Association Between Accelerated Atherosclerosis and High-Sensitivity C-Reactive Protein Levels in Bipolar Disorder...

Individuals with bipolar disorder (BPD) and schizophrenia (SCZ) are at increased risk for cardiovascular disease and have been reported to exhibit inflammatory activation. This study examined the link between systemic inflamm-ation and accelerated atherosclerosis, focusing on whether high-sensitivity C-reactive protein (hs-CRP) is associated with carotid intima-media thickness (cIMT) in these populations.

Physically healthy outpatients with bipolar I disorder or schizophrenia (DSM-5) as well as healthy controls, aged 20-60 years, were recruited to assess cIMT via high-resolution carotid ultrasound. Fasting venous blood samples were collected to measure levels of hs-CRP and lipid profiles on the day of ultrasonography. Clinical data were obtained from medical records and interviews.

Patients with BPD (n = 111) and SCZ (n = 115) demonstrated significantly higher cIMT and hs-CRP levels compared to healthy controls (n = 84). In the BPD group, age, BMI, hs-CRP levels, duration of illness, and lithium daily dosage were identified as significant correlates of cIMT in bivariate analyses. In the multivariate analyses, hs-CRP levels were independently associated with increased cIMT after adjustment for age, body mass index, sex, and smoking habit, explaining 5.6% of the variance. In SCZ group, only age was significantly associated with cIMT. Smoking status and lipid profiles were not significantly associated with cIMT in either group.

Even physically healthy patients with BPD and SCZ exhibit accelerated atherosclerosis before geriatric age, reflected by increased cIMT. The association between hs-CRP and cIMT is observed in BPD, but not in SCZ, suggesting a greater role of chronic low-grade inflammation in BPD-related early vascular changes.