INTRODUCTION & OBJECTIVE: Past studies have shown that metabolic syndrome (MetS) prevalence is high in patients with depression, bipolar disorder and schizophrenia. C-reactive protein (CRP) is among the independent risk factors for the development of cardiovascular disease (CVD) in the literature, but is less explored in psychiatric disorders. The aim of this study is to determine which specific subcomponents of MetS are associated with CRP levels in patients with depression, bipolar disorder, and schizophrenia.
METHOD: This study included 115 patients who were hospitalized at Bakirköy Prof. Dr. Mazhar Osman Mental Health and Neurological Diseases Training and Research Hospital, 15th Women's Psychiatry Clinic between October 2016 - January 2017, who were diagnosed with depression (n=27, 23.5%), bipolar disorder (n=45, 39.1%) and schizophrenia (n=43; 37.4%) according to DSM-5 diagnosis criteria. Patients were measured for height (cm), weight (kg), systolic and diastolic blood pressure (mmHg); C-Reactive Protein, blood was taken after fasting for 8-12 hours, lipid panel (cholesterol, LDL, HDL, triglyceride) was studied. CRP was studied by immunoturbidimetric method and glucose and lipid panel were studied by enzymatic colorometric method.
RESULTS: The mean age of the 115 patients studied was 38.6 ± 12; mean disease duration was calculated as 86.2 ± 101.7 months. When the patient groups were compared, it was found that there was a significant difference between the disease groups only in terms of weight (p = 0.007) and cholesterol (p = 0,041) values among MetS subcomponents. When we look at the difference between these two groups, bipolar and depression patients showed a meaningful difference in terms of cholesterol values (p=0.041), while bipolar and schizophrenia patients showed a significant difference in terms of weight (p=0.010). When correlation analysis was performed with the disease, it was understood that there was a significant correlation between CRP value and body mass index (BMI) (+0.402), triglyceride (+0.309), HDL (-0.214) and weight (+0.400) values. When the groups were separately examined, it was determined that there was no correlation between CRP and MetS components among depression patients; there was a significant correlation between CRP and triglyceride (+0.358) values, and for bipolar patients, there was a meaningful correlation among CRP and BMI (+0.456), triglyceride (+0.379) and weight (+0.460) values.
DISCUSSION & CONCLUSION: We can conclude that high levels of CRP are associated with increased risk for MetS development in psychiatric patients, particularly in patients with bipolar disorder. Inflammation plays an important role in atherosclerotic complications that are activated in MetS. There is a strong correlation between the high number of MetS subcomponents and the increase in inflammatory and metabolic markers. Measurement of serum inflammatory parameters in psychiatric patients may be useful in the prediction, detection and management of metabolic and cardiovascular events.