Towards a blood-based diagnostic panel for bipolar disorder
Towards a blood-based diagnostic panel for bipolar disorder
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DOI：
10.1016/j.bbi.2015.10.001
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发表时间：
2016-02-01
影响因子：
15.1
通讯作者：
Bahn, Sabine
中科院分区：
文献类型：
--
作者：
Haenisch, Frieder;Cooper, Jason D.;Bahn, Sabine
背景资料：双相情感障碍（BD）是一种代价高昂、毁灭性和缩短生命的精神障碍，经常被误诊，特别是在最初的表现。误诊经常导致治疗无效。我们调查了实用的生物标志物面板作为诊断测试BD.Methods和调查结果：我们进行了荟萃分析的8个病例对照研究，以确定一个诊断生物标志物面板BD。在对已确诊的BD患者进行验证后，我们将其应用于未确诊的BD患者。我们分析了249例BD，122例诊断前BD，75例诊断前精神分裂症和90例首发抑郁症（MDD）患者和371例对照。使用10倍交叉验证和应用于荟萃分析研究中的87种分析物的套索回归来鉴定生物标志物组。我们鉴定了20种具有优异预测性能的蛋白质分析物[曲线下面积（AUC）>= 0.90]。重要的是，该小组具有良好的预测性能（AUC 0.84），以区分12名误诊的BD患者和90名首次发作的MDD患者，以及良好的预测性能（AUC 0.79），以区分110名诊断前BD患者和184名对照。我们还证明了疾病的特异性panel.Conclusions：早期和准确的诊断有可能延迟，甚至防止BD的发病。这项研究证明了生物标志物面板作为BD诊断测试的潜在效用。(C)2015年，作者。爱思唯尔公司出版
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. (C) 2015 The Authors. Published by Elsevier Inc.