Bipolar bozukluğun manik ve remisyon dönemlerinde inflamatuvar yanıtın hastalık şiddeti ve cinsiyet ile ilişkisi

Year 2025, Volume: 50 Issue: 3, 908 - 918, 30.09.2025

Ülker Atılan Fedai , Sıdıka Baziki Çetin

https://doi.org/10.17826/cumj.1733754

Abstract

Amaç: Bu çalışma, bipolar bozuklukta (BB) manik epizodlar ve erken remisyon döneminde inflamatuar belirteç düzeylerini karşılaştırmayı, ruhsal epizodların sistemik inflamasyonla ilişkili olduğuna dair artan kanıtlar doğrultusunda, inflamatuar belirteçler ile hastalık şiddeti arasındaki ilişkiyi ve bu yanıtlardaki olası cinsiyete bağlı farklılıkları değerlendirmeyi amaçlamıştır.
Gereç ve Yöntem: Bu retrospektif klinik çalışmaya, manik epizod tanısı konan ve tedavi edilen 61 BB hastası ile 64 sağlıklı kontrol dahil edildi. Hastaların hastaneye kabulünden sonraki 24 saat içinde ve taburculukta hemogram değerleri, C-reaktif protein (CRP), albümin seviyeleri ile birlikte Young Mani Derecelendirme Ölçeği (YMDÖ) skorları ölçüldü.
Bulgular: Manik epizoddaki BB hastalarında sağlıklı kontrollere kıyasla CRP (0,96 ± 2,02 mg/L), CRP/albümin oranı (CAR) (0,24±0,534) , nötrofil (5,81±3,42 10³/µ) ve ortalama trombosit hacmi (OTH) ( 8,11±1,302 fL) seviyeleri sağlıklı kontrollere göre daha yüksekti [kontrol grubu: CRP (0,21 ± 0,34 mg/L), CAR (0,046±0,075 ), nötrofil (4,22±1,26 10³/µ ), OTH (9,78±1,97 fL)]. Albümin düzeyleri hasta grubunda (4,19±0,43 g/dL) kontrollere kıyasla (4,65±0,23 g/dL) daha düşüktü. Monosit ve sistemik immün inflamasyon indeksi değerleri kadın hastalarda tedavi sonrası anlamlı şekilde artarken erkek hastalarda bu durum gözlenmedi. YMDÖ skorları ile inflamatuar belirteçler arasında kadınlarda albümin ve monositler için negatif korelasyon tespit edilirken, erkeklerde CRP ve CAR için negatif korelasyon belirlendi.
Sonuç: Bu bulgular, BB’de sistemik inflamasyonun rolünü vurgulamakta ve hastalık özellikleri ile tedavi yanıtlarında cinsiyete özgü farklılıklar olduğunu göstermekte olup, ileri araştırmaları gerektirmektedir.

Keywords

Albümin , Bipolar Bozukluklar , Duygudurum Bozuklukları , İnflamasyon

Ethical Statement

Harran Üniversitesi Klinik Araştırmalar Etik Kurulu'ndan etik onay alınmıştır (27.04.2024 tarih, 07 sayılı oturum ve 12 sayılı karar).

The relationship between inflammatory response and disease severity and gender in the manic and remission phases of bipolar disorder

Abstract

Purpose: This study aimed to compare inflammatory marker levels during manic episodes and early remission in patients with bipolar disorder (BD), in light of increasing evidence linking mood episodes to alterations in systemic inflammation. Furthermore, it sought to examine the association between inflammatory markers and illness severity, as well as to explore potential gender-related differences in these inflammatory responses.
Materials and Methods: This retrospective clinical study included 61 patients diagnosed with BD manic episodes and treated and 64 healthy control subjects. Hemogram values, C-reactive protein (CRP), albumin levels and Young Mania Rating Scale (YMRS) scores were measured within 24 hours of admission and at discharge.
Results: In patients with BD experiencing a manic episode, CRP (0.96 ± 2.02 mg/L), CRP/albumin ratio (CAR) (0.24 ± 0.534), neutrophil count (5.81 ± 3.42 × 10³/µL), and mean platelet volume (MPV) (8.11 ± 1.302 fL) levels were higher compared to healthy controls [control group: CRP (0.21 ± 0.34 mg/L), CAR (0.046 ± 0.075), neutrophil count (4.22 ± 1.26 × 10³/µL), MPV (9.78 ± 1.97 fL)]. Albumin levels in the patient group (4.19 ± 0.43 g/dL) were lower than those in the controls (4.65 ± 0.23 g/dL). The monocyte level and systemic immune response index values significantly increased after treatment in female but not in male patients. A negative correlation was identified between the YMRS scores and inflammatory markers in females for albumin and monocytes, while in males, a negative correlation was identified for CRP and CAR.
Conclusion: These findings highlight the role of systemic inflammation in BD and suggest gender-specific differences in disorder characteristics and treatment responses, warranting further investigation.

Keywords

Albumin , Bipolar disorders , Affective disorders , Inflammation

Ethical Statement

Ethical approval was obtained from the Harran University Clinical Research Ethics Committee (27.04.2024 dated, 07 numbered session and 12 numbered decision).

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