No association between anti-thyroidperoxidase antibodies and bipolar disorder: a study in the Dutch Bipolar Cohort and a meta-analysis

Psychoneuroendocrinology. 2020 Feb:112:104518. doi: 10.1016/j.psyneuen.2019.104518. Epub 2019 Nov 16.

Abstract

Background: Thyroid autoimmunity has been associated with bipolar disorder (BD). However, results from previous studies on the seroprevalence of anti-thyroid peroxidase antibodies (TPO-abs) in BD are inconsistent.

Objectives: The aim of the present study is to investigate whether the seroprevalence and titer levels of TPO-abs are related to BD.

Method: TPO-abs were measured in plasma samples of 760 patients with bipolar disorder, 261 first-degree relatives and 363 controls by enzyme-linked immunosorbent assay (ELISA). To address methodological limitations of previous studies, we assessed clinical characteristics with several (self-reported) questionnaires to investigate whether TPO-abs positivity is related to particular clinical subgroups of BD patients. We performed an additional meta-analysis of seroprevalences of TPO-abs in BD patients including data from present and previous studies.

Results: Seroprevalence or titer levels of TPO-abs did not significantly differ between patients with BD, their first-degree relatives, and controls. In BD patients, the prevalence of TPO-abs was unrelated to specific clinical factors, including lithium use. Our meta-analysis of twelve studies showed an overall odds ratio of 1.3 (CI 95 %: 0.7-2.3; p = 0.30), reaffirming the absence of an association of BD with TPO-abs.

Conclusions: In the largest study of TPO-abs in BD to date, our findings indicate that TPO-abs are not associated with (the risk for) bipolar disorder.

Keywords: Antithyroid microsomal antibody; Bipolar disorder; Thyroid diseases.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Autoantibodies / blood*
  • Autoantigens / immunology*
  • Autoimmune Diseases / blood*
  • Autoimmune Diseases / epidemiology
  • Bipolar Disorder / blood*
  • Bipolar Disorder / epidemiology
  • Comorbidity
  • Family
  • Female
  • Humans
  • Iodide Peroxidase / immunology*
  • Iron-Binding Proteins / immunology*
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Risk
  • Seroepidemiologic Studies

Substances

  • Autoantibodies
  • Autoantigens
  • Iron-Binding Proteins
  • TPO protein, human
  • Iodide Peroxidase