Hormonal and inflammatory signatures of different mood episodes in bipolar disorder: a large-scale clinical study
Abstract Background Bipolar disorder (BD) is characterized by intensive mood fluctuations. While hormones imbalance plays important role in the mood swings, it is unknown whether peripheral hormones profiles could differentiate the manic and depressive mood episodes in BD. In this study, we investig...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-023-04846-1 |
| _version_ | 1797795552011747328 |
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| author | Nan Lyu Qian Zhao Bingbing Fu Jinhong Li Han Wang Fan Yang Sitong Liu Juan Huang Xinwei Zhang Ling Zhang Rena Li |
| author_facet | Nan Lyu Qian Zhao Bingbing Fu Jinhong Li Han Wang Fan Yang Sitong Liu Juan Huang Xinwei Zhang Ling Zhang Rena Li |
| author_sort | Nan Lyu |
| collection | DOAJ |
| description | Abstract Background Bipolar disorder (BD) is characterized by intensive mood fluctuations. While hormones imbalance plays important role in the mood swings, it is unknown whether peripheral hormones profiles could differentiate the manic and depressive mood episodes in BD. In this study, we investigated the changes of various hormones and inflammatory markers across distinct mood episodes of BD in a large clinical study to provide mood episode-specific peripheral biomarkers for BD. Methods A total of 8332 BD patients (n = 2679 depressive episode; n = 5653 manic episode) were included. All patients were in acute state of mood episodes and need hospitalization. A panel of blood tests were performed for levels of sex hormones (serum levels of testosterone, estradiol, and progesterone), stress hormones (adrenocorticotropic hormone and cortisol), and an inflammation marker (C-reactive protein, CRP). A receiver operating characteristic (ROC) curve was used to analyze the discriminatory potential of the biomarkers for mood episodes. Results In overall comparison between mood episodes, the BD patients expressed higher levels of testosterone, estradiol, progesterone, and CRP (P < 0.001) and lower adrenocorticotropic hormone (ACTH) level (P < 0.001) during manic episode. The episode-specific changes of testosterone, ACTH, and CRP levels remained between the two groups (P < 0.001) after correction for the confounding factors including age, sex, BMI, occupation, marital status, tobacco use, alcohol consumption, psychotic symptoms, and age at onset. Furthermore, we found a sex- and age-specific impact of combined biomarkers in mood episodes in male BD patients aged ≥ 45 years (AUC = 0.70, 95% CI, 0.634–0.747), not in females. Conclusions While both hormone and inflammatory change is independently associated with mood episodes, we found that the combination of sex hormones, stress hormones and CRP could be more effective to differentiate the manic and depressive episode. The biological signatures of mood episodes in BD patients may be sex- and age-specific. Our findings not only provide mood episode-related biological markers, but also better support for targeted intervention in BD treatments. |
| first_indexed | 2024-03-13T03:20:44Z |
| format | Article |
| id | doaj.art-f6edf0c40afa42909881baef82e5d6a5 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-03-13T03:20:44Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-f6edf0c40afa42909881baef82e5d6a52023-06-25T11:24:26ZengBMCBMC Psychiatry1471-244X2023-06-0123111110.1186/s12888-023-04846-1Hormonal and inflammatory signatures of different mood episodes in bipolar disorder: a large-scale clinical studyNan Lyu0Qian Zhao1Bingbing Fu2Jinhong Li3Han Wang4Fan Yang5Sitong Liu6Juan Huang7Xinwei Zhang8Ling Zhang9Rena Li10Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical UniversityBeijing SmindU Medical Science & Technology Co., LtdBeijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical UniversityBeijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical UniversityAbstract Background Bipolar disorder (BD) is characterized by intensive mood fluctuations. While hormones imbalance plays important role in the mood swings, it is unknown whether peripheral hormones profiles could differentiate the manic and depressive mood episodes in BD. In this study, we investigated the changes of various hormones and inflammatory markers across distinct mood episodes of BD in a large clinical study to provide mood episode-specific peripheral biomarkers for BD. Methods A total of 8332 BD patients (n = 2679 depressive episode; n = 5653 manic episode) were included. All patients were in acute state of mood episodes and need hospitalization. A panel of blood tests were performed for levels of sex hormones (serum levels of testosterone, estradiol, and progesterone), stress hormones (adrenocorticotropic hormone and cortisol), and an inflammation marker (C-reactive protein, CRP). A receiver operating characteristic (ROC) curve was used to analyze the discriminatory potential of the biomarkers for mood episodes. Results In overall comparison between mood episodes, the BD patients expressed higher levels of testosterone, estradiol, progesterone, and CRP (P < 0.001) and lower adrenocorticotropic hormone (ACTH) level (P < 0.001) during manic episode. The episode-specific changes of testosterone, ACTH, and CRP levels remained between the two groups (P < 0.001) after correction for the confounding factors including age, sex, BMI, occupation, marital status, tobacco use, alcohol consumption, psychotic symptoms, and age at onset. Furthermore, we found a sex- and age-specific impact of combined biomarkers in mood episodes in male BD patients aged ≥ 45 years (AUC = 0.70, 95% CI, 0.634–0.747), not in females. Conclusions While both hormone and inflammatory change is independently associated with mood episodes, we found that the combination of sex hormones, stress hormones and CRP could be more effective to differentiate the manic and depressive episode. The biological signatures of mood episodes in BD patients may be sex- and age-specific. Our findings not only provide mood episode-related biological markers, but also better support for targeted intervention in BD treatments.https://doi.org/10.1186/s12888-023-04846-1Bipolar disorderMood episodeHormoneStressSex |
| spellingShingle | Nan Lyu Qian Zhao Bingbing Fu Jinhong Li Han Wang Fan Yang Sitong Liu Juan Huang Xinwei Zhang Ling Zhang Rena Li Hormonal and inflammatory signatures of different mood episodes in bipolar disorder: a large-scale clinical study BMC Psychiatry Bipolar disorder Mood episode Hormone Stress Sex |
| title | Hormonal and inflammatory signatures of different mood episodes in bipolar disorder: a large-scale clinical study |
| title_full | Hormonal and inflammatory signatures of different mood episodes in bipolar disorder: a large-scale clinical study |
| title_fullStr | Hormonal and inflammatory signatures of different mood episodes in bipolar disorder: a large-scale clinical study |
| title_full_unstemmed | Hormonal and inflammatory signatures of different mood episodes in bipolar disorder: a large-scale clinical study |
| title_short | Hormonal and inflammatory signatures of different mood episodes in bipolar disorder: a large-scale clinical study |
| title_sort | hormonal and inflammatory signatures of different mood episodes in bipolar disorder a large scale clinical study |
| topic | Bipolar disorder Mood episode Hormone Stress Sex |
| url | https://doi.org/10.1186/s12888-023-04846-1 |
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