Fondation FondaMental, Créteil, France.
INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, Université Paris Est Créteil, Créteil, France.
Acta Psychiatr Scand. 2024 Mar;149(3):207-218. doi: 10.1111/acps.13655. Epub 2024 Jan 24.
Metabolic syndrome (MetS) is a cluster of components including abdominal obesity, hyperglycemia, hypertension, and dyslipidemia. MetS is highly prevalent in individuals with bipolar disorders (BD) with an estimated global rate of 32.6%. Longitudinal data on incident MetS in BD are scarce and based on small sample size. The objectives of this study were to estimate the incidence of MetS in a large longitudinal cohort of 1521 individuals with BD and to identify clinical and biological predictors of incident MetS.
Participants were recruited from the FondaMental Advanced Center of Expertise for Bipolar Disorder (FACE-BD) cohort and followed-up for 3 years. MetS was defined according to the International Diabetes Federation criteria. Individuals without MetS at baseline but with MetS during follow-up were considered as having incident MetS. A logistic regression model was performed to estimate the adjusted odds ratio and its corresponding 95% confidence interval (CI) for an association between each factor and incident MetS during follow-up. We applied inverse probability-of-censoring weighting method to minimize selection bias due to loss during follow-up.
Among individuals without MetS at baseline (n = 1521), 19.3% developed MetS during follow-up. Multivariable analyses showed that incident MetS during follow-up was significantly associated with male sex (OR = 2.2, 95% CI = 1.7-3.0, p < 0.0001), older age (OR = 2.14, 95% CI = 1.40-3.25, p = 0.0004), presence of a mood recurrence during follow-up (OR = 1.91, 95% CI = 1.22-3.00, p = 0.0049), prolonged exposure to second-generation antipsychotics (OR = 1.56, 95% CI = 0.99, 2.45, p = 0.0534), smoking status at baseline (OR = 1.30, 95% CI = 1.00-1.68), lifetime alcohol use disorders (OR = 1.33, 95% CI = 0.98-1.79), and baseline sleep disturbances (OR = 1.04, 95% CI = 1.00-1.08), independently of the associations observed for baseline MetS components.
We observed a high incidence of MetS during a 3 years follow-up (19.3%) in individuals with BD. Identification of predictive factors should help the development of early interventions to prevent or treat early MetS.
代谢综合征（MetS）是一组包括腹部肥胖、高血糖、高血压和血脂异常的成分。在双相情感障碍（BD）患者中，MetS 的患病率很高，估计全球患病率为 32.6%。BD 中发生 MetS 的纵向数据很少，并且基于小样本量。本研究的目的是在 1521 名患有 BD 的大型纵向队列中估计 MetS 的发生率，并确定发生 MetS 的临床和生物学预测因素。
参与者从 FondaMental 高级双相情感障碍专业中心（FACE-BD）队列中招募，并随访 3 年。MetS 根据国际糖尿病联合会的标准定义。基线时无 MetS 但随访期间出现 MetS 的个体被视为发生 MetS。使用逻辑回归模型估计每个因素与随访期间发生 MetS 之间的调整后比值比及其相应的 95%置信区间（CI）。我们应用逆概率删失加权法来最小化由于随访期间丢失而导致的选择偏差。
在基线时无 MetS 的个体中（n=1521），19.3%在随访期间发生 MetS。多变量分析表明，随访期间发生 MetS 与男性（OR=2.2，95%CI=1.7-3.0，p<0.0001）、年龄较大（OR=2.14，95%CI=1.40-3.25，p=0.0004）、随访期间出现心境复发（OR=1.91，95%CI=1.22-3.00，p=0.0049）、长期暴露于第二代抗精神病药物（OR=1.56，95%CI=0.99，2.45，p=0.0534）、基线时的吸烟状态（OR=1.30，95%CI=1.00-1.68）、终生酒精使用障碍（OR=1.33，95%CI=0.98-1.79）和基线时的睡眠障碍（OR=1.04，95%CI=1.00-1.08）独立相关。
我们观察到 BD 患者在 3 年随访期间（19.3%）发生 MetS 的发生率较高。识别预测因素应有助于制定早期干预措施，以预防或治疗早期 MetS。
