Department of Adult Psychiatry, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
Department of Public Health, Chair of Social Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland.
Int J Environ Res Public Health. 2019 Mar 29;16(7):1132. doi: 10.3390/ijerph16071132.
Bipolar patients have a higher risk of type 2 diabetes and obesity, which are associated with cardiovascular diseases as the leading cause of death in this group. Additionally, there is growing evidence that impaired glucose metabolism in bipolar patients is associated with rapid cycling, poor response to mood stabilizers and chronic course of illness. The aim of the study was to assess the prevalence of type 2 diabetes and other types of impaired glucose metabolism in bipolar patients along with an evaluation of the Fasting Triglycerides and Glucose Index (TyG) as a method of the insulin sensitivity assessment. The analysis of fasting glycemia, insulinemia and lipid profile in euthymic bipolar patients was performed, and the Homeostasis model assessment for insulin resistance (HOMA-IR) and TyG were computed. Type 2 diabetes was observed in 9% and insulin resistance with HOMA-IR in 48% of patients. The TyG and HOMA-IR indices were correlated ( < 0.0001), the TyG index value of 4.7 had the highest sensitivity and specificity for insulin resistance detection. The usefulness of TyG in the recognition of insulin resistance in bipolar patients was suggested. The significant role of psychiatrists in the detection and management of impaired glucose metabolism in bipolar patients was presented.
双相情感障碍患者患 2 型糖尿病和肥胖症的风险较高，而这些疾病与心血管疾病一起成为该人群的主要死亡原因。此外，越来越多的证据表明，双相情感障碍患者的葡萄糖代谢受损与快速循环、对心境稳定剂反应不佳和疾病慢性病程有关。本研究旨在评估双相情感障碍患者 2 型糖尿病和其他类型的葡萄糖代谢受损的患病率，并评估空腹甘油三酯和葡萄糖指数 (TyG) 作为胰岛素敏感性评估方法的效果。对病情稳定的双相情感障碍患者进行空腹血糖、胰岛素和血脂谱分析，并计算胰岛素抵抗的稳态模型评估 (HOMA-IR) 和 TyG。9%的患者患有 2 型糖尿病，48%的患者存在胰岛素抵抗（HOMA-IR）。TyG 和 HOMA-IR 指数呈正相关（<0.0001），TyG 指数值为 4.7 时对胰岛素抵抗的检测具有最高的灵敏度和特异性。提示 TyG 有助于识别双相情感障碍患者的胰岛素抵抗。提出了精神科医生在检测和管理双相情感障碍患者葡萄糖代谢受损方面的重要作用。
