Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysis
Abstract Purpose To investigate the difference in blood (serum/plasma) thyroid hormone (TH) levels, including thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine (FT4), and free triiodothyronine (FT3), in bipolar disorder (BD) during different mood episodes (depr...
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BMC
2024-11-01
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| Series: | BMC Endocrine Disorders |
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| Online Access: | https://doi.org/10.1186/s12902-024-01776-1 |
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| author | Shanshan Liu Xiaoai Chen Xiaotao Li Limin Tian |
| author_facet | Shanshan Liu Xiaoai Chen Xiaotao Li Limin Tian |
| author_sort | Shanshan Liu |
| collection | DOAJ |
| description | Abstract Purpose To investigate the difference in blood (serum/plasma) thyroid hormone (TH) levels, including thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine (FT4), and free triiodothyronine (FT3), in bipolar disorder (BD) during different mood episodes (depression and mania) compared with healthy control (HC) and between manic episodes (BD-M) and depressive episodes (BD-D). Methods As of September 1, 2024, the electronic databases PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, China Science and Technology Journal Database, Wanfang Database, and Clinical Trials. Gov were systematically searched with no language limitations. Standardized mean differences (SMD) with 95% confidence interval (CI) were summarized using a random effects model. The chi-squared-based Q test and the I 2 test assessed the size of heterogeneity. Results The 21 studies included a total of 3696 participants, Of the 2942 BD patients, 1583 were in depressive episodes 1359 were in manic episodes. The status of measuring blood TH levels included 2 studies in plasma and 19 in serum. Combined with the results of the sensitivity analyses, we obtained the following relatively reliable results: serum T3 (SMD: -0.63, 95%CI: -1.09 to -0.17) and FT3 (SMD: -0.42, 95%CI: -0.83 to -0.00) levels decreased significantly in BD-D compared to HC; serum T3 (SMD: -0.91, 95%CI: -1.49 to -0.32) levels decreased significantly and serum FT4 (SMD: 0.37, 95%CI: 0.14 to 0.60) levels increased significantly in BD-M than in HC; serum T3 (SMD: 0.87, 95%CI: 0.24 to 1.49) and FT3 (SMD: 0.27, 95%CI: 0.13 to 0.42) levels demonstrated a significant elevation in BD-M compared to BD-D. In the group of euthyroidism, apart from serum FT4 (SMD: 0.21, 95%CI: -0.15 to 0.58) levels showed no significant difference between BD-M and HC, other results above remained consistent. Conclusion Serum T3 and FT3 levels decreased significantly in BD-D compared to HC. Serum T3 levels decreased significantly and serum FT4 levels increased significantly in BD-M compared to HC. Serum T3 and FT3 levels increased significantly in BD-M than in BD-D. The temporality of changes in TH levels and BD progression demands further longitudinal studies to illustrate. Trial registration Number and date of registration for prospectively registered trials No. CRD42022378530. |
| format | Article |
| id | doaj-art-bd100799fc02468cbfde3cdbe4e8c5af |
| institution | OA Journals |
| issn | 1472-6823 |
| language | English |
| publishDate | 2024-11-01 |
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| series | BMC Endocrine Disorders |
| spelling | doaj-art-bd100799fc02468cbfde3cdbe4e8c5af2025-08-20T02:22:29ZengBMCBMC Endocrine Disorders1472-68232024-11-0124111810.1186/s12902-024-01776-1Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysisShanshan Liu0Xiaoai Chen1Xiaotao Li2Limin Tian3The First Clinical Medical College, Gansu University of Chinese MedicineDepartment of Endocrinology, Gansu Provincial HospitalDepartment of Endocrinology, Gansu Provincial HospitalThe First Clinical Medical College, Gansu University of Chinese MedicineAbstract Purpose To investigate the difference in blood (serum/plasma) thyroid hormone (TH) levels, including thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine (FT4), and free triiodothyronine (FT3), in bipolar disorder (BD) during different mood episodes (depression and mania) compared with healthy control (HC) and between manic episodes (BD-M) and depressive episodes (BD-D). Methods As of September 1, 2024, the electronic databases PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, China Science and Technology Journal Database, Wanfang Database, and Clinical Trials. Gov were systematically searched with no language limitations. Standardized mean differences (SMD) with 95% confidence interval (CI) were summarized using a random effects model. The chi-squared-based Q test and the I 2 test assessed the size of heterogeneity. Results The 21 studies included a total of 3696 participants, Of the 2942 BD patients, 1583 were in depressive episodes 1359 were in manic episodes. The status of measuring blood TH levels included 2 studies in plasma and 19 in serum. Combined with the results of the sensitivity analyses, we obtained the following relatively reliable results: serum T3 (SMD: -0.63, 95%CI: -1.09 to -0.17) and FT3 (SMD: -0.42, 95%CI: -0.83 to -0.00) levels decreased significantly in BD-D compared to HC; serum T3 (SMD: -0.91, 95%CI: -1.49 to -0.32) levels decreased significantly and serum FT4 (SMD: 0.37, 95%CI: 0.14 to 0.60) levels increased significantly in BD-M than in HC; serum T3 (SMD: 0.87, 95%CI: 0.24 to 1.49) and FT3 (SMD: 0.27, 95%CI: 0.13 to 0.42) levels demonstrated a significant elevation in BD-M compared to BD-D. In the group of euthyroidism, apart from serum FT4 (SMD: 0.21, 95%CI: -0.15 to 0.58) levels showed no significant difference between BD-M and HC, other results above remained consistent. Conclusion Serum T3 and FT3 levels decreased significantly in BD-D compared to HC. Serum T3 levels decreased significantly and serum FT4 levels increased significantly in BD-M compared to HC. Serum T3 and FT3 levels increased significantly in BD-M than in BD-D. The temporality of changes in TH levels and BD progression demands further longitudinal studies to illustrate. Trial registration Number and date of registration for prospectively registered trials No. CRD42022378530.https://doi.org/10.1186/s12902-024-01776-1Bipolar disorderDepressionManiaThyroid hormoneMeta-analysis |
| spellingShingle | Shanshan Liu Xiaoai Chen Xiaotao Li Limin Tian Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysis BMC Endocrine Disorders Bipolar disorder Depression Mania Thyroid hormone Meta-analysis |
| title | Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysis |
| title_full | Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysis |
| title_fullStr | Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysis |
| title_full_unstemmed | Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysis |
| title_short | Thyroid hormone levels in patients with bipolar disorder: a systematic review and meta-analysis |
| title_sort | thyroid hormone levels in patients with bipolar disorder a systematic review and meta analysis |
| topic | Bipolar disorder Depression Mania Thyroid hormone Meta-analysis |
| url | https://doi.org/10.1186/s12902-024-01776-1 |
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