title: Elevated C-reactive Protein Levels in Women with Bipolar Disorder may be Explained by a History of Childhood Trauma, Especially Sexual Abuse, Body Mass Index and Age.
abstract: OBJECTIVE
  To evaluate whether increased levels of high-sensitivity C- reactive protein (hs-CRP) observed in individuals with bipolar disorder (BD) compared to healthy controls (HCs) could be influenced by a previous exposure to early life stress (ELS) independently from other explanatory or background variables, including age, body mass index (BMI), and the presence of cooccurring mental disorders.
  
  
  METHODS
  In this case-control study, we included 142 healthy controls and 92 bipolar I and II patients. The Childhood Trauma Questionnaire was administered in a subset of 30 female patients with BD and 31 female HCs, and plasma hs-CRP was measured in all subjects. Multivariable models adjusted the data for the possible confounding variables.
  
  
  RESULTS
  Serum hs-CRP levels were significantly higher in patients with BD compared to HCs. However, after controlling for BMI, these differences were no longer significant. Around 55% of the variance in hs-CRP was explained by cumulative and independent effects of age, BMI and childhood trauma, especially sexual abuse.
  
  
  CONCLUSIONS
  Our results show that increased hs-CRP levels in BD patients are more related to childhood trauma, especially sexual abuse, age and BMI than to a diagnosis of BD per se. These data suggest that peripheral inflammation may underpin the well-known detrimental effects of childhood maltreatment and obesity in the course of BD. Hs-CRP data are difficult to interpret if they are not adjusted for effects of BMI and age.
authors.affiliation: Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, ZIP: 86035-380 - Londrina - Parana, Brazil.
authors.forename: Juliana Brum
authors.initials: JB
authors.lastname: Moraes
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, PO Box 281, Geelong 3220. Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Maes
authors.affiliation: Department of Clinical and Toxicological Analysis, Universidade Estadual de Londrina, Londrina, Brazil.
authors.forename: Decio Sabbatini
authors.initials: DS
authors.lastname: Barbosa
authors.affiliation: Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, ZIP: 86035-380 - Londrina - Parana, Brazil.
authors.forename: Thais Zagabria
authors.initials: TZ
authors.lastname: Ferrari
authors.affiliation: Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, ZIP: 86035-380 - Londrina - Parana, Brazil.
authors.forename: Marcela Keikko Spagolla
authors.initials: MKS
authors.lastname: Uehara
authors.affiliation: Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
authors.forename: Andre F
authors.initials: AF
authors.lastname: Carvalho
authors.affiliation: Department of Clinical and Toxicological Analysis, Universidade Estadual de Londrina, Londrina, Brazil.
authors.forename: Sandra Odebrecht Vargas
authors.initials: SOV
authors.lastname: Nunes
mesh_terms: D000293:Adolescent; D000328:Adult; D000069586:Adult Survivors of Child Adverse Events; D000368:Aged; D000375:Aging / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001714:Bipolar Disorder / Q000097:blood*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D013315:Stress, Psychological / Q000097:blood; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Bipolar disorder; C-reactive protein; childhood sexual abuse; depression; early life stress; immune activation; inflammation