PMID- 24331546
OWN - NLM
STAT- MEDLINE
DCOM- 20150824
LR  - 20220310
IS  - 1873-2402 (Electronic)
IS  - 0006-3223 (Linking)
VI  - 77
IP  - 3
DP  - 2015 Feb 1
TI  - Type 2 diabetes mellitus: a potentially modifiable risk factor for neurochemical 
      brain changes in bipolar disorders.
PG  - 295-303
LID - S0006-3223(13)00988-8 [pii]
LID - 10.1016/j.biopsych.2013.11.007 [doi]
AB  - BACKGROUND: Neuroimaging changes in bipolar disorder (BD) may be secondary to the 
      presence of certain clinical factors. Type 2 diabetes mellitus (T2DM) damages the 
      brain and frequently co-occurs with BD. Studying patients with both T2DM and BD 
      could help identify preventable risk factors for neuroimaging changes in BD. 
      METHODS: We used 1.5T magnetic resonance spectroscopy to measure prefrontal 
      N-acetylaspartate (NAA), which is mainly localized in neurons, and total creatine 
      (tCr), an energy metabolite, in 19 BD patients with insulin resistance/glucose 
      intolerance (BD + IR/GI), 14 BD subjects with T2DM (BD + T2DM), 15 euglycemic BD 
      participants, and 11 euglycemic, nonpsychiatric control. RESULTS: The levels of 
      NAA and tCr were lowest among BD + T2DM, intermediate in the BD + IR/GI, and 
      highest among the euglycemic BD and control subjects (F(3),(5)(5) = 4.57, p = .006; 
      F(3),(5)(5) = 2.92, p = .04, respectively). Even the BD + IR/GI subjects had lower NAA 
      than the euglycemic participants (t(4)(3) = 2.13, p = .04). Total Cr was associated 
      with NAA (beta = .52, t(5)(6) = 5.57, p = .000001). Both NAA and tCr correlated with 
      Global Assessment of Functioning scores (r(4)(6) = .28, p = .05; r(4)(6) = .48, p = 
      .0004, respectively). CONCLUSIONS: T2DM, but also prediabetes, may be risk 
      factors for prefrontal neurochemical alterations in BD. These changes were 
      associated with poor psychosocial functioning and could indicate impaired energy 
      metabolism. The findings emphasize the importance of improving diabetes care in 
      BD and suggest potential options for treatment of neuroimaging alterations.
CI  - (c) 2014 Society of Biological Psychiatry Published by Society of Biological 
      Psychiatry All rights reserved.
FAU - Hajek, Tomas
AU  - Hajek T
AD  - Department of Psychiatry (TH, CC, RB, CS, MA), Dalhousie University, Halifax, 
      Nova Scotia, Canada; Prague Psychiatric Center (TH, MA), Department of Psychiatry 
      and Medical Psychology, 3rd School of Medicine, Charles University, Prague, Czech 
      Republic. Electronic address: tomas.hajek@dal.ca.
FAU - Calkin, Cynthia
AU  - Calkin C
AD  - Department of Psychiatry (TH, CC, RB, CS, MA), Dalhousie University, Halifax, 
      Nova Scotia, Canada.
FAU - Blagdon, Ryan
AU  - Blagdon R
AD  - Department of Psychiatry (TH, CC, RB, CS, MA), Dalhousie University, Halifax, 
      Nova Scotia, Canada.
FAU - Slaney, Claire
AU  - Slaney C
AD  - Department of Psychiatry (TH, CC, RB, CS, MA), Dalhousie University, Halifax, 
      Nova Scotia, Canada.
FAU - Alda, Martin
AU  - Alda M
AD  - Department of Psychiatry (TH, CC, RB, CS, MA), Dalhousie University, Halifax, 
      Nova Scotia, Canada; Prague Psychiatric Center (TH, MA), Department of Psychiatry 
      and Medical Psychology, 3rd School of Medicine, Charles University, Prague, Czech 
      Republic.
LA  - eng
GR  - 103703/Canadian Institutes of Health Research/Canada
GR  - 106469/Canadian Institutes of Health Research/Canada
GR  - 64410/Canadian Institutes of Health Research/Canada
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131113
PL  - United States
TA  - Biol Psychiatry
JT  - Biological psychiatry
JID - 0213264
RN  - 30KYC7MIAI (Aspartic Acid)
RN  - 997-55-7 (N-acetylaspartate)
RN  - MU72812GK0 (Creatine)
SB  - IM
MH  - Adult
MH  - Aspartic Acid/*analogs & derivatives/metabolism
MH  - Bipolar Disorder/complications/*metabolism
MH  - Brain/*metabolism
MH  - Creatine/*metabolism
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/complications/*metabolism
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Spectroscopy
MH  - Male
MH  - Middle Aged
MH  - Psychiatric Status Rating Scales
MH  - Risk Factors
OTO - NOTNLM
OT  - Bipolar disorder
OT  - Global assessment of functioning
OT  - N-acetylaspartate
OT  - Prefrontal cortex
OT  - Total creatine
OT  - Type 2 diabetes mellitus
EDAT- 2013/12/18 06:00
MHDA- 2015/08/25 06:00
CRDT- 2013/12/17 06:00
PHST- 2013/08/18 00:00 [received]
PHST- 2013/11/08 00:00 [revised]
PHST- 2013/11/08 00:00 [accepted]
PHST- 2013/12/17 06:00 [entrez]
PHST- 2013/12/18 06:00 [pubmed]
PHST- 2015/08/25 06:00 [medline]
AID - S0006-3223(13)00988-8 [pii]
AID - 10.1016/j.biopsych.2013.11.007 [doi]
PST - ppublish
SO  - Biol Psychiatry. 2015 Feb 1;77(3):295-303. doi: 10.1016/j.biopsych.2013.11.007. 
      Epub 2013 Nov 13.