Serum Element Concentrations in Bipolar Disorder: A Case-Control Analysis by ICP-MS

Introduction Alterations in serum element concentrations have been proposed to contribute to the pathophysiology of psychiatric disorders. However, this association has not been thoroughly investigated in bipolar disorder (BD) and existing evidence remains inconsistent. This pilot study aimed to assess the relationship between the serum concentrations of essential trace elements (ETE) alkali metals (AM), alkaline earth metals (AEM) and non-essential elements in an euthymic sample of BD and healthy controls (HC) in order to identify both group- and sex-specific differences. Methods Serum levels of fourteen elements were quantified using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) in eleven euthymic patients with BD and nine HC. Both groups showed no statistical significance regarding age, sex and BMI. Results Serum Magnesium levels (Mg: t(18) = 2.441, p = .025) were significantly elevated in individuals with BD (24.5 ± 1.7 mg L-1) compared to HC (22.9 ± 1.1 mg L-1). In addition, serum copper (Cu) concentrations were significantly higher in female participants relative to males (Cu: t(18) = 2.329, p = .032), independent of diagnostic group. Conclusion This pilot study observed elevated serum Mg concentrations in euthymic BD patients. While our findings suggest that Mg may contribute to the pathophysiology of BD, the small sample size, cross-sectional design, and inability to separate medication effects from disease effects limit interpretation. Therefore, further research is necessary to gain deeper insights into elemental alterations in BD and to clarify their clinical significance.