Serum resistin levels and metabolic changes in bipolar disorder

Abstract

Aim: Metabolic changes in bipolar disorder appear to be among the cluster of disturbances that have insulin resistance as a common etiologic factor. Several recently discovered adipokines such as resistin and visfatin play a role in the pathogenesis of insulin resistance. In this study we aimed to evaluate the association between serum resistin levels and metabolic changes in bipolar disorder. Method: Sixty euthymic bipolar I disorder patients, of 29 on mood stabilizer (MS) (lithium, valproic acid, carbamazepine, and lamotrigine) treatment and of 31 on atypical antipsychotic (AA) (risperidone, quetiapine and olanzapine) treatment for at least 3 months, were enrolled. The control group consisted of 27 healthy members who have had similar distributions of age, sex, and BMI with the patients. Resistin, glucose, triglycerides, and high density lipoprotein (HDL) levels were measured in all groups. Results: Resistin levels were found to be significantly high in bipolar patients than that in the controls. However, when metabolic parameters were considered resistin levels were not significantly different between the patient and control groups (p>0.05). Conclusion: Despite serum resistin levels were high in bipolar patients, we did not find any association between metabolic disturbances and treatment modalities.

Keywords

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İkiuçlu bozuklukta serum rezistin düzeyleri ve metabolik değişiklikler

Öz

Amaç: İki uçlu bozuklukta (İUB) görülen metabolik değişiklikler insülin direnci gibi çeşitli etyolojik etmenlerin gösterildiği hastalıkların bir kümesi olarak görünmektedir. İnsülin direncinin patogenezinde rezistin, visfatin gibi adipokinlerin rolü keşfedilmiştir. Bu çalışmada İUB’de metabolik değişiklikler ve serum rezistin seviyeleri arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Yöntem: İUB tip I ötimik dönemdeki hastalardan en az 3 ay süre ile atipik antipsikotik (risperidon, ketiapin, olanzapin) almış 31 hasta ile mizaç düzenleyici (lityum, valproik asit, karbamazepin, lamotrijin) almış 29 hasta çalışmaya dahil edildi. Kontrol grubu 27 sağlıklı kişiden oluşmakta idi. Rezistin, glukoz, trigliserit ve HDL tüm gruplarda ölçüldü. Bulgular: İUB hasta grubunda kontrol grubuna kıyasla daha yüksek rezistin düzeyleri saptanmasına rağmen metabolik parametrelere bakıldığında serum rezistin seviyeleri açısından hastalar ve kontrol grubu arasında farklılık bulunmamıştır. Sonuç: Serum rezistin seviyeleri İUB hastalarında yüksek olmasına rağmen bu durumun metabolik değişiklikler ve tedavi modaliteleri ile ilişkisi bulunamamıştır.

Anahtar Kelimeler

• iki uçlu bozukluk, rezistin, metabolik değişiklik

Kaynakça

1. Steppan CM, Lazar MA. The current biology of resistin. J Intern Med. 2004; 255: 439-47.
2. McTernan PG, Fisher FM, Valsamakis G, Chetty R, Harte A, McTernan CL, Clark PM, Smith SA, Barnett AH, Kumar S. Resistin and type 2 diabetes: regulation of resistin expression by insulin and rosiglitazone and the effects of recombinant resistin on lipid and glucose metabolism in human differentiated adipocytes. J Clin Endocrinol Metab 2003; 88: 6098-106.
3. Heilbronn LK, Rood J, Janderova L, Albu JB, Kelley DE, Ravussin E, Smith SR. Relationship between serum resistin concentrations and insulin resistance in nonobese, obese, and obese diabetic subjects. J Clin Endocr Metab 2004; 89: 1844-8.
4. Fujinami A, Obayashi H, Ohta K, Ichimura T, Nishimura M, Matsui H, Kawahara Y, Yamazaki M, Ogata M, Hasegawa G, Nakamura N, Yoshikawa T, Nakano K, Ohta M. Enzyme-linked immunosorbent assay for circulating human resistin: resistin concentrations in normal subjects and patients with type 2 diabetes. Clin Chim Acta 2004; 339: 57-63.
5. Pfutzner A, Langenfeld M, Kunt T, Lobig M, Forst T. Evaluation of human resistin assays with serum from patients with type 2 diabetes and different degrees of insulin resistance. Clin Lab Med 2003; 49: 571-6.
6. Kawanami D, Maemura K, Takeda N, Harada T, Nojiri T, Imai Y, Manabe I, Utsunomiya K, Nagai R. Direct reciprocal effects of resistin and adiponectin on vascular endothelial cells: A new insight into adipocytokine-endothelial cell interactions. Biochem Biophys Res Commun 2004; 314: 415-9.
7. Gergerlioglu HS, Savas HA, Celik A, Savas E, Yumru M, Tarakcioglu M, Atmaca M. Atypical antipsychotic usage related higher serum leptin levels and disabled lipid profiles in euthymic bipolar patients. Neuropsychobiology 2006; 53: 108-12.
8. Yumru M, Savas E, Gergerlioglu HS, Basaralı K, Kalenderoglu A, Savas HA, Buyukbas S. The relationship of metabolic syndrome, serum leptin levels and treatment in bipolar disorder. Bull Clin Psychopharmacol 2008: 18; 87-91.

9. Kalenderoglu A, Savaş HA, Gergerlioglu HS, Basarali K, Yumru M, Selek S, Buyukbas S, Ergene N. Correlation between metabolic syndrome and serum ghrelin levels in bipolar patients. Archieves of Neuropsychiatry 2010; 47: 328-32.
10. Lehto SM, Huotari A, Niskanen L, Tolmunen T, Koivumaa- Honkanen H, Honkalampi K, Ruotsalainen H, Herzig KH, Viinamäki H, Hintikka J. Serum adiponectin and resistin levels in major depressive disorder. Acta Psychiatr Scand 2010; 121: 209-15.
11. Weber-Hamann B, Kratzsch J, Kopf D, Lederbogen F, Gilles M, Heuser I, Deuschle M. Resistin and adiponectin in major depression: the association with free cortisol and effects of antidepressant treatment. J Psychiatr Res. 2007; 41: 344-50.
12. Ari M, Ozturk OH, Bez Y, Arica S, Can Y, Erduran D. Serum adiponectin and resistin levels in patients with obsessive compulsive disorder. J Affect Disord. 2012; 136: 979-82.
13. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4.ed, Washington DC, American Psychiatric Association 1994:739-42.
14. Barbosa IG, Rocha NP, Miranda AS, Magalhães PV, Huguet RB, Souza LP, Kapczinski F, Teixeira AL. Increased levels of adipokines in bipolar disorder. J Psychiatr Res 2012; 46: 389-93.
15. Matsuzawa Y, Funahashi T, Nakamura T. Molecular mechanism of metabolic syndrome X: contribution of adipocytokines adipocytederived bioactive substances. Ann N Y Acad Sci 1999; 892: 146-54.
16. Arita Y, Kihara S, Ouchi N, Takahashi M, Maeda K, Miyagawa J, Hotta K, Shimomura I, Nakamura T, Miyaoka K, Kuriyama H, Nishida M, Yamashita S, Okubo K, Matsubara K, Muraguchi M, Ohmoto Y, Funahashi T, Matsuzawa Y. Paradoxical decrease of an adiposespecific protein, adiponectin in obesity. Biochem Biophys Res Commun 1999; 257: 79-83.
17. Weyer C, Funahashi T, Tanaka S, Hotta K, Matsuzawa Y, Pratley RE, Tataranni PA. Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J Clin Endocrinol Metab 2001; 86: 1930-5.
18. Yumru M, Savas HA, Kurt E, Kaya MC, Selek S, Savaş E, Oral ET, Atagün İ. Atypical antipsychotics related metabolic syndrome in bipolar patients. J Affect Disord. 2007; 98: 247-252.
19. McIntyre RS, Alsuwaidan M, Goldstein BI, Taylor VH, Schaffer A, Beaulieu S, Kemp DE. The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and comorbid metabolic disorders. Ann Clin Psychiatry 2012; 24: 69-81.