title: A Longitudinal Study of the Relationships Between Mood Symptoms, Body Mass Index, and Serum Adipokines in Bipolar Disorder.
abstract: OBJECTIVE
  There is a bidirectional relationship between obesity and mood disorders, with each increasing the risk of developing the other. This relationship suggests that they have overlapping pathophysiologic mechanisms. Adipose tissue-derived hormones, or adipokines, regulate appetite and metabolism and have activity in limbic brain regions, making them potential shared etiologic factors between elevated body mass index (BMI) and mood disorders. However, the precise relationships between BMI, mood, and adipokines are unknown.
  
  
  METHODS
  We measured the serum levels of adiponectin, lipocalin-2, resistin, adipsin, and leptin in 53 people with early-stage DSM-IV-defined bipolar disorder, diagnosed with the Mini-International Neuropsychiatric Interview, and 22 healthy comparison subjects. Participants were followed at the University of British Columbia Mood Disorders Centre between June 2004 and June 2012. We were primarily interested in determining, in patients, (1) whether BMI and recent mood episodes predicted adipokine levels and (2) whether adipokine levels in turn predicted subsequent mood relapses and change in BMI.
  
  
  RESULTS
  Using linear regression, we found that (1) past-6-month mood episodes predicted lower adiponectin (β = -0.385, P = .04) and adipsin (β = -0.376, P = .03) levels and higher lipocalin-2 levels (β = 0.411, P = .03), (2) BMI did not predict adipokine levels, and (3) treatment with second-generation antipsychotics was associated with higher resistin levels (β = 0.482, P < .01). Furthermore, lower adiponectin (β = -0.353, P = .01) and leptin (β = -0.332, P = .02) levels predicted depressive relapse over 12 months, while higher adipsin (β = 0.496, P < .01) and leptin (β = 0.421, P < .01) levels predicted BMI gain.
  
  
  CONCLUSIONS
  Our results suggest that mood episodes and medication treatment contribute to adipokine abnormalities in bipolar disorder and that adipokines influence psychiatric illness course and BMI change. Adipokines may represent a novel pathophysiologic mechanism linking elevated BMI and mood disorders and deserve further study as potential mood-regulating molecules.
authors: Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA.|Mood Disorders Centre, University of British Columbia, Vancouver, Canada.
authors: David J
authors: DJ
authors: Bond
authors: Departments of Psychiatry and Pharmacology, University of Toronto, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.
authors: Ana C
authors: AC
authors: Andreazza
authors: Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
authors: John
authors: J
authors: Hughes
authors: Mood Disorders Centre, University of British Columbia, Vancouver, Canada.
authors: Taj
authors: T
authors: Dhanoa
authors: Mood Disorders Centre, University of British Columbia, Vancouver, Canada.
authors: Ivan J
authors: IJ
authors: Torres
authors: Mood Disorders Centre, University of British Columbia, Vancouver, Canada.
authors: Jan-Marie
authors: JM
authors: Kozicky
authors: Departments of Psychiatry and Pharmacology, University of Toronto, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.
authors: L Trevor
authors: LT
authors: Young
authors: Mood Disorders Centre, University of British Columbia, Vancouver, Canada.
authors: Raymond W
authors: RW
authors: Lam
authors: Department of Psychiatry, University of British Columbia, Room 2C7-2255 Wesbrook Mall, Vancouver, BC, Canada V6T 2A1. yatham@mail.ubc.ca.|Mood Disorders Centre, University of British Columbia, Vancouver, Canada.
authors: Lakshmi N
authors: LN
authors: Yatham
mesh_terms: D054392:Adipokines / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000339:Affect / Q000502:physiology*; D001714:Bipolar Disorder / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012008:Recurrence; D055815:Young Adult
chemical_list: D054392:Adipokines