Abstract

Background: Weight gain and increased production of leptin may be associated with immuno-modulation and insulin resistance in bipolar disorder. The links among inflammatory markers, leptin, and insulin of bipolar patients from acute mania to full remission remain unclear. Methods: Thirty-three healthy, bipolar I patients under 45 years of age were enrolled. We measured the circulating levels of high-sensitivity C-reactive protein (hs-CRP), anti-inflammatory mediators (interleukin-1 receptor antagonist [IL-1Ra] and soluble tumor necrosis factor receptor 1 [sTNF-R1]), leptin, and insulin during acute mania and subsequent partial and full remission. The results were compared with 33 age- and gender-matched healthy subjects. Results: The levels of IL-1Ra and hs-CRP of bipolar patients in both acute mania and partial remission were significantly higher than their levels of control subjects. The hs-CRP level of bipolar patients was also elevated in full remission. The elevation of IL-1Ra and hs-CRP levels in acute mania was independent of each other. They were also independent of the body mass index (BMI) and levels of leptin and insulin measurements. The levels of leptin were all positively associated with insulin levels in the normal subjects and bipolar patients in three phases. However, a significant relationship between leptin and immunoparameter was only seen in full remission with sTNF-R1 (r = 0.51). Furthermore, IL-1Ra was inversely correlated with sTNF-R1 (r = - 0.37, p <0.05) during partly remission, and while levels of IL-1Ra tended to normalize when patients remitted, levels of hs-CRP and sTNF-R1 showed the opposite trend. Conclusions: Activated inflammation was found in acute mania, as evidenced by high levels of IL-1Ra, hs-CRP, and sTNF-R1. The production of leptin may be more tightly linked to insulin than the immunomodulators. Chronic inflammation may exist in bipolar patients and is reflected by elevations of IL-1Ra and hs-CRP levels in acute mania and persistent higher hs-CRP in full remission.

Original languageEnglish
Pages (from-to)110-116
Number of pages7
JournalJournal of Affective Disorders
Volume136
Issue number1-2
DOIs
Publication statusPublished - Jan 2012

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Interleukin-1 Receptors
Leptin
Bipolar Disorder
C-Reactive Protein
Tumor Necrosis Factor Receptors
Insulin
Inflammation
Immunologic Factors
Weight Gain
Insulin Resistance
Healthy Volunteers
Body Mass Index
Anti-Inflammatory Agents

Keywords

  • Bipolar mania
  • C-reactive protein
  • Insulin sensitivity
  • Interleukin-1 receptor antagonist (IL-1Ra)
  • Leptin
  • Soluble tumor necrosis factor receptor 1 (sTNF-R1)

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

@article{e90a4f2339fb4fad8411a573c9f064e7,
title = "Inflammatory markers and their relationships with leptin and insulin from acute mania to full remission in bipolar disorder",
abstract = "Background: Weight gain and increased production of leptin may be associated with immuno-modulation and insulin resistance in bipolar disorder. The links among inflammatory markers, leptin, and insulin of bipolar patients from acute mania to full remission remain unclear. Methods: Thirty-three healthy, bipolar I patients under 45 years of age were enrolled. We measured the circulating levels of high-sensitivity C-reactive protein (hs-CRP), anti-inflammatory mediators (interleukin-1 receptor antagonist [IL-1Ra] and soluble tumor necrosis factor receptor 1 [sTNF-R1]), leptin, and insulin during acute mania and subsequent partial and full remission. The results were compared with 33 age- and gender-matched healthy subjects. Results: The levels of IL-1Ra and hs-CRP of bipolar patients in both acute mania and partial remission were significantly higher than their levels of control subjects. The hs-CRP level of bipolar patients was also elevated in full remission. The elevation of IL-1Ra and hs-CRP levels in acute mania was independent of each other. They were also independent of the body mass index (BMI) and levels of leptin and insulin measurements. The levels of leptin were all positively associated with insulin levels in the normal subjects and bipolar patients in three phases. However, a significant relationship between leptin and immunoparameter was only seen in full remission with sTNF-R1 (r = 0.51). Furthermore, IL-1Ra was inversely correlated with sTNF-R1 (r = - 0.37, p <0.05) during partly remission, and while levels of IL-1Ra tended to normalize when patients remitted, levels of hs-CRP and sTNF-R1 showed the opposite trend. Conclusions: Activated inflammation was found in acute mania, as evidenced by high levels of IL-1Ra, hs-CRP, and sTNF-R1. The production of leptin may be more tightly linked to insulin than the immunomodulators. Chronic inflammation may exist in bipolar patients and is reflected by elevations of IL-1Ra and hs-CRP levels in acute mania and persistent higher hs-CRP in full remission.",
keywords = "Bipolar mania, C-reactive protein, Insulin sensitivity, Interleukin-1 receptor antagonist (IL-1Ra), Leptin, Soluble tumor necrosis factor receptor 1 (sTNF-R1)",
author = "Shang-Ying Tsai and Kuo-Hsuan Chung and Jui-Yu Wu and Kuo, {Chian Jue} and Hsin-Chien Lee and Shou-Hung Huang",
year = "2012",
month = "1",
doi = "10.1016/j.jad.2011.08.022",
language = "English",
volume = "136",
pages = "110--116",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier",
number = "1-2",

}

TY - JOUR

T1 - Inflammatory markers and their relationships with leptin and insulin from acute mania to full remission in bipolar disorder

AU - Tsai, Shang-Ying

AU - Chung, Kuo-Hsuan

AU - Wu, Jui-Yu

AU - Kuo, Chian Jue

AU - Lee, Hsin-Chien

AU - Huang, Shou-Hung

PY - 2012/1

Y1 - 2012/1

N2 - Background: Weight gain and increased production of leptin may be associated with immuno-modulation and insulin resistance in bipolar disorder. The links among inflammatory markers, leptin, and insulin of bipolar patients from acute mania to full remission remain unclear. Methods: Thirty-three healthy, bipolar I patients under 45 years of age were enrolled. We measured the circulating levels of high-sensitivity C-reactive protein (hs-CRP), anti-inflammatory mediators (interleukin-1 receptor antagonist [IL-1Ra] and soluble tumor necrosis factor receptor 1 [sTNF-R1]), leptin, and insulin during acute mania and subsequent partial and full remission. The results were compared with 33 age- and gender-matched healthy subjects. Results: The levels of IL-1Ra and hs-CRP of bipolar patients in both acute mania and partial remission were significantly higher than their levels of control subjects. The hs-CRP level of bipolar patients was also elevated in full remission. The elevation of IL-1Ra and hs-CRP levels in acute mania was independent of each other. They were also independent of the body mass index (BMI) and levels of leptin and insulin measurements. The levels of leptin were all positively associated with insulin levels in the normal subjects and bipolar patients in three phases. However, a significant relationship between leptin and immunoparameter was only seen in full remission with sTNF-R1 (r = 0.51). Furthermore, IL-1Ra was inversely correlated with sTNF-R1 (r = - 0.37, p <0.05) during partly remission, and while levels of IL-1Ra tended to normalize when patients remitted, levels of hs-CRP and sTNF-R1 showed the opposite trend. Conclusions: Activated inflammation was found in acute mania, as evidenced by high levels of IL-1Ra, hs-CRP, and sTNF-R1. The production of leptin may be more tightly linked to insulin than the immunomodulators. Chronic inflammation may exist in bipolar patients and is reflected by elevations of IL-1Ra and hs-CRP levels in acute mania and persistent higher hs-CRP in full remission.

AB - Background: Weight gain and increased production of leptin may be associated with immuno-modulation and insulin resistance in bipolar disorder. The links among inflammatory markers, leptin, and insulin of bipolar patients from acute mania to full remission remain unclear. Methods: Thirty-three healthy, bipolar I patients under 45 years of age were enrolled. We measured the circulating levels of high-sensitivity C-reactive protein (hs-CRP), anti-inflammatory mediators (interleukin-1 receptor antagonist [IL-1Ra] and soluble tumor necrosis factor receptor 1 [sTNF-R1]), leptin, and insulin during acute mania and subsequent partial and full remission. The results were compared with 33 age- and gender-matched healthy subjects. Results: The levels of IL-1Ra and hs-CRP of bipolar patients in both acute mania and partial remission were significantly higher than their levels of control subjects. The hs-CRP level of bipolar patients was also elevated in full remission. The elevation of IL-1Ra and hs-CRP levels in acute mania was independent of each other. They were also independent of the body mass index (BMI) and levels of leptin and insulin measurements. The levels of leptin were all positively associated with insulin levels in the normal subjects and bipolar patients in three phases. However, a significant relationship between leptin and immunoparameter was only seen in full remission with sTNF-R1 (r = 0.51). Furthermore, IL-1Ra was inversely correlated with sTNF-R1 (r = - 0.37, p <0.05) during partly remission, and while levels of IL-1Ra tended to normalize when patients remitted, levels of hs-CRP and sTNF-R1 showed the opposite trend. Conclusions: Activated inflammation was found in acute mania, as evidenced by high levels of IL-1Ra, hs-CRP, and sTNF-R1. The production of leptin may be more tightly linked to insulin than the immunomodulators. Chronic inflammation may exist in bipolar patients and is reflected by elevations of IL-1Ra and hs-CRP levels in acute mania and persistent higher hs-CRP in full remission.

KW - Bipolar mania

KW - C-reactive protein

KW - Insulin sensitivity

KW - Interleukin-1 receptor antagonist (IL-1Ra)

KW - Leptin

KW - Soluble tumor necrosis factor receptor 1 (sTNF-R1)

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U2 - 10.1016/j.jad.2011.08.022

DO - 10.1016/j.jad.2011.08.022

M3 - Article

C2 - 21962564

AN - SCOPUS:84857050654

VL - 136

SP - 110

EP - 116

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

IS - 1-2

ER -