Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder
Yıl: 2018 Cilt: 46 Sayı: 1 Sayfa Aralığı: 32 - 38 Metin Dili: İngilizce DOI: 10.5543/tkda.2017.23350 İndeks Tarihi: 04-08-2020
Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder
Öz: Objective: Individuals with bipolar disorder (BD) frequentlysuffer from cardiovascular disease (CVD), and it is a leadingcause of mortality. Clinicians use routine laboratory tests, including a lipid profile, to predict cardiovascular risk. In addition,a particular lipid ratio, the atherogenic index of plasma (AIP),is a sensitive, new parameter that can be used to assess highrisk groups. To our knowledge, this is the first study evaluatingcardiovascular risk via AIP in different stages of BD.Methods: The study group consisted of male patients withBD who were in a manic, depressive, or euthymic state, andage- and gender-matched healthy controls. Lipid profiles wereanalyzed and the AIP parameter of logarithm of triglyceride(TG) / high-density lipoprotein cholesterol (HDLc) was calculated for all of the participants. The significance level was setat p<0.05.Results: A total of 44 BD patients experiencing a manicepisode, 35 depressive BD patients, 42 euthymic patients,and 41 healthy controls matched for age, gender, and smoking status were enrolled in the study. The AIP level was significantly different between groups (p=0.009). Pairwise comparisons of the groups revealed that the AIP level of depressivepatients was significantly higher than that of the manic, euthymic, and control groups (p=0.013, p=0.048, and p=0.021,respectively). The AIP level was positively correlated withbody mass index, waist circumference, metabolic syndrome,total cholesterol, low-density lipoprotein, and triglyceride level,and was negatively correlated with the HDLc level.Conclusion: In this study, male BD patients in a depressiveepisode demonstrated an increase in cardiovascular risk. Thesignificant correlations between AIP and other conventionalcardiovascular risk factors indicate that AIP may be more useful to identify individuals with BD at high risk for CVD thanabsolute lipid parameters.
Anahtar Kelime: Bipolar bozukluğun manik, depresif ve ötimik evrelerinde bir kardiyovasküler risk belirleyicisi olarak aterojenik plazma indeksi
Öz: Amaç: Bipolar bozukluğu (BB) olan bireylerde, mortalitenin başlıca nedeni olan kardiyovasküler hastalıklar sıkça görülmektedir. Klinikçiler kardiyovasküler riski öngörmek için lipit profili de dahil olmak üzere rutin laboratuvar testlerini kullanmaktadırlar. Rutin testlerin yanında, lipit parametrelerinin çeşitli oranlamalarıyla hesaplanan aterojenik plazma indeksi (APİ) de, yüksek riskli grupları değerlendirmek için kullanılan yeni ve hassas bir parametredir. Bildiğimiz kadarıyla çalışmamız bipolar bozukluğun farklı evrelerinde APİ yoluyla kardiyovasküler riski değerlendiren ilk çalışmadır. Yöntemler: Çalışmamızın grupları, BB tanılı ve manik, depresif veya ötimik dönemde olan hastalar ile yaş-cinsiyet eşleştirilmiş sağlıklı kontrollerden oluşmaktadır. Tüm katılımcılar için lipit profili incelendi ve APİ log (TG / HDLc) parametresi hesaplandı. Anlamlılık düzeyi p<0.05 olarak belirlendi. Bulgular: Manik atakta olan 44, depresif dönemde 35, ötimik dönemde 42 BB’li hasta ve yaş, cinsiyet ve sigara içme durumu eşleştirilmiş 41 sağlıklı bireyden oluşan kontrol grubu çalışmaya alındı. APİ düzeyleri gruplar arasında anlamlı fark gösterdi (p=0.009). Grupların ikili karşılaştırmalarında, depresif hastaların APİ düzeyi manik, ötimik ve kontrol gruplarına göre anlamlı derecede yüksekti (sırasıyla, p=0.013, p=0.048 ve p=0.021). APİ düzeyleri vücut kitle indeksi, bel çevresi, metabolik sendrom varlığı, toplam kolesterol, düşük yoğunluklu lipoprotein, trigliserit düzeyleri ile pozitif yönde ve yüksek yoğunluklu lipoprotein düzeyi ile negatif korelasyon gösterdi. Sonuç: Çalışmamızda depresif dönemdeki BB’li hastalarda kardiyovasküler risk artışı saptandı. APİ’nin diğer geleneksel kardiyovasküler risk faktörleri ile anlamlı korelasyon göstermesi, yüksek riskli BB’li bireyleri tanımlamak için APİ’nin lipit parametrelerinin tek tek ölçülmelerinden daha yararlı olabileceğini göstermektedir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Goldstein BI, Carnethon MR, Matthews KA, McIntyre RS, Miller GE, Raghuveer G, et al; American Heart Association Atherosclerosis; Hypertension and Obesity in Youth Commit tee of the Council on Cardiovascular Disease in the Young. Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation 2015;132:965–86. [CrossRef]
- 2. Bhardwaj S, Bhattacharijee J, Bhatnagar MK, Tyagi S. Atherogenic index of plasma, castelli risk index and atherogenic coefficient - new parameters in assessing cardiovascular risk. Int J Pharm Biol Sci 2013;3:359–64.
- 3. Gubert C, Jacintho Moritz CE, Vasconcelos-Moreno MP, Quadros Dos Santos BT, Sartori J, Fijtman A, et al. Peripheral adenosine levels in euthymic patients with bipolar disorder. Psychiatry Res 2016;246:421–6. [CrossRef]
- 4. Mannangi NB, Jayaram S, Viruprakas HS, Kashinakunti S, Manjula R. Novel lipid indices in chronic kidney disease. Natl J Med Res 2015;5:39–42.
- 5. Nunes SO, Piccoli de Melo LG, Pizzo de Castro MR, Barbosa DS, Vargas HO, Berk M, et al. Atherogenic index of plasma and atherogenic coefficient are increased in major depression and bipolar disorder, especially when comorbid with tobacco use disorder. J Affect Disord 2015;172:55–62. [CrossRef]
- 6. Vargas HO, Nunes SO, Barbosa DS, Vargas MM, Cestari A, Dodd S, et al. Castelli risk indexes 1 and 2 are higher in major depression but other characteristics of the metabolic syndrome are not specific to mood disorders. Life Sci 2014;102:65–71.
- 7. Soreca I, Wallace ML, Frank E, Hasler BP, Levenson JC, Kupfer DJ. Sleep duration is associated with dyslipidemia in patients with bipolar disorder in clinical remission. J Affect Disord 2012;141:484–7. [CrossRef]
- 8. Chaggar PS, Shaw SM, Williams SG. Effect of antipsychotic medications on glucose and lipid levels. J Clin Pharmacol 2011;51:631–8. [CrossRef]
- 9. Correll CU, Detraux J, De Lepeleire J, De Hert M. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World Psychiatry 2015;14:119–36.
- 10. McIntyre RS, McElroy SL, Eudicone JM, Forbes RA, Carlson BX, Baker RA. A 52-week, double-blind evaluation of the metabolic effects of aripiprazole and lithium in bipolar I disorder. Prim Care Companion CNS Disord 2011;13. pii: PCC.11m01182.
- 11. Chang HH, Yang YK, Gean PW, Huang HC, Chen PS, Lu RB. The role of valproate in metabolic disturbances in bipolar disorder patients. J Affect Disord 2010;124:319–23. [CrossRef]
- 12. Pérez-Piñar M, Mathur R, Foguet Q, Ayis S, Robson J, Ayerbe L. Cardiovascular risk factors among patients with schizophrenia, bipolar, depressive, anxiety, and personality disorders. Eur Psychiatry 2016;35:8–15. [CrossRef]
- 13. Lehto SM, Hintikka J, Niskanen L, Tolmunen T, KoivumaaHonkanen H, Honkalampi K, et al. Low HDL cholesterol associates with major depression in a sample with a 7-year history of depressive symptoms. Prog Neuropsychopharmacol Biol Psychiatry 2008;32:1557–61. [CrossRef]
- 14. Łucka A, Arabska J, Fife E, Kroc Ł, Sołtysik BK, Kłoszewska I, et al. Atherogenic Indices Are Increased in Elderly Patients with Unipolar Depression-Case-Control Analysis. Metab Syndr Relat Disord 2017;15:291–5. [CrossRef]
- 15. Bortolasci CC, Vargas HO, Vargas Nunes SO, de Melo LG, de Castro MR, Moreira EG, et al. Factors influencing insulin resistance in relation to atherogenicity in mood disorders, the metabolic syndrome and tobacco use disorder. J Affect Disord 2015;179:148–55. [CrossRef]
- 16. de Melo LGP, Nunes SOV, Anderson G, Vargas HO, Barbosa DS, Galecki P, et al. Shared metabolic and immune-inflammatory, oxidative and nitrosative stress pathways in the metabolic syndrome and mood disorders. Prog Neuropsychopharmacol Biol Psychiatry 2017;78:34–50. [CrossRef]
- 17. Adibfar A, Saleem M, Lanctot KL1, Herrmann N. Potential Biomarkers for Depression Associated with Coronary Artery Disease: A Critical Review. Curr Mol Med 2016;16:137–64.
- 18. Vancampfort D, Probst M, Wyckaert S, De Hert M, Stubbs B, Rosenbaum S, et al. Physical activity as a vital sign in patients with bipolar disorder. Psychiatry Res 2016;246:218–22.
- 19. Morriss R, Mohammed FA. Metabolism, lifestyle and bipolar affective disorder. J Psychopharmacol 2005;19:94–101.
- 20. Swartz CM. Albumin decrement in depression and cholesterol decrement in mania. J Affect Disord 1990;19:173–6. [CrossRef]
- 21. Wysokiński A, Strzelecki D, Kłoszewska I. Levels of triglycerides, cholesterol, LDL, HDL and glucose in patients with schizophrenia, unipolar depression and bipolar disorder. Diabetes Metab Syndr 2015;9:168–76. [CrossRef]
- 22. Atmaca M, Kuloglu M, Tezcan E, Ustundag B, Bayik Y. Serum leptin and cholesterol levels in patients with bipolar disorder. Neuropsychobiology 2002;46:176–9. [CrossRef]
- 23. Kalelioglu T, Genc A, Karamustafalioglu N, Emul M. Assessment of cardiovascular risk via atherogenic indices in patients with bipolar disorder manic episode and alterations with treatment. Diabetes Metab Syndr 2017;11:473-5. [CrossRef]
| APA | KALELİOĞLU T, ÜNALAN P, KÖK B, SÖZEN Ş, Yüksel Ö, akkus m, CİHNİOĞLU R, KARAMUSTAFALIOĞLU N (2018). Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder. , 32 - 38. 10.5543/tkda.2017.23350 |
| Chicago | KALELİOĞLU Tevfik,ÜNALAN Pelin,KÖK Burcu,SÖZEN Şule,Yüksel Özge,akkus mustafa,CİHNİOĞLU Refik,KARAMUSTAFALIOĞLU Nesrin Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder. (2018): 32 - 38. 10.5543/tkda.2017.23350 |
| MLA | KALELİOĞLU Tevfik,ÜNALAN Pelin,KÖK Burcu,SÖZEN Şule,Yüksel Özge,akkus mustafa,CİHNİOĞLU Refik,KARAMUSTAFALIOĞLU Nesrin Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder. , 2018, ss.32 - 38. 10.5543/tkda.2017.23350 |
| AMA | KALELİOĞLU T,ÜNALAN P,KÖK B,SÖZEN Ş,Yüksel Ö,akkus m,CİHNİOĞLU R,KARAMUSTAFALIOĞLU N Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder. . 2018; 32 - 38. 10.5543/tkda.2017.23350 |
| Vancouver | KALELİOĞLU T,ÜNALAN P,KÖK B,SÖZEN Ş,Yüksel Ö,akkus m,CİHNİOĞLU R,KARAMUSTAFALIOĞLU N Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder. . 2018; 32 - 38. 10.5543/tkda.2017.23350 |
| IEEE | KALELİOĞLU T,ÜNALAN P,KÖK B,SÖZEN Ş,Yüksel Ö,akkus m,CİHNİOĞLU R,KARAMUSTAFALIOĞLU N "Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder." , ss.32 - 38, 2018. 10.5543/tkda.2017.23350 |
| ISNAD | KALELİOĞLU, Tevfik vd. "Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder". (2018), 32-38. https://doi.org/10.5543/tkda.2017.23350 |
| APA | KALELİOĞLU T, ÜNALAN P, KÖK B, SÖZEN Ş, Yüksel Ö, akkus m, CİHNİOĞLU R, KARAMUSTAFALIOĞLU N (2018). Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder. Türk Kardiyoloji Derneği Arşivi, 46(1), 32 - 38. 10.5543/tkda.2017.23350 |
| Chicago | KALELİOĞLU Tevfik,ÜNALAN Pelin,KÖK Burcu,SÖZEN Şule,Yüksel Özge,akkus mustafa,CİHNİOĞLU Refik,KARAMUSTAFALIOĞLU Nesrin Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder. Türk Kardiyoloji Derneği Arşivi 46, no.1 (2018): 32 - 38. 10.5543/tkda.2017.23350 |
| MLA | KALELİOĞLU Tevfik,ÜNALAN Pelin,KÖK Burcu,SÖZEN Şule,Yüksel Özge,akkus mustafa,CİHNİOĞLU Refik,KARAMUSTAFALIOĞLU Nesrin Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder. Türk Kardiyoloji Derneği Arşivi, vol.46, no.1, 2018, ss.32 - 38. 10.5543/tkda.2017.23350 |
| AMA | KALELİOĞLU T,ÜNALAN P,KÖK B,SÖZEN Ş,Yüksel Ö,akkus m,CİHNİOĞLU R,KARAMUSTAFALIOĞLU N Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder. Türk Kardiyoloji Derneği Arşivi. 2018; 46(1): 32 - 38. 10.5543/tkda.2017.23350 |
| Vancouver | KALELİOĞLU T,ÜNALAN P,KÖK B,SÖZEN Ş,Yüksel Ö,akkus m,CİHNİOĞLU R,KARAMUSTAFALIOĞLU N Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder. Türk Kardiyoloji Derneği Arşivi. 2018; 46(1): 32 - 38. 10.5543/tkda.2017.23350 |
| IEEE | KALELİOĞLU T,ÜNALAN P,KÖK B,SÖZEN Ş,Yüksel Ö,akkus m,CİHNİOĞLU R,KARAMUSTAFALIOĞLU N "Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder." Türk Kardiyoloji Derneği Arşivi, 46, ss.32 - 38, 2018. 10.5543/tkda.2017.23350 |
| ISNAD | KALELİOĞLU, Tevfik vd. "Atherogenic index of plasma as a cardiovascular risk marker in manic, depressive, and euthymic stages of bipolar disorder". Türk Kardiyoloji Derneği Arşivi 46/1 (2018), 32-38. https://doi.org/10.5543/tkda.2017.23350 |
