Mood disorders Are the levels of ICAM, VCAM and E-Selectin levels different in the first manic episode and subsequent remission?

Objective: It is known that mortality rates in bipolar disorder are twice higher than other diseases. Cell adhesion molecules feature in the formation of aterosclerosis. Some of the adhesion molecules reveal the risks of cardiovascular disease and atherosclerosis: Intracellular adhesive molecule (ICAM), vascular cell adhesive molecule (VCAM), and E-selectin. The aim of this study is to compare ICAM, VCAM, E-selectin levels between first manic episode and subsequent remission and, to obtain whether differentiated from healthy controls.

Methods: In Erenköy Training and Research Hospital for Mental and Neurological Diseases , 50 patients who are diagnosed as first episode mania according to DSM-IV-TR and never received an antipsychotic treatment before as well as a control group consisting of 50 healthy volunteers were enrolled in the study. At the beginning of the study (n= 50) and after the remission (n= 40), ICAM, VCAM and E-selectin, Fasting Blood Glucose, Total Cholesterol, LDL Cholesterol, HDL Cholesterol, and Triglyceride levels were assessed and compared. For the control group, only the same biochemical parameters at the beginning of the study were investigated. In order to detect the termination of acute episode, the patient group was given Young Mania Rating Scale and Hamilton Depression Rating Scale.

Results: First manic episode ICAM and VCAM levels were higher than subsequent remission and healthy controls (F= 3.388, p= 0.037 ve F= 108.030, p<0.001). It was found that there was a weak correlation between ICAM and cholesterol (total and LDL) in the first manic episode (r= 0.315, p= 0.029 and r= 0.279, p= 0.055). In the same period, a weak correlation was found between adhesion molecules and BMI (r= 0.238, p= 0.054; r= -0. 278, p= 0.049 and r= 0.298, p= 0.046).

Conclusion: Proinşamatuar and protrombic situations, which were known as risk factors for metabolic syndrome and cardiovascular disease were firstly investigated in this study. It was found that, ICAM and VCAM levels were higher in the first episode mania than the subsequent remission group and healthy controls. There is no perpetual inşuence of the psychotropics use, because our experimental group involved the first episode mania patients. The cardiovascular risk in the bipolar disorder cases, which was represented by the elevated ICAM and VCAM levels was existent from the beginning of the disease. Secondly, in manic episode, increased ICAM and VCAM levels turned into normal ranges during the subsequent remission period. After the recurrent episodes of illness, differentiation ofthe levels of ICAM and VCAM from healthy people in the remission period cannot be explained with our findings.