Wang Ying, Liu Yiyi, Zhang Xun, Wu Qing
Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, Hefei, People's Republic of China.
Anhui Mental Health Center, Hefei Fourth People's Hospital, Hefei, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Nov 6;16:3533-3545. doi: 10.2147/DMSO.S428523. eCollection 2023.
Sex-based differences in patients with bipolar disorders (BD) are well recognized, and it is well known that the prevalence and severity of nonalcoholic fatty liver disease (NAFLD) are both higher in men than in women. Although metabolic disorders such as NAFLD are common in patients with BD, sex differences and risk factors for NAFLD comorbidity in these patients have not been thoroughly explored. This study aimed to investigate sex differences in patients with comorbid NAFLD and BD and associated risk factors.
This retrospective cross-sectional study included 710 patients with BD. Clinical data of patients with BD, including information on fasting glucose, liver function-related enzymes, relevant lipid data, uric acid, the triglyceride-glucose index (TyG), and demographics, were derived from the hospital electronic medical record system from June 2020 to July 2022. We performed logistic regression analysis and calculated the odds ratios with 95% confidence intervals of factors using -tests, -tests, and receiver operating characteristic. NAFLD was diagnosed using liver ultrasonography.
The prevalence of NAFLD was higher in male patients with BD than in female patients (50.9% vs 38.5%), and there were significant differences in the years of education and marital status (all <0.05). Regression analysis showed that the risk factors for comorbidities were the body mass index (BMI), fasting glucose, and apolipoprotein B levels in male patients and the BMI, bipolar disease course, glutamine transpeptidase levels, and the TyG in female patients.
Sex-based differences exist in risk factors and in the prevalence of comorbid NAFLD among patients with BD. BMI is a sex-independent risk factor, and clinical attention should be targeted to risk factors associated with comorbid NAFLD related to sex, especially in female patients with BD who presenting a high TyG index.
双相情感障碍（BD）患者存在基于性别的差异，众所周知，非酒精性脂肪性肝病（NAFLD）的患病率和严重程度在男性中均高于女性。虽然诸如NAFLD等代谢紊乱在BD患者中很常见，但这些患者中NAFLD合并症的性别差异和危险因素尚未得到充分探讨。本研究旨在调查合并NAFLD和BD的患者的性别差异及相关危险因素。
这项回顾性横断面研究纳入了710例BD患者。BD患者的临床数据，包括空腹血糖、肝功能相关酶、相关血脂数据、尿酸、甘油三酯-葡萄糖指数（TyG）以及人口统计学信息，均来自2020年6月至2022年7月的医院电子病历系统。我们进行了逻辑回归分析，并使用t检验、F检验和受试者工作特征曲线计算了各因素的比值比及其95%置信区间。NAFLD通过肝脏超声检查进行诊断。
BD男性患者中NAFLD的患病率高于女性患者（50.9%对38.5%），且在受教育年限和婚姻状况方面存在显著差异（均P<0.05）。回归分析表明，男性患者合并症的危险因素是体重指数（BMI）、空腹血糖和载脂蛋白B水平，而女性患者的危险因素是BMI、双相情感障碍病程、谷氨酰转肽酶水平和TyG。
BD患者中，NAFLD合并症的危险因素和患病率存在基于性别的差异。BMI是一个与性别无关的危险因素，临床应关注与性别相关的NAFLD合并症的危险因素，尤其是TyG指数较高的BD女性患者。
