Bipolar disorder (BD) has been associated with clinical signs of accelerated aging, which potentially underlies its association with several age-related medical conditions, such as hypertension, metabolic imbalances, dementia, and cancer. This paper aims to comprehensively review evidence of biological aging in BD and explore findings and controversies related to common biological clocks in patients, including telomere length, DNA methylation, mitochondrial DNA copy number, inflammation, and oxidative stress. Our results suggest a complex interplay between biological markers and a potential key role of environmental factors, such as childhood trauma and psychological stress, in determining premature aging in patients. Moreover, given its multifactorial nature, our summary evidences the need for further studies incorporating clinical evidence with biomarkers of accelerated aging in BD. Results of this review strongly suggest BD as an accelerated aging disease seen in both clinical and molecular aspects. Understanding the pathophysiology of aging in BD may ultimately lead to identification of pathways that can be targeted for prevention of premature aging in patients and early onset of aging-related conditions.

中文翻译：

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双相情感障碍的加速衰老：分子发现及其临床意义的全面综述。

躁郁症（BD）与加速衰老的临床体征相关，这可能与与年龄相关的多种医学疾病（例如高血压，代谢失衡，痴呆和癌症）相关。本文旨在全面审查BD中生物衰老的证据，并探讨与患者常见的生物钟有关的发现和争议，包括端粒长度，DNA甲基化，线粒体DNA拷贝数，炎症和氧化应激。我们的研究结果表明，生物学标志物之间的复杂相互作用以及环境因素（例如儿童期创伤和心理压力）在确定患者过早衰老方面的潜在关键作用。而且，鉴于其多因素性质，我们的总结证明有必要进行进一步的研究，以结合临床证据和BD加速衰老的生物标志物。这篇综述的结果有力地表明，在临床和分子方面，BD都是一种加速衰老的疾病。了解BD衰老的病理生理学可能最终导致鉴定可用于预防患者过早衰老和与衰老相关的疾病的早期发作的途径。