title: Thiobarbituric Acid-Reactive Substances: Markers of an Acute Episode and a Late Stage of Bipolar Disorder.
abstract: BACKGROUND
  Lowered antioxidant defense systems and increased oxidative stress are implicated in bipolar disorders (BD). Early and late stages of BD may present different biological features (including the level of oxidative stress) and may therefore require different treatment strategies. The aim of this study was to analyze serum levels of lipid peroxidation [measured as thiobarbituric acid-reactive substances (TBARS), a derivative of malondialdehyde] in BD patients at various stages and phases of the illness and compare their TBARS levels with those of healthy controls.
  
  
  METHODS
  A total of 129 patients (58 in the depressive episode, 23 in the manic episode and 48 in remission) diagnosed with type I (n = 69) or type II (n = 60) BD and 50 healthy volunteers (control group) were enrolled in the study. The level of lipid peroxidation was measured in blood serum using a TBARS assay kit.
  
  
  RESULTS
  TBARS levels in the acute episode of mania/hypomania and depression (but not in remission) were significantly higher than in healthy controls. With regard to the BD stage, both early- and late-stage BD TBARS levels were significantly increased in patients in the depressive episode. In late-stage BD, the TBARS level in patients in remission remained elevated compared with controls. A multiple regression model confirmed the association between the TBARS level and BD stage or acute BD.
  
  
  CONCLUSIONS
  Our findings indicate that TBARS levels reflect the oxidative stress state which increases both in the acute phase of BD (mania/hypomania and depression) and with BD progression (stage).
authors.affiliation: Department of Affective Disorders, Chair of Psychiatry, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Siwek
authors.forename: Magdalena
authors.initials: M
authors.lastname: Sowa-Kucma
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Styczen
authors.forename: Paulina
authors.initials: P
authors.lastname: Misztak
authors.forename: Bernadeta
authors.initials: B
authors.lastname: Szewczyk
authors.forename: Roman
authors.initials: R
authors.lastname: Topor-Madry
authors.forename: Gabriel
authors.initials: G
authors.lastname: Nowak
authors.forename: Dominika
authors.initials: D
authors.lastname: Dudek
authors.forename: Janusz K
authors.initials: JK
authors.lastname: Rybakowski
mesh_terms: D000208:Acute Disease; D000328:Adult; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000097:blood* / Q000188:drug therapy; D001774:Blood Chemical Analysis; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D006801:Humans; D015227:Lipid Peroxidation / Q000502:physiology; D008297:Male; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis*
chemical_list: D017392:Thiobarbituric Acid Reactive Substances