Predictive value of oxidative stress biomarkers in drug-free patients with bipolar disorder

Abstract

Objective

Oxidative stress is one of the primary etiological mechanisms of bipolar disorder (BD).

Methods

The present study was conducted over a period of 24 months on Tunisian on 34 drug‑free male patients with BD (mean age: 34.5 years) and 101 age and gender matched controls (mean age: 34.20 years) were enrolled in the study.

Results

Plasma reduced glutathione (GSH) and total thiols levels were significantly decreased in patients compared to controls (respectively p < .001; p = .009). In addition, malondialdehyde (MDA), advanced oxidation protein products (AOPP), protein carbonyls (PC) and homocysteine (Hcys) concentrations and glutathione peroxidase (GSH-Px) activity were significantly increased in patients compared to controls (p = .002; p < .001; p = .001; p < .001 and p = .016, respectively). The binary logistic regression analysis revealed that MDA, AOPP and Hcys could be considered as independent risk factors for BD. When using CombiROC analysis, a remarkable increase in the area under the curve (AUC) with higher sensitivity (Se) and specificity (Sp) for MDA, AOPP, PC, GSH-Px and Hcys combined markers was observed.

Conclusions

Overall, the identification of the predictive value of these five selected biomarkers related to oxidative stress in drug free patients should lead to a better identification of the etiological mechanism of BD.

Keywords:

• Bipolar disorder
• oxidative stress
• homocysteine
• CombiROC

Acknowledgments

We would like to thank the patients and their parents for participating in the study.

Ethical approval

All the procedures adopted in studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Authors’ contributions

Naifar M, Maalej M and Ayedi F designed the study.

Guidara. W, Grayaa S and Messedi M worked oxidative stress analysis and drafted the manuscript. All authors read and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The Ministry of Higher Education and Scientific Research and the Ministry of Health, Tunisia supported this work.

Notes on contributors

Wassim Guidara

Wassim Guidara is a Ph.D student in biochemistry in Faculty of science of sfax, Sfax University. his research was started in the Laboratory of research ‘Molecular Basis of Human Diseases’, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia. Holder of a research master's degree in microbial biotechnology at the faculty of science of sfax in 2015.

Meriam Messedi

Meriam Messedi is a Ph.D. in biochemistry. Doctoral degree holder since 2016. His research his research was started in the Laboratory of research ‘Molecular Basis of Human Diseases’, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia. His Ph.D. research aims to study of biological disruption in chronic inflammatory diseases like Behcet.

Manel Naifar

Manel Naifar is associate professor of biochemistry at laboratory of biochemistry Habib Bourguiba Hospital of Sfax. Tunisia.

Nada Charfi

Nada Charfi is associate professor of psychiatry at psychiatry C department, Hedi chaker hospital, Sfax. Tunisia.

Sahar Grayaa

Sahar Grayaa is a Ph.D. candidate in Faculty of science of sfax, Sfax University. His research was started in the Laboratory of research ‘Molecular Basis of Human Diseases’, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia. His Ph.D. research aims to study of biological disruption in children with autism.

Mohamed Maalej

Mohamed Maalej is Professor of psychiatry, Former Head of psychiatry "C" deparment in Hedi chaker hospital in Sfax. Tunisia

Manel Maalej

Manel Maalej is associate professor of psychiatry at Psychiatry "C" department, Hedi Chaker Hospital. Sfax. Tunisia

Fatma Ayadi

Fatma Ayadi is professor of biochemistry, Head of Laboratory of research ‘Molecular Basis of Human Diseases’, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia. Head of laboratory of biochemistry Habib Bourguiba Hospital of Sfax. Tunisia.