Elevated prevalence of obesity, metabolic syndrome, and cardiovascular risk factors in bipolar disorder.
BACKGROUND
Bipolar disorder is associated with excess cardiovascular mortality. We hypothesized outpatients with bipolar disorder would exhibit excess cardiovascular risk factors, particularly among prevalent users of the second-generation antipsychotics associated with weight gain and valproic acid derivatives.


METHODS
This chart review of 217 patients with bipolar disorder examined cardiovascular risk factors of the metabolic syndrome. We also evaluated if certain medications were cross-sectionally associated with metabolic syndrome.


RESULTS
Fifty-six patients were not weighed and many did not have available lipid profiles. Over three-quarters of those with available data (n = 161) were overweight or obese (body mass index >or= 25) and nearly half were obese (body mass index >or= 30). A prevalence exceeding general population estimates was also observed for hypertriglyceridemia, elevated blood pressure/hypertension, and elevated fasting glucose/diabetes. Among those with all requisite data (n = 60), over 50% met criteria for National Cholesterol Education Program-defined metabolic syndrome, nearly double the expected prevalence. A trend toward greater prevalence of metabolic syndrome among prevalent users of the second-generation antipsychotics associated with weight gain was observed.


CONCLUSIONS
Obesity and the metabolic syndrome were common in patients with bipolar disorder. These patients may be under-evaluated for cardiovascular risk and warrant screening and early intervention.
Fiedorowicz
Jess G
JG
Department of Psychiatry, Roy J and Lucille A Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA. jess-fiedorowicz@uiowa.edu
Palagummi
Narasimha M
NM
Forman-Hoffman
Valerie L
VL
Miller
Del D
DD
Haynes
William G
WG
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D018692:Antimanic Agents / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002784:Cholesterol / Q000097:blood; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D018020:Lithium Compounds / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D000927:Anticonvulsants; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D018020:Lithium Compounds; D014280:Triglycerides; D002784:Cholesterol