Relationship between food consumption, cronotype, clinical course and homocystei̇n levels in remission period of bipolar disorders

AIM OF STUDY:Bipolar disorder (BAB) is an important and chronic mental illness that leads to disability. In recent years, like other mental disorders, biological markers have began to important in bipolar disorder. Homocysteine is considered to be a risk factor for many neurological and cardiovascular diseases, and hiperhomocysteinemia has been detected in depression, schizophrenia and bipolar disorder . ın addition, bipolar patients show some circadian rhythm disorders even during remission periods. Among these, sleep disorders have been shown at the beginning, while chronotypes that reflecting the circadian preferences of individuals have also been shown in studies which evening type is more common in bipolar disorder and this is associated with sleep disturbance. In this study, we aimed to determine blood homocysteine levels and chronotype of patients in bipolar disorder in remission period and to investigate whether they are related to the clinical course of the disease. MATERIAL AND METHOD:In this study, 80 patients between 18-65 years old who were remotely referred to Atatürk University Training and Research Hospital psychiatry outpatient clinic were recruited. The Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS) were used to determine if the patients were in the remission period. The Pittsburg Sleep Quality Scale (PUKI) was administered to assess the sleep quality of the patients. A questionnaire consisting of 100 questions was prepared to provide the pathology of the illness and to determine the sociodemographic characteristics. To calculate their daily protein consumption, they were asked about the type and amount of food they had eaten the day before, and the protein intake was calculated by the BeBis program. Blood samples were taken in the morning for homocysteine blood levels, centrifuged, kept at -40 ° C, all blood was collected, and the blood was resolved on the day of study and measured directly on the Advia Centaur XP (Siemens) using Siemens commercial kits. . >15 µmol/L homocysteine is evaluated as high. RESULTS: Patients homocysteine levels were correlated with the number of mixed episodes after conservative treatment (p: 0.007). There were more mixed episodes in patient with high homocysteine blood levels. Blood levels of homocysteine were significantly higher in those with low MEQ scores (evening type).There was an association between homocysteine and vitamin B12 (p: 0.003). patients with low serum B12 levels had higher homocysteine levels. When we look at the chronotype, we see that the number of children is more in the morningness type (p: 0,023). In addition, the level of LDL cholesterol was again higher in the eveningness type (p: 0.001). CONCLUSİON: The most important outcome of our study was that %13,75 of patients were in the remission period had a high blood homocystein levels despite the absence of additional medical illnesses and this was related to the type of eveningness. Bipolar disorder is very important for both individual, family and society. Concrete indications for the treatment and follow-up of patients will facilitate the work of psychiatrists, and will also benefit patients in their treatment and follow-up. KEY WORDS: Bipolar disorder, homocysteine, chronotype