Coello Klara, Vinberg Maj, Knop Filip K, Pedersen Bente K, McIntyre Roger S, Kessing Lars V, Munkholm Klaus
Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Department O, 6243, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Int J Bipolar Disord. 2019 Apr 2;7(1):8. doi: 10.1186/s40345-019-0142-3.
The prevalence of metabolic syndrome and insulin resistance is twice as high in patients with bipolar disorder compared with the general population, and possibly associated with a disabling illness trajectory of bipolar disorder, an increased risk of cardiovascular disease and premature death. Despite these detrimental effects, the prevalence of metabolic syndrome and insulin resistance in patients newly diagnosed with bipolar disorder and their unaffected first-degree relatives is largely unknown.
In a cross-sectional study of 206 patients with newly diagnosed bipolar disorder, 50 of their unaffected first-degree relatives and 109 healthy age- and sex-matched individuals, we compared the prevalence of metabolic syndrome and insulin resistance (HOMA-IR). In patients with bipolar disorder, we further investigated illness and medication variables associated with the metabolic syndrome and insulin resistance.
Higher rates of metabolic syndrome (odds ratio = 3.529, 95% CI 1.378-9.041, P = 0.009) and levels of insulin resistance (B = 1.203, 95% CI 1.059-1.367, P = 0.005) were found in patients newly diagnosed with bipolar disorder, but not in their unaffected first-degree relatives compared with matched healthy individuals (data adjusted for sex and age). Most patients with bipolar disorder (94.7%) were diagnosed within the preceding 2 years, and the average illness duration, defined as time from first mood episode, was 10 years.
Our findings of elevated prevalence of metabolic syndrome and insulin resistance in patients with newly diagnosed bipolar disorder highlight the importance of screening for these conditions at an early stage to employ adequate and early care reducing the risk of cardiovascular disease and premature death.
双相情感障碍患者中代谢综合征和胰岛素抵抗的患病率是普通人群的两倍，且可能与双相情感障碍导致功能障碍的病程、心血管疾病风险增加及过早死亡有关。尽管有这些有害影响，但新诊断的双相情感障碍患者及其未患病的一级亲属中代谢综合征和胰岛素抵抗的患病率在很大程度上尚不清楚。
在一项横断面研究中，我们比较了206例新诊断的双相情感障碍患者、其中50例未患病的一级亲属以及109名年龄和性别匹配的健康个体的代谢综合征患病率和胰岛素抵抗（稳态模型评估胰岛素抵抗指数）。对于双相情感障碍患者，我们进一步研究了与代谢综合征和胰岛素抵抗相关的疾病及用药变量。
新诊断的双相情感障碍患者中代谢综合征发生率较高（比值比=3.529，95%置信区间1.378-9.041，P=0.009），胰岛素抵抗水平也较高（B=1.203，95%置信区间1.059-1.367，P=0.005），但与匹配的健康个体相比，其未患病的一级亲属中未出现这种情况（数据经性别和年龄校正）。大多数双相情感障碍患者（94.7%）在之前2年内被诊断，平均病程（定义为从首次情绪发作开始的时间）为10年。
我们关于新诊断的双相情感障碍患者中代谢综合征和胰岛素抵抗患病率升高的研究结果凸显了早期筛查这些情况以采取适当的早期护理从而降低心血管疾病风险和过早死亡风险的重要性。
