Xinyue Wang,1 Sili Wang,2 Wenbo Qi,3 Ying Wang,2 Lei Zhang,4,* Ping Sun3,* 

1Acute Intervention Department (Female III Part), Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, Guangdong, People’s Republic of China; 2Clinical Laboratory, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, Guangdong, People’s Republic of China; 3Geriatric Medicine Department II, Qingdao Mental Health Center, Qingdao, Shandong, People’s Republic of China; 4Endocrine Department, Qingdao Endocrine & Diabetes Hospital, Qingdao, Shandong, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ping Sun, Qingdao Mental Health Center, 299 Nanjing Road, Shandong, 266034, People’s Republic of China, Tel +86 135 8939 4393, Email qdsunping99@sina.com

Purpose: Previous studies have shown that serum uric acid (UA) levels are significantly higher in patients with bipolar disorder (BD) than in patients with depressive disorder (DD), schizophrenia, and healthy controls. Currently, studies generally report that there is a complex bidirectional interaction between mood disorders (MD) and hyperuricemia (HUA). We investigated the prevalence and related factors of hyperuricemia in Chinese patients with mood disorders to find out potential mechanisms and build a predictive model.
Patients and Methods: A total of 771 patients with mood disorders who met the criteria were enrolled. The demographic and disease characteristics of MD patients were collected by a self-designed questionnaire. Depression severity was assessed by the Hamilton Depression Scale (HAMD-17). The Positive and Negative Symptom Scale (PANSS) was used to assess psychotic symptoms. The Nurse’s Guided Assessment of Suicide Risk Scale (NGASR) was used to assess suicide risk. Laboratory parameters of metabolism include blood cell-related parameters, electrolytes, liver function-related parameters, etc.
Results: The prevalence of hyperuricemia was 21.68% in patients with depressive disorder and 39.25% in patients with depressive episodes of bipolar disorder (DEBD). Among MD patients with or without hyperuricemia, there were some differences such as gender, mood stabilizers, systolic blood pressure etc. The independent risk factors of MD patients with hyperuricemia followed: lithium carbonate, urea (Ur), triglycerides (TG), lactate dehydrogenase (LDH), and white blood cell (WBC) (all p< 0.05). After combining the independent risk factors with platelets (PLT), albumin (ALB), alanine aminotransferase (ALT), and C-peptide by multivariate Logistic regression, we obtained an optimal predictive model.
Conclusion: MD patients treated with lithium carbonate should be closely monitored for uric acid levels. We suggested that hepatic TG accumulation and psychiatric drug-induced hepatocellular damage may contribute to hyperuricemia in patients with mood disorders.

Keywords: bipolar disorder, depressive disorder, uric acid, lithium carbonate