Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.47626/2237-6089-2020-0132
Trends in Psychiatry and Psychotherapy
Original Article

Bipolar disorder: an association between body mass index and cingulate gyrus fractional anisotropy not mediated by systemic inflammation

Ramiro Reckziegel, Francisco Diego Rabelo-da-Ponte, Jacson Gabriel Feiten, Isadora Bosini Remus, Pedro Domingues Goi, Miréia Fortes Vianna-Sulzbach, Raffael Massuda, Danielle Macedo, David de Lucena, Letícia Sanguinetti Czepielewski, Clarissa Severino Gama

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Abstract

Objective
To investigate associations between body mass index (BMI), white matter fractional anisotropy (FA), and C-reactive protein (CRP) in a group of individuals with bipolar disorder (BD) during euthymia and compare them with a control group of healthy subjects (CTR). 

Methods
The sample consisted of 101 individuals (BD n = 35 and CTR n = 66). Regions of interest (ROI) were defined using a machine learning approach. For each ROI, a regression model tested the association between FA and BMI, controlling for covariates. Peripheral CRP levels were assayed, correlated with BMI, and included in a mediation analysis. 

Results
BMI predicted the FA of the right cingulate gyrus in BD (AdjR² = 0.312 F(3) = 5.537 p = 0.004; β = -0.340 p = 0.034), while there was no association in CTR. There was an interaction effect between BMI and BD diagnosis (F(5) = 3.5857 p = 0.012; Fchange = 0.227 AdjR² = 0.093; β = -1.093, p = 0.048). Furthermore, there was a positive correlation between BMI and CRP in both groups (AdjR² = 0.170 F(3) = 7.337 p < 0.001; β = 0.364 p = 0.001), but it did not act as a mediator of the effect on FA. 

Conclusion
Higher BMI is associated with right cingulate microstructure in BD, but not in CTR, and this effect could not be explained by inflammatory mediation alone. 

Keywords

Bipolar disorder, obesity, white matter, diffusion tensor imaging  

Submitted date:
09/20/2020

Accepted date:
04/26/2021

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