title: Weight cycling in bipolar disorder.
abstract: BACKGROUND
  An association between excess weight and/or weight fluctuations and cardiovascular morbidity and mortality is amply documented. Individuals with bipolar disorder (BD) are differentially affected by overweight/obesity, chaotic eating patterns (e.g., binge eating), as well as cardiovascular morbidity and mortality. Weight cycling (WCYC) is defined as a pattern of repetitive weight loss and gain.
  
  
  METHODS
  We sought to determine the relationship between course of illness and BD and WCYC retrospectively as well whether these co-occurring phenotypes identify a biologically distinct subpopulation on the basis of having a unique inflammatory biomarker/biosignature profile. Sociodemographic, clinical, and inflammatory markers were gathered from a well-characterized cohort of actual euthymic adults with BD (n=101) and a healthy control group (n=48).
  
  
  RESULTS
  Individuals with BD with a history of WCYC were provided evidence of a greater frequency of prior episodes (i.e., both manic and depressed), as well as of significantly higher levels of circulating IL-6 concentrations when compared to non-WCYC individuals with BD. The association persisted after adjusting for relevant covariates (e.g., BMI, age, number of prior episodes).
  
  
  CONCLUSIONS
  Include the small control group, differing medication status and that all data relies on personal information. Nevertheless we tried to verify all data as far as clinical disclosure was available.
  
  
  CONCLUSIONS
  The results of this study indicate that adults with BD excessive in weight are not only more susceptible to a relapse-prone course of illness, but also are more likely to present with WCYC. The finding of elevated pro-inflammatory cytokines in this subpopulation may identify a separate subpopulation with greater susceptibility to cardiovascular disease. The overarching aim of personalized treatment and preventive strategies in BD begins with appropriate, empirically supported patient stratification. Our results provide preliminary support for stratifying BD cardiovascular risk on the basis of anthropometrics and WCYC.
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Eva Z
authors.initials: EZ
authors.lastname: Reininghaus
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Nina
authors.initials: N
authors.lastname: Lackner
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Frederike T
authors.initials: FT
authors.lastname: Fellendorf
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Susanne
authors.initials: S
authors.lastname: Bengesser
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Armin
authors.initials: A
authors.lastname: Birner
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Bernd
authors.initials: B
authors.lastname: Reininghaus
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Renate
authors.initials: R
authors.lastname: Unterweger
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Martina
authors.initials: M
authors.lastname: Platzer
authors.affiliation: Institute of Pathophysiology and Immunology, Medical University of Graz, Austria.
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Wallner-Liebmann
authors.affiliation: Research Unit on Lifestyle and Inflammation-associated Risk Biomarkers, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8043 Graz, Austria.
authors.forename: Sieglinde
authors.initials: S
authors.lastname: Zelzer
authors.affiliation: Research Unit on Lifestyle and Inflammation-associated Risk Biomarkers, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8043 Graz, Austria; BioTechMed-Graz, Austria. Electronic address: harald.mangge@medunigraz.at.
authors.forename: Harald
authors.initials: H
authors.lastname: Mangge
authors.affiliation: Division of Biological Chemistry, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Fuchs
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Kapfhammer
authors.affiliation: Mood Disorders Psychopharmacology Unit at the University Health Network, Toronto, Canada; Department of Psychiatry and Pharmacology at the University of Toronto, Toronto, Canada.
authors.forename: Roger S
authors.initials: RS
authors.lastname: McIntyre
mesh_terms: D000328:Adult; D001317:Austria; D056912:Binge-Eating Disorder / Q000097:blood / Q000150:complications* / Q000523:psychology; D001714:Bipolar Disorder / Q000097:blood / Q000150:complications* / Q000523:psychology*; D002097:C-Reactive Protein; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000523:psychology; D050177:Overweight / Q000097:blood / Q000150:complications* / Q000523:psychology; D012189:Retrospective Studies; D015430:Weight Gain / Q000502:physiology; D015431:Weight Loss / Q000502:physiology
chemical_list: D015850:Interleukin-6; D002097:C-Reactive Protein
keywords: Bipolar disorder; Cardiovascular disease; Inflammation; Obesity; Overweight; Weight cycling