2 research outputs found
Oxidative stress parameters and antioxidants in patients with bipolar disorder: Results from a meta-analysis comparing patients, including stratification by polarity and euthymic status, with healthy controls
Abstract
Objective: To investigate oxidative stress markers and antioxidants in bipolar disorder
(BD).
Methods: Electronic MEDLINE/PubMed/Cochrane-Library/Scopus/TripDatabase
search until 06/30/2019 for studies comparing antioxidant or oxidative stress markers
between BD and healthy controls (HCs). Standardized mean differences (SMD)
and 95% confidence intervals (CIs) were calculated for ≥3 studies.
Results: Forty-four studies (n = 3,767: BD = 1,979; HCs = 1,788) reported on oxidative
stress markers malondialdehyde (MDA), thiobarbituric acid reactive substances
(TBARS), and total nitrites; antioxidants glutathione (GSH), uric acid, and zinc; or antioxidantenhancing
enzymes superoxide dismutase (SOD), catalase (CAT), glutathione
peroxidase (GPX), and GSH-transferase (GST). Compared with HCs, BD was associated
with higher GST (P = .01), CAT (P = .02), nitrites (P < .0001), TBARS (P < .0001), MDA
(P = .01), uric acid (P < .0001), and lower GSH (P = .006), without differences in SOD,
GPX, and zinc. Compared to HCs, levels were higher in BD-mania for TBARS (P < .0001)
and uric acid (P < .0001); in BD-depression for TBARS (P = .02); and BD-euthymia for
uric acid (P = .03). Uric acid levels were higher in BD-mania vs BD-depression (P = .002),
but not vs BD euthymia. TBARS did not differ between BD-mania and BD-depression.
Medication-free BD-mania patients had higher SOD (P = .02) and lower GPX (P < .0001)
than HCs. After treatment, BD did not differ from HCs regarding SOD and GPX.
Conclusions: Beyond a single biomarker of oxidative stress, the combination of several
parameters appears to be more informative for BD in general and taking into
account illness polarity. BD is associated with an imbalance in oxidative stress with
some phase-specificity for uric acid and TBARS and possible treatment benefits for
SOD and GPX. Future studies should take into account confounding factors that can
modify oxidative stress status and simultaneously measure oxidative stress markers
and antioxidants including different blood sources
Features Associated With Depressive Predominant Polarity and Early Illness Onset in Patients With Bipolar Disorder
Objective: The aim of this study is to determine the prevalence of three possible
diagnostic specifiers, namely predominant polarity (PP) throughout illness, polarity of the
first episode and early age at onset, in a sample of bipolar disorder (BD) patients and their
association with important socio-demographic, clinical and course-of-illness variables.
Methods: A retrospective and naturalistic study on 108 BD outpatients, who were
classified according to the PP, polarity of the first episode and early age at onset ( 20
years) [vs. late (>20 years)] and were characterized by their demographics, clinical data,
functionality and social support, among others features. After bivariate analyses, those
variables showing certain association (P value < 0.25) with the three dependent variables
were entered in logistic regression backward selection procedures to identify the variables
independently associated with the PP, polarity of the first episode and early age at onset.
Results: The sample consisted of 75 women ad 33 men, 74% with type I BD and 26%
with type II. Around 70% had depressive PP, onset with a depressive episode and onset
after age 20. Depressive PP was independently associated with depressive onset, higher
score on the CGI severity scale and work disability. Onset with depressive episode was
associated with type II BD, longer diagnostic delay and higher score on family disability.
Early age at onset ( 20 years) was associate with younger age, longer diagnostic delay,
presence of ever psychotic symptoms, current use of antipsychotic drugs and higher
social support score.
Conclusions: The results of this study show that BD patients with depressive PP, onset
with depression and early age at onset may represent greater severity, because they are
frequently associated with variables that worsen the prognosis. Our findings match up
with the conclusions of two systematic reviews and we also include a disability factor (at
family and work) that has not been previously reported. This work contributes to the use
of polarity and age at onset in BD patients, as it can become a useful instrument in the
prognostic and therapeutic applications