title: Elevated triglycerides are associated with decreased executive function among adolescents with bipolar disorder.
abstract: Cardiovascular risk factors that comprise metabolic syndrome (MetS) have been linked with cognition in adults with bipolar disorder (BD). This study examines the association between MetS components and executive function in adolescents with BD.
  
  
  
  A total of 34 adolescents with BD and 35 healthy control (HC) adolescents were enrolled. MetS components included triglycerides, high-density lipoprotein, glucose, waist circumference, and systolic and diastolic blood pressure. Executive functioning was measured using the intra-extra-dimensional (IED) set-shifting task from the Cambridge Neuropsychological Tests Automated Battery.
  
  
  
  Adolescents with BD were more likely to have ≥1 MetS components (64.7%) as compared to HC participants (22.9%, χ(2) = 12.29, P = <0.001). Adolescents with BD also had poorer IED task performance compared to HC adolescents (composite Z-score: 0.21 ± 0.52 vs. 0.49 ± 0.51, P = 0.011). Within the BD group, IED composite Z-scores were correlated with diastolic blood pressure and triglyceride levels (ρ = -0.358, P = 0.041 and ρ = -0.396, P = 0.020 respectively). The association of triglycerides with executive function remained significant after controlling for age, IQ, and current use of second-generation antipsychotics.
  
  
  
  Elevated triglycerides are associated with poorer executive function among adolescents with BD. Studies of behavioural and pharmacological interventions targeting MetS components for the purpose of improving executive function among adolescents with BD are warranted.
authors.affiliation: Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.|Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.
authors.forename: M R
authors.initials: MR
authors.lastname: Naiberg
authors.affiliation: Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.|Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.
authors.forename: D F
authors.initials: DF
authors.lastname: Newton
authors.affiliation: Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: J E
authors.initials: JE
authors.lastname: Collins
authors.affiliation: Bradley Hospital, Pedi-MIND Program, East Providence, RI, USA.
authors.forename: D P
authors.initials: DP
authors.lastname: Dickstein
authors.affiliation: Department of Psychology, Department of Psychiatry, Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.|Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors.forename: C R
authors.initials: CR
authors.lastname: Bowie
authors.affiliation: Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.|Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.
authors.forename: B I
authors.initials: BI
authors.lastname: Goldstein
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000150:complications / Q000378:metabolism / Q000523:psychology*; D003430:Cross-Sectional Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000378:metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000378:metabolism; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D014280:Triglycerides / Q000378:metabolism*; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D008075:Lipoproteins, HDL; D014280:Triglycerides
keywords: bipolar disorder; cognition; lipid; metabolic syndrome; neurocognition