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Yıl:2009; Cilt: 10; Sayı: Ek 1>> Özet
Anadolu Psikiyatri Dergisi; 2009;10(Ek 1):64-65
İki uçlu bozuklukta lipit döngüselliği
K Altınbaş, ET Oral
Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Hastanesi, İstanbul
Amaç: Serum lipit düzeyinin psikiyatrik bozukluklardaki rolü uzun yıllardır araştırılmaktadır. Anksiyete bozuklukları, depresyon ve şizofreni gibi birçok psikiyatrik bozuklukta serum lipit düzeyleri araştırılmış; intihar girişimi ve saldırganlıkla ilişkisi sorgulanmıştır. Özellikle duygudurum bozuklukları ile kan lipit düzeyleri ilişkisi çalışılmış ve mevsim değişikliklerinde güneş ışığı, sirkadiyen ritm değişikliklerinin bozukluğun ortaya çıkışında önemli olabileceği öne sürülmüştür. Buradan hareketle biz de bu çalışma ile iki uçlu bozukluk hastalarında kan lipit düzeyinin mevsimsel döngüselliğini sorgulamayı amaçladık. Yöntem: İki uçlu bozukluk tanısıyla Raşit Tahsin Duygudurum Merkezi'nde izlenmekte olan hastaların ve kontrol gurubunun 12 saatlik açlık sonrası, yaz ve kış mevsimlerinin ikinci yarısında (Yaz: 15 Temmuz-1 Eylül, Kış: 15 Ocak-1 Mart) kan lipit düzeyi ölçülmüştür. Elde edilen veriler SPSS 16 versiyonuna girile-rek tanımlayıcı istatistik yapılmış; kan lipit düzeyindeki değişkenlik eşleştirilmiş grupların t testi ile değerlendirilmiştir. Sonuçlar: Kontrol gurubunun ve iki uçlu hastaların kan lipit düzeyi karşılaştırıldığında, hem yaz, hem de kış mevsiminde kontrol grubunda kan kolesterol düzeyinin anlamlı düzeyde daha yüksek olduğu saptandı. Ayrıca yalnız kış mevsiminde iki uçlu hastalara göre kontrol gurubunda kan LDL düzeyleri de anlamlı düzeyde yüksekti. Kan trigliserit düzeyi hem yaz, hem de kış mevsiminde iki uçlu hastalarda daha yüksek olmasına karşın, bu yükseklik istatistiksel olarak anlamlı değildi. Kan lipit düzeyinin mevsimsel değişimi değerlendirildiğinde, kontrol gurubunun yaz-kış mevsimlerindeki lipit değişiminin istatistiksel olarak anlamlı olmadığı görüldü. İki uçlu hastaların kış aylarındaki kan trigliserit ve kolesterol düzeyleri daha yüksek olup HDL ve LDL düzeyleri düşük bulundu. Yalnız trigliserit düzeyindeki değişikliğin istatistiksel olarak anlamlı olduğu görüldü. Tartışma: Literatürde genel popülasyonda kan kolesterol düzeyinin mevsimsel döngüsellik gösterdiği belirtilmişken, trigliserit düzeyindeki değişimin yalnız kadınlarda görüldüğü öne sürülmüştür. Kan trigliserit düzeyinin iki uçlu hastalarda kış mevsiminde daha yüksek olması, yaz mevsiminde sıcaklığın artması ve/veya fiziksel aktiviteye bağlı olarak interstisiyel alandaki sıvının intravasküler alana geçmesiyle oluşan hemodilüsyon ile açıklanabilir. Ancak bu değişikliğin bozukluğun doğası ile ilişkisini açıklamak için daha kapsamlı izlem çalışmaları gerekmektedir.
Seasonal variation of blood lipid levels in bipolar disorder
Objective: Association between seasonal varia-tion of blood lipid levels and psychiatric disor-ders has been studied during the past half century. Possible impact of blood lipid levels on anxiety disorders, depression and schizophrenia were evaluated, also for suicide and aggression. Particularly, the relationship between seasonal changes in blood lipids and mood dis-orders was evaluated and it was suggested that seasonal variation is related to changes in temperature, exposure to daylight and various other mechanisms that could be related to etiology of mood disorders. The aim of this study is to evaluate seasonal lipid variation in bipolar patients comparing with the control group. Methods: Blood lipids levels of patients who are followed up in Rasit Tahsin Mood Disor-ders Outpatient Unit with bipolar disorder diag-nosis and control group were measured after 12 hours fasting during the second part of summer (15 July-1 September) and winter (15 January-1 March). Statistical analysis was performed with the Statistical Package for Social Sciences (SPSS) 16 for Windows and groups were com-pared with paired-samples t test. Results: Blood cholesterol levels were higher in control group comparing with the bipolar patients in the sum-mer and winter; also, LDL levels were higher just for winter. Blood triglyceride levels were higher in bipolar patients but the difference was not statistically significant. Seasonal variation of blood lipids was not statistically significant in the control group although, blood triglyceride changes between summer and winter was statistically significant in patient group. However, blood triglyceride and cholesterol levels were higher but LDL and HDL levels were lower in bipolar patients during winter comparing with the summer measurements. Discussion: Currently, there is not any study, which evaluates blood lipid seasonality in bipolar patients. In literature, it was suggested that blood cholesterol levels vary between seasons in general population but seasonal variation in blood triglyceride levels were statistically significant just for females. Seasonal changes in blood triglyceride levels for bipolar patients might be related with intravascular hemodilution caused by physical exercise and high temperature in the summer. Controlled long-term follow up studies are required to explain the seasonality of blood lipid levels and possible relationship with the etiology of illness.

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