C-reactive protein alterations in bipolar disorder: a meta-analysis.

Abstract

OBJECTIVE:

There is growing evidence that bipolar disorder (BD) is associated with inflammation, including abnormal levels of acute-phase C-reactive protein (CRP). Our meta-analysis was conducted to estimate the size of the association between CRP levels and BD, accounting also for subgroup differences (mood phases and treatment).

DATA SOURCES:

MEDLINE, EMBASE, PsycINFO, and ISI Web of Science and references of identified articles were searched up to June 2013 using the keywords (bipolar disorder) AND (C-reactive protein OR CRP).

STUDY SELECTION:

English language studies measuring blood levels of CRP in patients with BD and control subjects were selected, 136 abstracts were reviewed, 20 articles retrieved, and 11 studies included.

DATA EXTRACTION:

Two independent reviewers extracted data. All studies were included in the primary analyses, and between-group differences for subanalyses were also reported. This meta-analysis was performed using random-effects models.

RESULTS:

Eleven studies comprising 1,618 subjects were eligible for inclusion. Overall, CRP levels were significantly elevated in patients with BD versus controls (standardized mean difference [SMD] = 0.39; 95% CI, 0.24 to 0.55; P < .0001). CRP levels were significantly higher in manic (SMD = 0.73; 95% CI, 0.44 to 1.02; P < .001) and euthymic (SMD = 0.26; 95% CI, 0.01 to 0.51; P = .04), but not in depressed (SMD = 0.28; 95% CI, -0.17 to 0.73; P = .22) patients with BD compared to controls. CRP levels were unrelated to use of lithium or antipsychotic medication.

CONCLUSIONS:

This meta-analysis supports an association between increased CRP levels and BD. Given that an elevated level of CRP is a marker of low-grade inflammation and a risk factor for cardiovascular and malignant diseases, measurement of CRP level might be relevant to the clinical care of bipolar patients.

• Authors: Aroldo A Dargél, Ophelia Godin, Flávio Kapczinski, David J Kupfer, Marion Leboyer
• Journal: The Journal of clinical psychiatry (J Clin Psychiatry) Vol. 76 Issue 2 Pg. 142-50 (Feb 2015) ISSN: 1555-2101 [Electronic] United States
• PMID: 25742201 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
• Copyright: © Copyright 2015 Physicians Postgraduate Press, Inc.

Chemical References

• Biomarkers
• C-Reactive Protein

Topics

• Affect (physiology)
• Biomarkers (blood)
• Bipolar Disorder (diagnosis, immunology, pathology)
• C-Reactive Protein (metabolism)
• Humans
• Predictive Value of Tests