Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
CNS Spectr. 2022 Oct;27(5):598-603. doi: 10.1017/S1092852921000158. Epub 2021 Mar 11.
High prevalence of insulin resistance (IR) has been reported in bipolar disorder (BD) patients. Importantly, impaired insulin sensitivity could modulate the course and treatment outcome in BD. Here, we hypothesized that insulin sensitivity could be potentially associated with the neurocognitive trajectory in euthymic BD. We aimed to examine differences in insulin sensitivity and executive function between BD patients and controls.
Sixty-two patients with BD receiving mood stabilizer treatment and 62 controls, matching age, sex, and body mass index, were recruited in this study. Insulin sensitivity was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). The Wisconsin card-sorting test (WCST) was applied to test participants' ability to shift cognitive set. Group differences were measured and multivariate regression analysis was performed to examine relationships among factors.
The results indicated that the HOMA-IR ( = .048) value in the patients with BD were significantly higher than those in controls. With regards to executive function, the BD patients performed significantly poorer than the control subjects ( < .05). Moreover, the interaction effect between BD diagnosis and HOMA-IR value on the WCST-preservation errors was significant ( = .01), and analyses showed that the cognitive abilities were worse in the BD patients with a higher IR than in the others groups.
Insulin sensitivity is associated with the neurocognitive performance in euthymic BD patients. Although the underlying mechanisms remain unclear, interventions to improve insulin sensitivity could potentially improve the functional outcome of BD.
有报道称双相障碍（BD）患者存在较高的胰岛素抵抗（IR）发生率。重要的是，胰岛素敏感性受损可能会影响 BD 的病程和治疗结局。在这里，我们假设胰岛素敏感性可能与缓解期 BD 的神经认知轨迹有关。我们旨在检查 BD 患者和对照组之间胰岛素敏感性和执行功能的差异。
本研究纳入了 62 名正在接受心境稳定剂治疗的 BD 患者和 62 名年龄、性别和体重指数匹配的对照组。使用稳态模型评估的胰岛素抵抗（HOMA-IR）来评估胰岛素敏感性。采用威斯康星卡片分类测验（WCST）来测试参与者的认知定势转换能力。测量组间差异，并进行多元回归分析以检验各因素之间的关系。
结果表明，BD 患者的 HOMA-IR 值（=0.048）明显高于对照组。就执行功能而言，BD 患者的表现明显差于对照组（<0.05）。此外，BD 诊断和 HOMA-IR 值对 WCST 保持错误的交互作用具有统计学意义（=0.01），分析显示，IR 较高的 BD 患者的认知能力更差。
胰岛素敏感性与缓解期 BD 患者的神经认知表现有关。尽管潜在机制尚不清楚，但改善胰岛素敏感性的干预措施可能会改善 BD 的功能结局。
