Metabolic syndrome in patients with bipolar disorder: comparison with major depressive disorder and non-psychiatric controls.
OBJECTIVE
We aimed to investigate the prevalence of the metabolic syndrome (MetS) and its individual components in subjects with bipolar disorder (BD) compared to those with major depressive disorder (MDD) and non-psychiatric controls.


METHODS
We examined 2431 participants (mean age 44.3±13.0, 66.1% female), of whom 241 had BD; 1648 had MDD; and 542 were non-psychiatric controls. The MetS was ascertained according to NCEP ATP III criteria. Multivariable analyses were adjusted for age, sex, ethnicity, level of education, smoking status and severity of depressive symptoms, and in the case of BD subjects, also for psychotropic medication use.


RESULTS
Subjects with BD had a significantly higher prevalence of MetS when compared to subjects with MDD and non-psychiatric controls (28.4% vs. 20.2% and 16.5%, respectively, p<0.001), also when adjusted for sociodemographic and lifestyle factors (OR 1.52, 95% CI: 1.09-2.12, p=0.02 compared to MDD; OR 1.79, 95% CI: 1.20-2.67, p=0.005 compared to non-psychiatric controls). The differences between BD subjects with controls could partly be ascribed to a higher mean waist circumference (91.0 cm vs. 88.8, respectively, p=0.03). In stratified analysis, the differences in the prevalence of MetS between patients with BD and MDD were found in symptomatic but not in asymptomatic cases.


CONCLUSIONS
This study confirms a higher prevalence of MetS in patients with BD compared to both MDD patients and controls. Specifically at risk are patients with a higher depression score and abdominal obesity.
PsyQ, Department of Mood Disorders, Rotterdam, The Netherlands. Electronic address: silarova.barbora@gmail.com.
Barbora
B
Silarova
Leiden University Medical Center, Department of Psychiatry, Leiden, The Netherlands.
Erik J
EJ
Giltay
GGZinGeest, VU University Medical Center, Amsterdam, The Netherlands.
Arianne
A
Van Reedt Dortland
Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands.
Elisabeth F C
EF
Van Rossum
Parnassia Group, The Hague, The Netherlands; Institute of Psychology, Leiden University, The Netherlands.
Erik
E
Hoencamp
Leiden University Medical Center, Department of Psychiatry, Leiden, The Netherlands; Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
Brenda W J H
BW
Penninx
PsyQ, Department of Mood Disorders, Rotterdam, The Netherlands.
Annet T
AT
Spijker
D000328:Adult; D001714:Bipolar Disorder / Q000150:complications* / Q000523:psychology; D003863:Depression / Q000150:complications*; D003865:Major Depressive Disorder / Q000150:complications*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000453:epidemiology / Q000523:psychology; D016017:Odds Ratio; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D055105:Waist Circumference
Abdominal obesity; Bipolar disorder; Major depressive disorder; Metabolic syndrome; Psychotropic drugs