Department of Biomedical Sciences, Seoul National University Graduate School, 28 Yongon-Dong, Chongno-Gu, Seoul 110-744, Republic of Korea.
Prog Neuropsychopharmacol Biol Psychiatry. 2010 Oct 1;34(7):1243-9. doi: 10.1016/j.pnpbp.2010.06.029. Epub 2010 Jul 3.
Despite growing concerns about the co-morbidity of metabolic syndrome (MetS) and bipolar disorder, few studies have been conducted on this topic in Asian populations. This study examined Korean patients with bipolar disorder to assess its co-morbidity with MetS and to compare the prevalence of MetS in patients with medication for bipolar disorder with that of healthy patients. We used cross-sectional data from the medical records of patients with bipolar disorder who presented to the psychiatric clinic in Seoul National University Hospital between June 2007 and June 2008. The control group, matched for age and gender, was randomly drawn from visitors to the Health Promotion Center at the same hospital during the same period. We compared the prevalence of MetS between these two groups with independent sample t-tests and chi-squared tests. We also calculated the indirectly standardized prevalence ratio (ISPR) with a standardization that used the Fourth Korean National Health and Nutrition Examination Survey (KNHNES, 2007). The prevalence of MetS in patients who took medication for bipolar disorder (N=152) was 27.0%, 25.0% and 25.7%, based on the definitions of the American Heart Association and the National Heart, Lung and Blood Institute's adaptation of the Adult Treatment Panel III (AHA), the National Cholesterol Education Program for Adult Treatment Panel III (ATPIII) and the International Diabetes Federation (IDF), respectively. The present study determined that the prevalence of MetS was significantly higher in patients with bipolar disorder than in the control group; the odds ratios (OR) (95% CI) were 2.44 (1.35-4.40), 2.48 (1.34-4.59) and 2.57 (1.40-4.74), based on the definition of the AHA, ATPIII and IDF, respectively. The ISPR (95% CI) was 1.48 (1.02-1.93), 1.54 (1.05-2.03) and 1.98 (1.36-2.60), respectively. Patients with medications for bipolar disorder showed a significantly higher prevalence of increased waist circumference, elevated triglycerides, and reduced HDL-cholesterol than the control group. The prevalence of MetS in patients taking medication for bipolar disorder was higher than that in the general population. Obesity and dyslipidemia were particularly prevalent in patients with bipolar disorder.
尽管代谢综合征(MetS)和双相情感障碍共病的问题越来越受到关注,但在亚洲人群中对此进行的研究很少。本研究检查了韩国的双相情感障碍患者,以评估其与 MetS 的共病情况,并比较接受双相情感障碍药物治疗的患者与健康患者的 MetS 患病率。我们使用了 2007 年 6 月至 2008 年 6 月期间在首尔国立大学医院精神病诊所就诊的双相情感障碍患者的病历的横断面数据。对照组按年龄和性别与患者相匹配,是同期从同一医院健康促进中心的访客中随机抽取的。我们通过独立样本 t 检验和卡方检验比较了这两组的 MetS 患病率。我们还使用第四次韩国国家健康和营养检查调查(2007 年,KNHNES)的标准化方法计算了间接标准化患病率比(ISPR)。根据美国心脏协会和国家心肺血液研究所对成人治疗小组 III(AHA)的改编、国家胆固醇教育计划成人治疗小组 III(ATPIII)和国际糖尿病联合会(IDF)的定义,服用双相情感障碍药物的患者的 MetS 患病率分别为 27.0%、25.0%和 25.7%。本研究确定,双相情感障碍患者的 MetS 患病率明显高于对照组;基于 AHA、ATPIII 和 IDF 的定义,优势比(OR)(95%CI)分别为 2.44(1.35-4.40)、2.48(1.34-4.59)和 2.57(1.40-4.74)。ISPR(95%CI)分别为 1.48(1.02-1.93)、1.54(1.05-2.03)和 1.98(1.36-2.60)。服用双相情感障碍药物的患者腰围增加、甘油三酯升高和高密度脂蛋白胆固醇降低的比例明显高于对照组。服用双相情感障碍药物的患者 MetS 的患病率高于一般人群。肥胖和血脂异常在双相情感障碍患者中尤为普遍。