Purinergic Dysfunction and Electrolyte Imbalance in Newly Diagnosed Bipolar Disorder Patients: A Case-control Study

Aim and background: Patients with bipolar disorder experience alternating episodes of mania and depression.Adenosine, a purinergic base, plays a critical role in regulating mood, sleep, activity, appetite, cognition, memory, seizure threshold, social behavior, motivation, and impulsivity.Dopamine, a neurotransmitter associated with euphoria, also contributes to maintaining renal electrolyte balance.This study aimed to assess the levels of serum adenosine deaminase, uric acid, and electrolyte imbalance in bipolar disorder patients.Materials and methods: This case-control study involved patients diagnosed with bipolar disorder between May 2019 and October 2019 in an outpatient psychiatric clinic at a tertiary care hospital.The study included all patients with bipolar disorder who were newly diagnosed, on treatment for more than 6 months, and age-and sex-matched healthy controls.Results: Serum adenosine deaminase and uric acid were significantly increased in patients with newly diagnosed bipolar disorder patients (uric acid-mean/SD 6.82 0.75, serum adenosine deaminase-mean/SD 31.1 6) when compared to healthy controls (uric acid-mean/SD 3.92 0.55, serum adenosine deaminase-mean/SD 14.2 3.8) and known bipolar disorder patients on treatment for more than 6 months (uric acidmean/SD 4.1 0.47, serum adenosine deaminase-mean/SD 13.5 2.7).Serum sodium levels were found to be statistically significant between group A and group C using the ANOVA test. Conclusion:Based on the results of our study, we concluded that uric acid and adenosine deaminase levels were impaired in newly diagnosed bipolar disorder patients.Numerous previous studies have highlighted abnormalities in uric acid levels in individuals with bipolar disorder.However, this study demonstrates that adenosine deaminase levels and electrolytes were impaired in these patients.Clinical significance: Combining these markers with clinical evaluations and additional biochemical profiles could improve diagnostic precision and prognostic insights, supporting the development of a comprehensive multi-biomarker strategy for managing mood disorders.