Metabolic syndrome in bipolar disorder: findings from the Bipolar Disorder Center for Pennsylvanians

Authors

  • Andrea Fagiolini,

    1. Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh and Dubois Regional Medical Center, Dubois, PA, USA
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  • Ellen Frank,

    1. Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh and Dubois Regional Medical Center, Dubois, PA, USA
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  • John A Scott,

    1. Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh and Dubois Regional Medical Center, Dubois, PA, USA
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  • Scott Turkin,

    1. Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh and Dubois Regional Medical Center, Dubois, PA, USA
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  • David J Kupfer

    1. Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh and Dubois Regional Medical Center, Dubois, PA, USA
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  • AF is a consultant to Bristol-Myers Squibb; consultant/scientific advisory board for Pfizer, Inc., and serves on the speakers bureau of Bristol-Myers Squibb, Eli Lilly-Italy, Pfizer, Inc., Shire. EF is a consultant to Pfizer Italia, Servier Amerique, and serves on the advisory boards of Pfizer, Inc., Eli Lilly & Co. DJK is a consultant to Servier Amerique and serves on the advisory boards of Pfizer, Inc., Eli Lilly & Co., Forest Pharmaceuticals, Inc., and F. Hoffmann-La Roche, Ltd. Scott Turkin serves on the speakers bureau of Forest Pharmaceuticals, INC., Wyeth Pharmaceuticals, Janssen Glaxon Smithkline and Sonofi. JAS has no reported conflict of interest.

Andrea Fagiolini, MD, Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. Fax: 412 246 5520; e-mail: fagiolinia@upmc.edu

Abstract

Objective:  This study sought to evaluate the presence of the metabolic syndrome in a group of 171 patients with bipolar disorder who were consecutively recruited in the Bipolar Disorder Center for Pennsylvanians.

Methods:  Data were collected from participants entering the Bipolar Disorder Center for Pennsylvanians protocol between 2003 and 2004. The study focused on the presence of the metabolic syndrome, as defined by the National Cholesterol Education Program Expert Panel on Detection, Evaluation And Treatment of High Blood Cholesterol in Adults (NCEP ATP III).

Results:  Thirty percent of the sample met the NCEP ATP III criterion for the metabolic syndrome, 49% met the criterion for abdominal obesity, 41% met the criterion for hypertriglyceridemia, 48% met the criterion for hypertriglyceridemia or were on a cholesterol-lowering medication, 23% met the criterion for low high-density lipoprotein cholesterol, 39% met the criterion for hypertension and 8% met the criterion for high fasting glucose or antidiabetic medication use. Patients with the metabolic syndrome and patients endorsing the obesity criterion were more likely (p = 0.05 and p = 0.004, respectively) to report a lifetime history of suicide attempt/s.

Conclusions:  The prevalence of the metabolic syndrome in patients with bipolar disorder is alarmingly high, as it is for the general population. The prevalence of obesity is even higher than the already very high prevalence that has been estimated for the US general population. Our findings are a reason for concern, considering the difficulty in implementing prevention and treatment programs in the bipolar population. We strongly support the development and testing of interventions specifically designed for preventing and treating the metabolic syndrome and its components in patients with bipolar disorder.

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