Serum levels of carcinoembryonic antigen (CEA) in patients with bipolar disorder

Executive functions and addictions: a Structural Equation Modeling Approach and the Italian validation of the Adult Executive Functioning Inventory (ADEXI)

INTRODUCTION

the work aims to observe the associations between psychoactive substance use and gambling and executive functioning as well as to validate the Italian version of the "Adult Executive Functioning Inventory" (ADEXI) scale.

METHODS

data were collected through a representative cross-sectional study among 5,160 people (18-84 years old) called IPSAD® (Italian Population Survey on Alcohol and Other Drugs). Structural Equation Modeling (SEM) was performed to explore the associations between ADEXI and other behaviors measured with standardized questionnaires. Cronbach α has been performed to investigate the psychometric properties of the Italian version of the ADEXI scale.

RESULTS

SEM showed that both WM and INH were correlated with problematic cannabis use (WM r = 0.112; INH r = 0.251) and gambling (WM r = 0.101; INH r = 0.168), while problematic alcohol use was correlated only with INH (r = 0.233). Cronbach α for the WM subscale was 0.833 (CI 0.826-0.840), while for INH was 0.694 (CI 0.680-0.708).

CONCLUSION

results pointed out a strong correlation between addictions (substance-related and non-substance-related) and WM and INH impairments among the adult general population. Moreover, the ADEXI scale could be considered a valuable tool for general population surveys to detect working memory and inhibition characteristics.

High Prevalence of Abnormal Carcinoembryonic Antigen in Diabetic Inpatients with Poor Glycemic Control

INTRODUCTION

Higher serum carcinoembryonic antigen (CEA) was found in diabetic patients rather than controls. However, the prevalence of abnormal CEA among diabetic inpatients with a large proportion of poor glycemic control is unclear.

METHODS

A total of 385 diabetic inpatients were included in this study. We collected information from a large clinical database. Patients with malignant tumors were excluded by examination and follow-up.

RESULTS

We found a surprisingly high prevalence (14.3%) of diabetic inpatients with CEA above normal. The proportion of patients with abnormal CEA was significantly different in subgroups with different blood glucose levels, 20.4% in the HbA1c ≥ 9% group, and 8.5% in the HbA1c < 9%, p = 0.000. We found that the CEA levels were correlated with age, body mass index and HbA1c. The regression coefficient of HbA1c was the highest, B = 0.284, p = 0.000. We also found that the CEA levels were higher in diabetic inpatients with BMI < 24 kg/m2 than the overweight or obesity patients. There was a significant difference in the insulin level and C peptide level between the elevated CEA group and the non-elevated CEA group.

CONCLUSION

The elevation of CEA is common in diabetic inpatients, especially those with poor hyperglycemia controlled (HbA1c ≥ 9%). The underlying mechanism may be related to glucose toxicity.

Evaluation of serum inflammatory markers in treatment-resistant manic patients and adequate responder manic patients

Mania is accompanied with immune activation as indicated by increased pro-inflammatory cytokines, acute phase proteins; and carcinoembryonic antigen (CEA) is known to accompany signs of immune-inflammatory responses in bipolar disorder (BD) and medical disorders. In this study, it was aimed to compare high sensitivity C-reactive protein (hsCRP), CEA levels and white blood cells (WBCs) counts in the treatment-resistant BD (Group 3), the treatment-responsive BD patients (Group 2), and the healthy control group (Group 1). The sociodemographic data form, the Young Mania Rating Scale (YMRS), the Hamilton Depression Rating Scale (HDRS), and the Clinical Global Impression Severity of Illness (CGI-S) Scale were applied to the patients. In Group 3, the WBCs counts, and CEA levels were significantly higher than the other two groups. There was a positive correlation between WBCs counts and YMRS and CGI-S scores in all manic patients. There was a positive correlation between CEA levels and YMRS, HDRS and CGI-S in manic patients. This study shows that there is an activation of the immune-inflammatory response system in treatment resistant manic patients; and, WBCs counts and CEA levels are associated with severity of disease in manic patients.

Association between high serum carcinoembryonic antigen and clinical state of male anorexia nervosa: A case report

Anorexia nervosa (AN) is a complex psychiatric disorder, which is not yet fully understood. Several studies reported that AN was associated with disruption of cytokine network. Carcinoembryonic antigen (CEA) is a glycoprotein related to its network, used as a tumor marker of adenocarcinoma, and suggested to stimulate monocytes and macrophages to release proinflammatory cytokines. Here, we report a 41-year-old male suffering from AN who was suspected of having a malignant tumor due to markedly elevated serum CEA levels. However, on further examinations, he was discovered to have no malignant tumors, and, interestingly, his CEA levels actually decreased as his clinical state of AN improved. Furthermore, it was found that his CEA levels were elevated proportionally to his clinical state of AN and that his body mass index was significantly correlated with serum CEA levels. Therefore, it is suggested that inflammatory responses may be associated with the clinical state of AN.

Towards a blood-based diagnostic panel for bipolar disorder

BACKGROUND

Bipolar disorder (BD) is a costly, devastating and life shortening mental disorder that is often misdiagnosed, especially on initial presentation. Misdiagnosis frequently results in ineffective treatment. We investigated the utility of a biomarker panel as a diagnostic test for BD.

METHODS AND FINDINGS

We performed a meta-analysis of eight case-control studies to define a diagnostic biomarker panel for BD. After validating the panel on established BD patients, we applied it to undiagnosed BD patients. We analysed 249 BD, 122 pre-diagnostic BD, 75 pre-diagnostic schizophrenia and 90 first onset major depression disorder (MDD) patients and 371 controls. The biomarker panel was identified using ten-fold cross-validation with lasso regression applied to the 87 analytes available across the meta-analysis studies. We identified 20 protein analytes with excellent predictive performance [area under the curve (AUC)⩾0.90]. Importantly, the panel had a good predictive performance (AUC 0.84) to differentiate 12 misdiagnosed BD patients from 90 first onset MDD patients, and a fair to good predictive performance (AUC 0.79) to differentiate between 110 pre-diagnostic BD patients and 184 controls. We also demonstrated the disease specificity of the panel.

CONCLUSIONS

An early and accurate diagnosis has the potential to delay or even prevent the onset of BD. This study demonstrates the potential utility of a biomarker panel as a diagnostic test for BD.