMental Health Center, West China Hospital of Sichuan University, Chengdu, ChinaSichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaKey Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, ChinaMental Health Center, West China Hospital of Sichuan University, Chengdu, ChinaObjectiveThe treatment of bipolar disorder (BD) remains challenging. The study evaluated the impact of the hypothalamic–pituitary–adrenal (HPA) axis/hypothalamic–pituitary-thyroid (HPT) axis and glucose metabolism on the clinical outcomes in patients with bipolar depression (BD-D) and manic bipolar (BD-M) disorders.MethodsThe research design involved a longitudinal prospective study. A total of 500 BD patients aged between 18 and 65 years treated in 15 hospitals located in Western China were enrolled in the study. The Young Mania Rating Scale (YMRS) and Montgomery and Asberg Depression Rating Scale (MADRS) were used to assess the BD symptoms. An effective treatment response was defined as a reduction in the symptom score of more than 25% after 12 weeks of treatment. The score of symptoms was correlated with the homeostatic model assessment of insulin resistance (HOMA-IR) index, the HPA axis hormone levels (adrenocorticotropic hormone (ACTH) and cortisol), and the HPT axis hormone levels (thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free triiodothyronine (fT3), and free thyroxine (fT4)).ResultsIn the BD-M group, the YMRS was positively correlated with baseline T4 (r = 0.349, p = 0.010) and fT4 (r = 0.335, p = 0.013) and negatively correlated with fasting insulin (r = −0.289, p = 0.013). The pre-treatment HOMA-IR was significantly correlated with adverse course (p = 0.045, OR = 0.728). In the BD-D group, the baseline MADRS was significantly positively correlated with baseline fT3 (r = 0.223, p = 0.032) and fT4 (r = 0.315, p = 0.002), while baseline T3 (p = 0.032, OR = 5.071) was significantly positively related to treatment response.ConclusionThe HPT axis and glucose metabolism were closely associated with clinical outcomes at 12 weeks in both BD-D and BD-M groups. If confirmed in further longitudinal studies, monitoring T3 in BD-D patients and HOMA-IR for BD-M could be used as potential treatment response biomarkers.https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1275177/fullbipolar disorderHPA axisHPT axisglucose metabolisminsulin resistancebipolar depression |
| spellingShingle | Xu Zhang Xu Zhang Yaling Zhou Yuexin Chen Yuexin Chen Shengnan Zhao Bo Zhou Bo Zhou Xueli Sun The association between neuroendocrine/glucose metabolism and clinical outcomes and disease course in different clinical states of bipolar disorders Frontiers in Psychiatry bipolar disorder HPA axis HPT axis glucose metabolism insulin resistance bipolar depression |
| title | The association between neuroendocrine/glucose metabolism and clinical outcomes and disease course in different clinical states of bipolar disorders |
| title_full | The association between neuroendocrine/glucose metabolism and clinical outcomes and disease course in different clinical states of bipolar disorders |
| title_fullStr | The association between neuroendocrine/glucose metabolism and clinical outcomes and disease course in different clinical states of bipolar disorders |
| title_full_unstemmed | The association between neuroendocrine/glucose metabolism and clinical outcomes and disease course in different clinical states of bipolar disorders |
| title_short | The association between neuroendocrine/glucose metabolism and clinical outcomes and disease course in different clinical states of bipolar disorders |
| title_sort | association between neuroendocrine glucose metabolism and clinical outcomes and disease course in different clinical states of bipolar disorders |
| topic | bipolar disorder HPA axis HPT axis glucose metabolism insulin resistance bipolar depression |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1275177/full |
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