Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico; Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota.
Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota.
J Affect Disord. 2021 Mar 1;282:637-643. doi: 10.1016/j.jad.2020.12.121. Epub 2020 Dec 29.
To evaluate the association between cardiometabolic markers and bipolar disorder (BD), examining the impact of sex and cardiometabolic medication use, from a large case-control biorepository of more than 1300 participants.
Recruited from July 2009 through September 2017, cardiometabolic markers were harvested from electronic health records (EHR) of participants (n=661) from the Mayo Clinic Individualized Medicine Biobank for Bipolar Disorder and Mayo Clinic Biobank age-sex-matched controls (n=706). Markers were compared between cases and controls using logistic regression, stratified by sex, adjusting for cardiometabolic medications and current smoking status. We studied the effect of psychotropics in case-only analyses.
The mean age of the sample was 52.5 ± 11.6 years and 55% were female. BD patients had higher rates of smoking, but lower utilization of lipid-lowering medication compared with controls. After adjustment, BD was associated with obesity [Odds ratio (CI) 1.62 (1.22-2.15)], elevated systolic blood pressure (SBP) [2.18 (1.55-3.06)] and elevated triglycerides [1.58 (1.13-2.2)]. When stratified by sex, obesity [1.8 (1.23-2.66)] and systolic blood pressure [2.32 (1.46-3.7)] were associated with BD females compared to female controls; however, only systolic blood pressure [2.04 (1.23-3.42)] was associated with male bipolars compared to male controls. Psychotropics were marginally associated with mean BMI, abnormal triglycerides, and HbA1c.
EHR cross-sectional data CONCLUSION: To our knowledge, this is the largest case controlled study to date to explore the association between cardiometabolic markers and bipolar disorder adjusting for utilization of cardiometabolic medication. Identification of significant, non-laboratory based cardiometabolic markers that are associated with increased risk of major cardiovascular adverse events in patients with bipolar disorder, underscores, both the utility and importance of risk monitoring that can be easily done in community mental health centers.
从一个超过 1300 名参与者的大型病例对照生物库中，评估心脏代谢标志物与双相情感障碍（BD）之间的关联，检查性别和心脏代谢药物使用的影响。
从 2009 年 7 月至 2017 年 9 月招募，从梅奥诊所个体化医学生物银行的双相情感障碍参与者（n=661）和梅奥诊所生物银行年龄性别匹配的对照者（n=706）的电子健康记录（EHR）中提取心脏代谢标志物。使用逻辑回归比较病例和对照者之间的标志物，按性别分层，调整心脏代谢药物和当前吸烟状态。我们在病例仅分析中研究了精神药物的作用。
样本的平均年龄为 52.5±11.6 岁，55%为女性。BD 患者的吸烟率较高，但与对照组相比，降脂药物的使用率较低。调整后，BD 与肥胖[比值比（CI）1.62（1.22-2.15）]、收缩压（SBP）升高[2.18（1.55-3.06）]和甘油三酯升高[1.58（1.13-2.2）]相关。按性别分层时，与女性对照组相比，肥胖[1.8（1.23-2.66）]和收缩压[2.32（1.46-3.7）]与女性 BD 相关；然而，只有收缩压[2.04（1.23-3.42）]与男性双相情感障碍者与男性对照组相关。精神药物与平均 BMI、异常甘油三酯和 HbA1c 略有相关。
EHR 横断面数据。
据我们所知，这是迄今为止最大的病例对照研究，目的是在调整心脏代谢药物使用的情况下，探索心脏代谢标志物与双相情感障碍之间的关联。确定与双相情感障碍患者发生主要心血管不良事件风险增加相关的重要、非实验室心脏代谢标志物，突显了在社区心理健康中心可以轻松进行的风险监测的实用性和重要性。
