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Homocysteine as a peripheral biomarker in bipolar disorder: A meta-analysis

Published online by Cambridge University Press:  23 March 2020

E. Salagre ,
A.F. Vizuete ,
M. Leite ,
D.J. Brownstein ,
A. McGuinness ,
F. Jacka ,
S. Dodd ,
B. Stubbs ,
C.A. Köhler  and
E. Vieta
...Show all authors
E. Salagre*
Affiliation:
Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia Bipolar Unit, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
A.F. Vizuete
Affiliation:
Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
M. Leite
Affiliation:
Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
D.J. Brownstein
Affiliation:
Monash University, Faculty of Medicine, Nursing and Health Sciences, Melbourne, Australia
A. McGuinness
Affiliation:
Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia
F. Jacka
Affiliation:
Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia
S. Dodd
Affiliation:
Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia Department of Psychiatry, University of Melbourne, Parkville, Australia Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
B. Stubbs
Affiliation:
Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK Geriatrics Division, Department of Medicine-DIMED, University of Padova, Padova, Italy Institute of clinical Research and Education in Medicine (IREM), Padova, Italy Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, SE5 8AZLondon, UK
C.A. Köhler
Affiliation:
Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
E. Vieta
Affiliation:
Bipolar Unit, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
A.F. Carvalho
Affiliation:
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, SE5 8AZLondon, UK
M. Berk
Affiliation:
Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia Department of Psychiatry, University of Melbourne, Parkville, Australia Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Australia Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, Australia
B.S. Fernandes*
Affiliation:
Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
*
*Corresponding author. Deakin University, School of Medicine, Barwon Health, Geelong, Victoria, Australia.
*Corresponding author. Deakin University, School of Medicine, Barwon Health, Geelong, Victoria, Australia.
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Abstract

Background:

Bipolar disorder (BD) is a psychiatric disorder with an uncertain aetiology. Recently, special attention has been given to homocysteine (Hcy), as it has been suggested that alterations in 1-carbon metabolism might be implicated in diverse psychiatric disorders. However, there is uncertainty regarding possible alterations in peripheral Hcy levels in BD.

Methods:

This study comprises a meta-analysis comparing serum and plasma Hcy levels in persons with BD and healthy controls. We conducted a systematic search for all eligible English and non-English peer-reviewed articles.

Results:

Nine cross-sectional studies were included in the meta-analyses, providing data on 1547 participants. Random-effects meta-analysis showed that serum and plasma levels of Hcy were increased in subjects with BD in either mania or euthymia when compared to healthy controls, with a large effect size in the mania group (g = 0.98, 95% CI: 0.8–1.17, P < 0.001, n = 495) and a small effect in the euthymia group (g = 0.3, 95% CI: 0.11–0.48, P = 0.002, n = 1052).

Conclusions:

Our meta-analysis provides evidence that Hcy levels are elevated in persons with BD during mania and euthymia. Peripheral Hcy could be considered as a potential biomarker in BD, both of trait (since it is increased in euthymia), and also of state (since its increase is more accentuated in mania). Longitudinal studies are needed to clarify the relationship between bipolar disorder and Hcy, as well as the usefulness of peripheral Hcy as both a trait and state biomarker in BD.

Keywords

Precision psychiatryBiomarkerHomocysteineBipolar disorderSystematic reviewMeta-analysis
Type
Review
Information
European Psychiatry , Volume 43 , June 2017 , pp. 81 - 91
Copyright
Copyright © European Psychiatric Association 2017

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