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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO049

İki uçlu bozuklukta serum apelin-13 düzeyinin duruma bağlı değişimi: manik ve remisyon dönemlerini karşılaştıran prospektif boylamsal çalışma (State-dependent changes in serum apelin-13 levels in bipolar disorder: a prospective longitudinal study comparing manic episodes and remission)

STATE-DEPENDENT ALTERATIONS OF SERUM APELIN-13 IN BIPOLAR DISORDER: A PROSPECTIVE LONGITUDINAL STUDY COMPARING MANIC AND REMITTED STATES

Serum apelin-13 levels are markedly reduced during manic episodes, normalize with remission, and show high diagnostic accuracy in identifying the manic state.

The study aimed to evaluate differences in levels of apelin-13, a neuropeptide involved in neuroinflammation, synaptic plasticity, and hypothalamic–pituitary–adrenal (HPA) axis regulation, between manic and euthymic states, its associations with cognitive and inflammatory markers, and its potential as a state-dependent biomarker. This prospective study enrolled 47 patients with bipolar disorder experiencing a manic episode and 46 healthy controls; serum apelin-13 was measured using ELISA, the neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) were calculated, and the Young Mania Rating Scale (YMRS) and Montreal Cognitive Assessment (MoCA) were administered. Blood sampling and cognitive assessment were repeated after clinical remission (at least 8 weeks of stability). During mania, apelin-13 levels were lower in patients than in controls (133.06 ± 27.36 vs. 205.93 ± 85.34; p < 0.001); at follow-up, levels increased to 227.05 ± 93.19 and no longer differed significantly from control values (p = 0.255). At baseline, MoCA scores were 21.00 ± 3.00 in patients and 27.00 ± 1.00 in controls; at follow-up, patient scores increased to 24.00 ± 3.00 but remained below control levels (p < 0.001). YMRS scores decreased from 32.00 ± 8.00 to 5.00 ± 3.00; NLR decreased from 236.34 ± 124.93 to 172.08 ± 107.11, and SII decreased from 633.59 ± 279.93 to 497.94 ± 277.33 (within-group changes, p < 0.001). No significant correlations were found between apelin-13 and cognitive or inflammatory parameters; receiver operating characteristic (ROC) analysis demonstrated high diagnostic accuracy in identifying the manic state (AUC = 0.882, sensitivity 77%, specificity 89%). These findings suggest that apelin-13 may be a candidate biomarker for monitoring disease activity in bipolar disorder and may provide a peripheral indicator of the neurobiological changes accompanying transitions between mood states.

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