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Adolescents with or at ultra-high risk for bipolar disorder exhibit erythrocyte docosahexaenoic acid and eicosapentaenoic acid deficits: a candidate prodromal risk biomarker.
Early Interv Psychiatry 2016; 10(3):203-11EI

Abstract

AIM

Mood disorders are associated with low levels of the long-chain omega-3 (LCn-3) fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). This study investigated LCn-3 fatty acid biostatus in youth with or at varying risk for developing mania to assess its utility as a prodromal risk biomarker.

METHOD

Erythrocyte fatty acid composition was determined in healthy adolescents (n = 28, HC), asymptomatic adolescents with a biological parent with bipolar I disorder (n = 30; 'high risk', HR), adolescents with a biological parent with bipolar I disorder and major depressive disorder, or depressive disorder not otherwise specified (n = 36; 'ultra-high risk', UHR), and first-episode adolescent bipolar manic patients (n = 35, BP).

RESULTS

Group differences were observed for DHA (P ≤ 0.0001) and EPA (P = 0.03). Compared with HC, erythrocyte EPA + DHA ('omega-3 index') was significantly lower in BP (-24%, P ≤ 0.0001) and UHR (-19%, P = 0.0006) groups, and there was a trend in the HR group (-11%, P = 0.06). Compared with HC (61%), a greater percentage of HR (77%, P = 0.02), UHR (80%, P = 0.005) and BP (97%, P = 0.001) subjects exhibited EPA + DHA levels of ≤4.0%. Among all subjects (n = 130), EPA + DHA was inversely correlated with manic (r = -0.29, P = 0.0008) and depressive (r = -0.28, P = 0.003) symptom severity. The AA/EPA + DHA ratio was significantly greater in BP (+22%, P = 0.0002) and UHR (+16%, P = 0.001) groups.

CONCLUSIONS

Low EPA + DHA levels coincide with the initial onset of mania, and increasing risk for developing bipolar disorder is associated with graded erythrocyte EPA + DHA deficits. Low erythrocyte EPA + DHA biostatus may represent a promising prodromal risk biomarker warranting additional evaluation in future prospective studies.

Authors+Show Affiliations

Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.Department of Pathology, University of Cincinnati, Cincinnati, Ohio, USA.Department of Pathology, University of Cincinnati, Cincinnati, Ohio, USA.Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26486098

Citation

McNamara, Robert K., et al. "Adolescents With or at Ultra-high Risk for Bipolar Disorder Exhibit Erythrocyte Docosahexaenoic Acid and Eicosapentaenoic Acid Deficits: a Candidate Prodromal Risk Biomarker." Early Intervention in Psychiatry, vol. 10, no. 3, 2016, pp. 203-11.
McNamara RK, Jandacek R, Tso P, et al. Adolescents with or at ultra-high risk for bipolar disorder exhibit erythrocyte docosahexaenoic acid and eicosapentaenoic acid deficits: a candidate prodromal risk biomarker. Early Interv Psychiatry. 2016;10(3):203-11.
McNamara, R. K., Jandacek, R., Tso, P., Blom, T. J., Welge, J. A., Strawn, J. R., ... DelBello, M. P. (2016). Adolescents with or at ultra-high risk for bipolar disorder exhibit erythrocyte docosahexaenoic acid and eicosapentaenoic acid deficits: a candidate prodromal risk biomarker. Early Intervention in Psychiatry, 10(3), pp. 203-11. doi:10.1111/eip.12282.
McNamara RK, et al. Adolescents With or at Ultra-high Risk for Bipolar Disorder Exhibit Erythrocyte Docosahexaenoic Acid and Eicosapentaenoic Acid Deficits: a Candidate Prodromal Risk Biomarker. Early Interv Psychiatry. 2016;10(3):203-11. PubMed PMID: 26486098.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adolescents with or at ultra-high risk for bipolar disorder exhibit erythrocyte docosahexaenoic acid and eicosapentaenoic acid deficits: a candidate prodromal risk biomarker. AU - McNamara,Robert K, AU - Jandacek,Ronald, AU - Tso,Patrick, AU - Blom,Thomas J, AU - Welge,Jeffrey A, AU - Strawn,Jeffrey R, AU - Adler,Caleb M, AU - Strakowski,Stephen M, AU - DelBello,Melissa P, Y1 - 2015/10/20/ PY - 2015/08/23/received PY - 2015/09/21/accepted PY - 2015/10/22/entrez PY - 2015/10/22/pubmed PY - 2017/1/5/medline KW - arachidonic acid (AA) KW - eicosapentaenoic acid (EPA) KW - mania KW - omega-3 index KW - ultra-high risk SP - 203 EP - 11 JF - Early intervention in psychiatry JO - Early Interv Psychiatry VL - 10 IS - 3 N2 - AIM: Mood disorders are associated with low levels of the long-chain omega-3 (LCn-3) fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). This study investigated LCn-3 fatty acid biostatus in youth with or at varying risk for developing mania to assess its utility as a prodromal risk biomarker. METHOD: Erythrocyte fatty acid composition was determined in healthy adolescents (n = 28, HC), asymptomatic adolescents with a biological parent with bipolar I disorder (n = 30; 'high risk', HR), adolescents with a biological parent with bipolar I disorder and major depressive disorder, or depressive disorder not otherwise specified (n = 36; 'ultra-high risk', UHR), and first-episode adolescent bipolar manic patients (n = 35, BP). RESULTS: Group differences were observed for DHA (P ≤ 0.0001) and EPA (P = 0.03). Compared with HC, erythrocyte EPA + DHA ('omega-3 index') was significantly lower in BP (-24%, P ≤ 0.0001) and UHR (-19%, P = 0.0006) groups, and there was a trend in the HR group (-11%, P = 0.06). Compared with HC (61%), a greater percentage of HR (77%, P = 0.02), UHR (80%, P = 0.005) and BP (97%, P = 0.001) subjects exhibited EPA + DHA levels of ≤4.0%. Among all subjects (n = 130), EPA + DHA was inversely correlated with manic (r = -0.29, P = 0.0008) and depressive (r = -0.28, P = 0.003) symptom severity. The AA/EPA + DHA ratio was significantly greater in BP (+22%, P = 0.0002) and UHR (+16%, P = 0.001) groups. CONCLUSIONS: Low EPA + DHA levels coincide with the initial onset of mania, and increasing risk for developing bipolar disorder is associated with graded erythrocyte EPA + DHA deficits. Low erythrocyte EPA + DHA biostatus may represent a promising prodromal risk biomarker warranting additional evaluation in future prospective studies. SN - 1751-7893 UR - https://www.unboundmedicine.com/medline/citation/26486098/Adolescents_with_or_at_ultra_high_risk_for_bipolar_disorder_exhibit_erythrocyte_docosahexaenoic_acid_and_eicosapentaenoic_acid_deficits:_a_candidate_prodromal_risk_biomarker_ L2 - https://doi.org/10.1111/eip.12282 DB - PRIME DP - Unbound Medicine ER -