Associations between bipolar disorder and metabolic syndrome: A review.
OBJECTIVE
To examine the pathophysiologic mechanisms that may link bipolar disorder and metabolic syndrome and to discuss whether the consequences of metabolic syndrome underlie a substantive portion of the premature morbidity and mortality observed in persons with bipolar disorder.


METHODS
A MEDLINE search, citing articles from 1966 onward, supplemented by a review of bibliographies, was conducted to identify relevant studies. Bipolar disorder, mood disorder, metabolic syndrome, diabetes, cardiovascular illness, and obesity were used as keywords. Criteria used to select studies included (1) English language, (2) published studies with original data in peer-reviewed journals, and (3) studies that confirmed the nature of the mood disorder examined.


RESULTS
Ninety-seven studies met criteria and were reviewed for evidence of dysregulation in various physiologic systems. Bipolar disorder and metabolic syndrome share features of hormonal, immunologic, and autonomic nervous system dysregulation.


CONCLUSIONS
Lifestyle features may account, in part, for the premature mortality observed in bipolar disorder, but the somatic correlates of the illness may also predispose patients to metabolic syndrome and the consequent increased risk of diseases such as diabetes and vascular disease.
Taylor
Valerie
V
Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada. taylorv@mcmaster.ca
MacQueen
Glenda
G
D001714:Bipolar Disorder / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology; D015897:Comorbidity; D016207:Cytokines / Q000502:physiology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D006854:Hydrocortisone / Q000502:physiology; D008019:Life Style; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000453:epidemiology* / Q000503:physiopathology*; D009026:Mortality; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology; D011619:Psychotropic Drugs / Q000009:adverse effects; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000503:physiopathology
D016207:Cytokines; D011619:Psychotropic Drugs; D006854:Hydrocortisone