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Individuals with Bipolar Disorder Have a Higher Level of Homocysteine Than Major Depressive Disorder: A Retrospective
Miao Zhao1, Tengteng Liu1, Sufang Qi1
1Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China.
Insights
Homocysteine (Hcy) levels are elevated in major depressive disorder (MDD) and bipolar disorder (BD) patients. Higher Hcy levels in bipolar disorder may help distinguish it from major depressive disorder.
Area of Science:
- Neuroscience
- Biochemistry
- Psychiatry
Background:
- Homocysteine (Hcy) is implicated in the pathogenesis of major depressive disorder (MDD) and bipolar disorder (BD) through mechanisms like glutamatergic transmission and inflammation.
- Currently, no established biomarkers can reliably differentiate between BD and MDD.
Purpose of the Study:
- This study aimed to compare homocysteine levels between patients diagnosed with bipolar disorder and major depressive disorder.
- To investigate the potential of homocysteine as a distinguishing biomarker between BD and MDD.
Main Methods:
- The study included 104 MDD patients, 103 BD patients, and 80 healthy controls (HC).
- Homocysteine levels were measured in patients during acute and non-acute phases and compared to HC.
- Multivariate logistic regression was used to assess the association between Hcy levels and BD diagnosis.
Main Results:
- Homocysteine levels were significantly higher in both MDD and BD groups compared to HC.
- BD patients exhibited higher homocysteine levels than MDD patients in both acute and non-acute phases.
- Elevated homocysteine levels were significantly associated with an increased likelihood of BD diagnosis, independent of medication use, gender, age, and metabolic indicators.
Conclusions:
- Homocysteine levels are elevated in patients with MDD and BD, with higher concentrations observed in BD.
- These findings suggest a potential role for homocysteine and one-carbon metabolism in the pathogenesis of bipolar disorder.
- Homocysteine may serve as a potential biomarker for differentiating bipolar disorder from major depressive disorder.
Purpose:
Previous studies suggest that homocysteine (Hcy) may be involved in the pathogenesis of bipolar disorder (BD) and major depressive disorder (MDD) by influencing glutamatergic transmission, inflammation, and other mechanisms. There are no established biomarkers to distinguish BD from MDD. This study aims to compare Hcy levels between BD and MDD.
Patients And Methods:
We collected medical records of patients aged 14-75 admitted to the hospital from January 1 to July 1, 2022 with a discharge diagnosis of MDD or BD, including all examinations of patients at admission (acute phase) and discharge (non-acute phase). We measured Hcy levels in healthy controls (HC).
Results:
The analysis included 104 patients with MDD, 103 patients with BD, and 80 HC. Hcy levels were higher in the MDD and BD group than in the HC group and higher in the BD group than in the MDD group, both in the acute and non-acute phases (all P < 0.05). There was no significant difference in Hcy levels between the psychotropic medication users and non-users in the BD or MDD group (all P > 0.05). Multivariate logistic regression analysis only for the MDD and BD group indicated that the likelihood of BD diagnosis was significantly associated with Hcy levels (in the acute phase: OR = 1.052, P = 0.016; in the non-acute phase: OR = 1.101, P < 0.001) after controlling for gender, age, and metabolic indicators.
Conclusion:
Our study suggests that Hcy levels were elevated in MDD and BD patients and were higher in BD patients than in MDD patients, which provides evidence for a possible relationship between one-carbon metabolism and the pathogenesis of BD. Besides, Hcy may be one of the potential biomarkers to distinguish BD from MDD.
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