title: Creatine kinase levels in patients with bipolar disorder: depressive, manic, and euthymic phases.
abstract: OBJECTIVE
  Bipolar disorder is a severe, recurrent, and often chronic psychiatric illness associated with significant functional impairment, morbidity, and mortality. Creatine kinase is an important enzyme, particularly for cells with high and fluctuating energy requirements, such as neurons, and is a potential marker of brain injury. The aim of the present study was to compare serum creatine kinase levels between bipolar disorder patients, in the various phases (depressive, manic, and euthymic), and healthy volunteers.
  
  
  METHODS
  Forty-eight bipolar patients were recruited: 18 in the euthymic phase; 17 in the manic phase; and 13 in the depressive phase. The control group comprised 41 healthy volunteers. The phases of bipolar disorder were defined as follows: euthymic-not meeting the DSM-IV criteria for a mood episode and scoring < 8 on the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS); manic-scoring < 7 on the HDRS and > 7 on the YMRS; depressive-scoring > 7 on the HDRS and < 7 on the YMRS. Patients in mixed phases were excluded. Blood samples were collected from all participants.
  
  
  RESULTS
  Creatine kinase levels were higher in the manic patients than in the controls. However, we observed no significant difference between euthymic and depressive patients in terms of the creatine kinase level.
  
  
  CONCLUSIONS
  Our results suggest that the clinical differences among the depressive, manic, and euthymic phases of bipolar disorder are paralleled by contrasting levels of creatine kinase. However, further studies are needed in order to understand the state-dependent differences observed in serum creatine kinase activity.
authors.affiliation: Laboratory of Neurosciences, National Institute for Translational Medicine, Postgraduate Program in Health Sciences, Health Sciences Unit, Universidade do Extremo Sul Catarinense, SC, Brazil.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Feier
authors.forename: Samira S
authors.initials: SS
authors.lastname: Valvassori
authors.forename: Gislaine T
authors.initials: GT
authors.lastname: Rezin
authors.forename: Márcio
authors.initials: M
authors.lastname: Búrigo
authors.forename: Emilio L
authors.initials: EL
authors.lastname: Streck
authors.forename: Flávio
authors.initials: F
authors.lastname: Kapczinski
authors.forename: João
authors.initials: J
authors.lastname: Quevedo
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001714:Bipolar Disorder / Q000097:blood* / Q000523:psychology; D016022:Case-Control Studies; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male
chemical_list: D015415:Biomarkers; D003402:Creatine Kinase