Metabolic syndrome twice as prevalent among patients with bipolar disorder than the general population

Results of a review of outpatients with bipolar disorder support previous findings that this patient group carries an excess cardiovascular burden, and prevalence of metabolic syndrome among people with bipolar disorder is twice that seen in the general population. Bipolar disorder is associated with excess cardiovascular mortality, and it has been reported that they also have a higher rate of cardiovascular risk factors compared with the general population. Second-generation antipsychotics have been increasingly associated with significant metabolic complications. In the current study, Fiedorowicz et al. sought to confirm if the previously suggested increased risk of obesity, metabolic syndrome and other cardiovascular risk factors were indeed more prevalent among patients with bipolar disorder than the general population, and investigate if patients treated with second-generation antipsychotic agents were associated with a greater burden of cardiovascular risk factors than those not on these medications. Using the available medical records data from a clinical sample of 161 outpatients with bipolar disorder (mean age 46.3 years, 63% female) the researchers examined cardiovascular risk factors of the metabolic syndrome, and evaluated if certain medications were cross-sectionally associated with metabolic syndrome. Frequencies and percentages of cardiovascular risk factor components of the metabolic syndrome were compared to published National Health And Nutrition Examination Survey (NHANES) data. They found that more than 75% of their subjects were overweight or obese (body mass index [BMI] =25) and almost half were obese (BMI=30). The prevalence of hypertriglyceridaemia, elevated blood pressure or hypertension, and elevated fasting glucose levels or diabetes rates were found to be higher among patients than those of the general population estimates. Of patients with all the requisite data (n=60), more than half met the criteria for metabolic syndrome; approximately double the general population estimates. “The prevalence of obesity, hypertriglyceridaemia, elevated fasting glucose or diabetes, and elevated blood pressure or treatment for hypertension was significantly higher than expected from gender-proportioned, age-appropriate, national general population estimates,” the authors stated. Interestingly, current medication use was not significantly associated with the metabolic syndrome or any specific components of the metabolic syndrome; however, a trend toward higher burden of cardiovascular risk factors was seen among those patients treated with second generation antipsychotic agents. The authors concluded that their study provides evidence for an elevated risk for cardiovascular disease among this group of outpatients with bipolar disorder. “Our results bolster concerns that patients with bipolar disorder bear an excess burden of cardiovascular risk and are suboptimally monitored for this,” they summarised. Reference Fiedorowicz, J. Palagummi, N. et al. 2008, ‘Elevated prevalence of obesity, metabolic syndrome, and cardiovascular risk factors in bipolar disorder’ Annals of Clinical Psychiatry; 20: 131—137....