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双相障碍患者的兄弟姐妹发生心血管代谢疾病的风险。

Risk of cardiometabolic diseases among siblings of patients with bipolar disorder.

机构信息

Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.

Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

J Affect Disord. 2019 Jun 15;253:171-175. doi: 10.1016/j.jad.2019.04.094. Epub 2019 Apr 22.

Abstract

BACKGROUND

Cardiometabolic diseases are suggested to be associated with bipolar disorder. However, the risk of metabolic disorders in unaffected siblings of patients with bipolar disorder remains unclear.

METHODS

From the Taiwan National Health Insurance Research Database, 7,225 unaffected siblings of bipolar probands and 28,900 age-/sex-/income-/residence-matched control individuals were included and followed until the end of 2011. Individuals who developed metabolic disorders during the follow-up period were identified.

RESULTS

The unaffected siblings of bipolar probands had a higher prevalence of dyslipidemia (5.4% vs. 4.5%, p = 0.001), younger age at diagnosis of type 2 diabetes mellitus (34.81 vs. 37.22, p = 0.024), and higher prevalence of any stroke (1.5% vs. 1.1%, p = 0.007) than the controls. Moreover, only male siblings of bipolar probands had an increased risk of dyslipidemia (odds ratio [OR]: 1.28, 95% confidence interval [CI]: 1.10-1.48) and higher rates of any stroke (OR: 1.38, 95% CI: 1.02-1.85) and ischemic stroke (OR: 2.43, 95% CI: 1.60-3.70) during the follow-up compared with the controls.

DISCUSSION

Unaffected siblings of bipolar patients, particularly brothers, had a higher prevalence of dyslipidemia and ischemic stroke compared with the controls. The result suggests the familial association between cardiometabolic diseases and bipolar disorder. Further research may be necessary to identify this shared etiology between the disorders.

摘要

背景

心血管代谢疾病与双相障碍有关。然而,双相障碍患者未受影响的兄弟姐妹发生代谢紊乱的风险尚不清楚。

方法

从台湾全民健康保险研究数据库中,纳入 7225 名双相障碍先证者的未受影响的兄弟姐妹和 28900 名年龄、性别、收入和居住地匹配的对照者,并随访至 2011 年底。在随访期间发生代谢紊乱的个体被确定。

结果

双相障碍先证者未受影响的兄弟姐妹中血脂异常的患病率较高(5.4%比 4.5%,p=0.001),2 型糖尿病的诊断年龄较小(34.81比 37.22,p=0.024),任何卒中的患病率较高(1.5%比 1.1%,p=0.007)。此外,只有双相障碍先证者的男性兄弟姐妹发生血脂异常的风险增加(比值比[OR]:1.28,95%置信区间[CI]:1.10-1.48),且任何卒中(OR:1.38,95%CI:1.02-1.85)和缺血性卒中(OR:2.43,95%CI:1.60-3.70)的发生率高于对照组。

讨论

双相障碍患者未受影响的兄弟姐妹,尤其是男性,血脂异常和缺血性卒中的患病率高于对照组。结果提示心血管代谢疾病和双相障碍之间存在家族相关性。可能需要进一步研究以确定两种疾病之间的这种共同病因。

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