Institute of Biopharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan 70428, Taiwan.
J Affect Disord. 2010 Aug;124(3):319-23. doi: 10.1016/j.jad.2009.12.011. Epub 2010 Jan 13.
Our previous report showed that patients with bipolar disorder (BD) have higher prevalence of hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL) and obesity in Taiwan. To confirm whether the metabolic disturbances is associated with the disease itself or the medications used for treating BD, we further compared the metabolic status among the valproate (VPA) treated BD patients, drug-free BD patients and healthy controls in Taiwan.
This cross-sectional study included 119 healthy controls and 77 BD patients diagnosed according to the DSMIV-TR criteria in a university hospital. Among the diseased group, 25 remitted BD patients were drug-free (BD-F), and 52 of them were treated with VPA (BD-VPA). Their body mass index (BMI), plasma glucose levels and plasma lipid profiles were measured.
Plasma fasting glucose, insulin, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (LDL) levels were significantly different among BD-VPA, the BD-F, and the healthy control groups. Valproate treatment was associated with significant higher plasma insulin, triglyceride, and BMI levels as well as lower fasting glucose and HDL levels. However, these biochemical indexes did not differ significantly between the BD-F and the healthy control groups.
These results provide further evidence that VPA treatment for BD may increase the risk of metabolic disturbances. The risk may be reduced after discontinuing VPA medication.
我们之前的报告表明，台湾的双相情感障碍（BD）患者中，高脂血症、低高密度脂蛋白胆固醇（HDL）和肥胖的患病率较高。为了确定代谢紊乱是否与疾病本身或用于治疗 BD 的药物有关，我们进一步比较了台湾地区丙戊酸（VPA）治疗的 BD 患者、无药物治疗的 BD 患者和健康对照组之间的代谢状况。
这项横断面研究包括了在一家大学医院根据 DSMIV-TR 标准诊断的 119 名健康对照者和 77 名 BD 患者。在患病组中，25 名缓解的 BD 患者无药物治疗（BD-F），其中 52 名患者使用 VPA 治疗（BD-VPA）。测量了他们的体重指数（BMI）、血浆葡萄糖水平和血浆血脂谱。
BD-VPA、BD-F 和健康对照组之间的血浆空腹血糖、胰岛素、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇（LDL）水平有显著差异。VPA 治疗与显著更高的血浆胰岛素、甘油三酯和 BMI 水平以及更低的空腹血糖和 HDL 水平相关。然而，BD-F 和健康对照组之间这些生化指标没有显著差异。
这些结果进一步提供了证据，表明 VPA 治疗 BD 可能会增加代谢紊乱的风险。停止 VPA 药物治疗后，这种风险可能会降低。
