Endothelial Function in Youth With Bipolar Disorder: Preliminary Evidence for Mood Polarity Differences

Area of Science:

• Cardiovascular Health
• Adolescent Psychiatry
• Endothelial Function Research

Background:

• Bipolar disorder (BD) is associated with increased risk for accelerated atherosclerosis and early cardiovascular disease (CVD).
• In adults, the burden of mood symptoms in BD correlates with CVD.
• Endothelial dysfunction is an early predictor of CVD and its relationship with mood states in youth with BD requires examination.

Purpose of the Study:

• To investigate endothelial dysfunction in relation to mood states and symptoms among youth with bipolar disorder.
• To compare endothelial function (Reactive Hyperemia Index - RHI) across different mood states in adolescents with BD and healthy controls.

Main Methods:

• A study involving 209 youth (13-20 years), including 114 with BD and 95 healthy controls (HC).
• Diagnoses and mood symptoms were assessed using validated semi-structured interviews based on DSM-IV-TR criteria.
• Endothelial function was measured non-invasively using the Reactive Hyperemia Index (RHI) via pulse amplitude tonometry (PAT).

Main Results:

• Significant differences in RHI were observed between groups (BD-euthymic, BD-depressed, BD-hypomanic/mixed, and HC).
• The BD-depressed group exhibited lower RHI compared to HC (P=.04).
• The BD-hypomanic/mixed group showed higher RHI than BD-euthymic (P=.02), BD-depressed (P<.001), and HC (P=.04) groups. Higher RHI in the BD group correlated with mania scores (P=.006) but not depression scores.

Conclusions:

• Symptomatic youth with bipolar disorder demonstrate abnormal RHI that varies with mood polarity.
• These findings suggest that endothelial dysfunction may play a role in the psychiatric symptoms and cardiovascular risk observed in BD.
• Further research with larger samples and prospective measures is warranted to explore the link between endothelial dysfunction and BD outcomes.