Introduction: Bipolar disorder is a complex psychiatric condition marked by recurrent episodes of mania and depression. Despite its prevalence, the underlying pathophysiology remains poorly understood, and there is still a lack of objective biomarkers for diagnosis. Metabolomics is a promising approach for exploring biological alterations associated with specific mood states. This study aimed to investigate differences in the urinary metabolome between patients with bipolar disorder in the manic phase and healthy controls.
Methods: Urine samples were collected from 22 manic bipolar disorder patients and 31 healthy controls. Samples were analyzed using Ultra-High Performance Liquid Chromatography Mass Spectrometry. The data were processed using MZmine and TidyMass, and then subjected to statistical and multivariate analyses in MetaboAnalyst 5.0. Metabolites showing significant fold changes were then evaluated using a receiver operating characteristic analysis.
Results: The levels of two phosphatidylcholine derivatives, 1.2-dioleoyl-sn-glycero-3-phosphatidylcholine and 1-stearoyl-2-linoleoyl-sn-glycero-3-phosphocholine, were significantly higher in the manic group (p<0.05). Receiver Operating Characteristic analysis revealed that these metabolites had limited discriminatory performance when evaluated individually.
Conclusion: The findings suggest that the manic phase of bipolar disorder is associated with alterations in urinary lipid-related metabolites. While the identified metabolites exhibited modest diagnostic value individually, they could potentially reflect phase-specific metabolic changes relevant to bipolar disorder. These exploratory results warrant further investigation in larger longitudinal studies that include different mood states.
Keywords: Biomarker, bipolar disorder, mass spectrometry,