People who have bipolar disorder are at a high risk for developing the metabolic syndrome and related cardiovascular disorders, say researchers.
"Treating psychiatrists should implement the necessary screening assessments and, where necessary, referral for treatment," recommend Davy Vancampfort (KU Leuven, Kortenberg, Belgium) and colleagues. "Multidisciplinary assessment of medical and behavioral conditions is needed, and psychiatric treatment facilities should offer and promote healthy lifestyle interventions."
The investigators conducted a systemic review and meta-analysis of 37 studies that looked at the prevalence of the metabolic syndrome in those with bipolar disorder (n=6983).
Results published in the American Journal of Psychiatry show that the estimated mean metabolic syndrome prevalence rate was 37.3%. Six of the studies compared patients with bipolar disorder and healthy matched controls, and the risk for the metabolic syndrome was found to be nearly twice as high in the bipolar population (odds ratio [OR]=1.98).
Bipolar disorder patients who were taking antipsychotic medications had a significantly greater risk for developing the metabolic syndrome than those who were not (OR=1.72), possibly because these drugs are associated with weight gain. Those with bipolar I disorder had a lower risk than patients with mixed or unspecified bipolar disorder; however, these results were not adjusted for age.
The rates of individual metabolic abnormalities in the bipolar disorder group were also high. About 49% had abdominal obesity, 47% had high blood pressure, 40% had hypertriglyceridemia, and 11% to 17% had hyperglycemia.
Vancampfort and colleagues emphasize the need to identify the most at-risk patients and to become familiar with factors that are associated with the metabolic syndrome, including older age and being a smoker. They also recommend taking regular weight, blood pressure, and fasting lipid and glucose measurements of patients with bipolar disorder taking antipsychotics.
They add: "Future research should focus on evaluating interventions that target metabolic syndrome risk factors. It should also examine whether cardio-metabolic outcomes are moderated by clinical and treatment characteristics or by genetic factors and study interventions that may avert or delay adverse cardiovascular outcomes."
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