Comparison of insulin resistance, metabolic syndrome and adiponectin in overweight bipolar patients taking sodium valproate and controls.
OBJECTIVE
Metabolic abnormalities in patients with bipolar disorder may be secondary to obesity, aspects of the disorder or its treatment. To investigate this further, the purpose the present study was to compare insulin resistance, components of the metabolic syndrome and adiponectin levels in a group of overweight bipolar patients taking sodium valproate and a group of non-psychiatric control subjects.


METHODS
Data were collected from 60 overweight bipolar patients who had experienced clinically significant weight gain thought to be related to sodium valproate treatment and from 60 control subjects without psychiatric illness matched for age, gender, body mass index and ethnicity.


RESULTS
The frequency of the metabolic syndrome was high in both groups (50% and 32%, respectively), although not significantly different between groups (p = 0.06). Similar frequencies of insulin resistance (HOMA-IR), abdominal obesity, hypertriglyceridaemia, hypertension and fasting hyperglycaemia were found in both groups. High-density lipoprotein cholesterol levels were lower in patients (p = 0.006), while adiponectin was unexpectedly higher than in control subjects (9.6+/-5.9 microg mL(-1) vs 7.4+/-4.3 microg mL(-1), p = 0.03). The frequencies of insulin resistance (HOMA-IR), the metabolic syndrome and its individual components were not significantly different in patients taking atypical antipsychotic medication and patients not on these medications.


CONCLUSIONS
Frequencies of insulin resistance and the metabolic syndrome were similar in bipolar patients taking sodium valproate and matched control subjects, but dyslipidaemia was more frequent. Adiponectin levels were higher in patients. Further research is required to clarify the reasons for these findings.
Elmslie
Jane L
JL
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand. jane.elmslie@otago.ac.nz
Porter
Richard J
RJ
Joyce
Peter R
PR
Hunt
Penelope J
PJ
Shand
Brett I
BI
Scott
Russell S
RS
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000927:Anticonvulsants / 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; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D050177:Overweight / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D012307:Risk Factors; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D049629:Waist-Hip Ratio
D052242:Adiponectin; D000927:Anticonvulsants; D014150:Antipsychotic Agents; D014635:Valproic Acid