Lipid-lipoprotein and leptin changes associated with full remission in bipolar I disorder

Bipolar I disorder (BD I) has been associated with increased risk for obesity, Diabetes Mellitus, metabolic syndrome and cardiovascular disease (CVD). Thirty-one adult outpatients (18-56 years, 16F/15M) with BD I at manic phase were recruited and interviewed for this prospective study. Body Mass Index (BMI), serum leptin, total cholesterol, low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c) and triglycerides were analysed at first day (manic phase) and after 1 month's naturalistic medical therapy. In male subjects total cholesterol and triglycerides levels were significantly increased (p<0.05). In female subjects total cholesterol and LDL-c increments did not reach significance level (p:0.066 and p:0.056 respectively). However according to the NCEP ATP III classification, number of patients carrying increased risk for CVD increased in both male and femele patients. In both sexes serum leptin levels did not accompany significant but relatively small (0.56±0.14 kg/m2 ) BMI rises. According to the generel lineer model, pre-after treatment leptin changes as the dependent variable, sex, beginning age and previous attack type were significant contributors (68.7%, p<0.007). These results suggest that remission in BD I is associated with significant BMI and systemic lipid and/or lipoprotein differences in both sexes , but in different patterns. These differences may be due to direct or indirect effect of drugs and life style changes. However it is also possible that alterations in plasma lipid and lipoproteins could positively affect mood by affecting cell membrane lipid content. Key words : Bipolar I disorder, Body Mass Index, cholesterol, leptin, triglycerides, LDL-c