Mohite Satyajit, Wu Hanjing, Sharma Shiva, Lavagnino Luca, Zeni Cristian P, Currie Terrence T, Soares Jair C, Pigott Teresa A
The University of Texas Harris County Psychiatric Center, Houston, TX, USA.
Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center, Houston, TX, USA.
Clin Psychopharmacol Neurosci. 2020 May 31;18(2):279-288. doi: 10.9758/cpn.2020.18.2.279.
Previous studies have indicated a convergent and bidirectional relationship between metabolic syndrome (MetS) and bipolar disorder (BD). As most of these studies focused mainly on adults diagnosed with BD, our study aims to investigate and characterize metabolic disturbances in child-adolescents diagnosed with BD.
We retrospectively examined the medical records of psychiatric hospitalizations with admitting diagnosis of BD in child-adolescents (age < 18 years). Body mass index (BMI), lipid profile, fasting blood glucose, and blood pressure were primary variables. National Cholesterol Education Program criteria were used to define MetS. Reference group data was obtained from the National Health and Nutrition Examination Survey study. Statistical analyses included t tests, chi-square tests, and Fisher's exact tests.
We identified 140 child-adolescent patients with BD (mean age = 15.12 ± 1.70 years, 53% male). MetS was significantly more common in BD compared to the reference group: 14% (95% confidence interval [95% CI] 8-20) vs. 6.7% (95% CI 4.1-9.2), = 0.001 with no significant difference by sex. MetS components were higher in the BD group, particularly BMI ≥ 95% (25% vs. 11.8%, < 0.001) and high blood pressure (17% vs. 8%, = 0.05). Moreover, female patients had lower odds of high blood pressure (odds ratio = 0.24 [95% CI 0.08-0.69], = 0.005).
Compared with the general child-adolescent population, the prevalence of MetS was significantly higher in patients with BD of same age. This reiterates the notion of an increased risk of MetS in patients diagnosed with BD; and thus, further exploration is warranted.
既往研究表明代谢综合征(MetS)与双相情感障碍(BD)之间存在趋同且双向的关系。由于这些研究大多主要关注成年BD患者,我们的研究旨在调查并描述儿童青少年BD患者的代谢紊乱情况。
我们回顾性检查了儿童青少年(年龄<18岁)因BD入院诊断的精神科住院病历。体重指数(BMI)、血脂谱、空腹血糖和血压为主要变量。采用美国国家胆固醇教育计划标准来定义MetS。参考组数据来自美国国家健康与营养检查调查研究。统计分析包括t检验、卡方检验和费舍尔精确检验。
我们确定了140例儿童青少年BD患者(平均年龄 = 15.12 ± 1.70岁,53%为男性)。与参考组相比,MetS在BD患者中显著更常见:14%(95%置信区间[95%CI] 8 - 20)对6.7%(95%CI 4.1 - 9.2),P = 0.001,按性别无显著差异。BD组的MetS各组分更高,尤其是BMI≥95%(25%对11.8%,P<0.001)和高血压(17%对8%,P = 0.05)。此外,女性患者患高血压的几率较低(优势比 = 0.24 [95%CI 0.08 - 0.69],P = 0.005)。
与一般儿童青少年人群相比,同龄BD患者中MetS的患病率显著更高。这再次强调了BD患者发生MetS风险增加的观点;因此,有必要进一步探索。