Kalelioğlu Tevfik, Ünalan Pelin, Kök Burcu, Sözen Şule, Yüksel Özge, Akkuş Mustafa, Cihnioğlu Refik, Karamustafalıoğlu Nesrin
Department of Psychiatry, Bakırköy Mental Health Research and Teaching Hospital, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2018 Jan;46(1):32-38. doi: 10.5543/tkda.2017.23350.
Individuals with bipolar disorder (BD) frequently suffer from cardiovascular disease (CVD), and it is a leading cause of mortality. Clinicians use routine laboratory tests, including a lipid profile, to predict cardiovascular risk. In addition, a particular lipid ratio, the atherogenic index of plasma (AIP), is a sensitive, new parameter that can be used to assess highrisk groups. To our knowledge, this is the first study evaluating cardiovascular risk via AIP in different stages of BD.
The study group consisted of male patients with BD who were in a manic, depressive, or euthymic state, and age- and gender-matched healthy controls. Lipid profiles were analyzed and the AIP parameter of logarithm of triglyceride (TG) / high-density lipoprotein cholesterol (HDLc) was calculated for all of the participants. The significance level was set at p<0.05.
A total of 44 BD patients experiencing a manic episode, 35 depressive BD patients, 42 euthymic patients, and 41 healthy controls matched for age, gender, and smoking status were enrolled in the study. The AIP level was significantly different between groups (p=0.009). Pairwise comparisons of the groups revealed that the AIP level of depressive patients was significantly higher than that of the manic, euthymic, and control groups (p=0.013, p=0.048, and p=0.021, respectively). The AIP level was positively correlated with body mass index, waist circumference, metabolic syndrome, total cholesterol, low-density lipoprotein, and triglyceride level, and was negatively correlated with the HDLc level.
In this study, male BD patients in a depressive episode demonstrated an increase in cardiovascular risk. The significant correlations between AIP and other conventional cardiovascular risk factors indicate that AIP may be more useful to identify individuals with BD at high risk for CVD than absolute lipid parameters.
双相情感障碍（BD）患者常患心血管疾病（CVD），且这是导致死亡的主要原因。临床医生使用包括血脂谱在内的常规实验室检查来预测心血管风险。此外，一种特定的血脂比值，即血浆致动脉粥样硬化指数（AIP），是一个可用于评估高危人群的敏感新参数。据我们所知，这是第一项通过AIP评估BD不同阶段心血管风险的研究。
研究组由处于躁狂、抑郁或心境正常状态的男性BD患者以及年龄和性别匹配的健康对照组成。分析所有参与者的血脂谱，并计算甘油三酯（TG）/高密度脂蛋白胆固醇（HDLc）对数的AIP参数。显著性水平设定为p<0.05。
本研究共纳入44例经历躁狂发作的BD患者、35例抑郁BD患者、42例心境正常患者以及41例年龄、性别和吸烟状况匹配的健康对照。各组间AIP水平差异有统计学意义（p=0.009）。组间两两比较显示，抑郁患者的AIP水平显著高于躁狂、心境正常和对照组（分别为p=0.013、p=0.048和p=0.021）。AIP水平与体重指数、腰围、代谢综合征、总胆固醇、低密度脂蛋白和甘油三酯水平呈正相关，与HDLc水平呈负相关。
在本研究中，处于抑郁发作期的男性BD患者心血管风险增加。AIP与其他传统心血管危险因素之间的显著相关性表明，与绝对血脂参数相比，AIP可能更有助于识别BD中CVD高危个体。
