A biomarker for endocrine side effects of lithium carbonate and valporic acid in bipolar disorder patients: Sex hormone-binding globulin.

INTRODUCTION

Monitoring and managing endocrine comorbidities in patients with bipolar disorder (BD) is essential for both physical and mental health. Lithium (Li) and valproic acid (VPA) are commonly prescribed mood stabilizers in BD and are associated with various endocrine side effects. Identifying biomarkers that can predict these effects is crucial for timely monitoring and intervention. This study aimed to evaluate the potential role of sex hormone-binding globulin (SHBG) as a biomarker for endocrine side effects in BD patients treated with Li or VPA.

METHOD: A total of 99 patients diagnosed with BD, who had no prior endocrine disorders and had been treated with Li or VPA for at least three months, were retrospectively evaluated. Endocrine and metabolic parameters were compared between treatment groups, and correlations with SHBG levels were analysed.

RESULTS

There were no significant differences in age or endocrine parameters between Li and VPA users. SHBG levels showed significant negative correlations with HbA1c, total cholesterol, triglycerides, HOMA-IR, metabolic syndrome and body mass index. In multivariate analysis, SHBG was independently associated with total cholesterol and metabolic syndrome.

DISCUSSION: The findings suggest that SHBG may serve as a useful biomarker for detecting drug-induced endocrine disturbances in BD patients receiving Li or VPA. Monitoring SHBG levels may enhance early identification of metabolic dysfunction in clinical follow-up.

CONCLUSION

Regular assessment of endocrine side effects, including SHBG levels, should be considered in the routine care of BD patients treated with mood stabilizers such as Li or VPA.