High prevalence of metabolic disturbances in patients with bipolar disorder in Taiwan

Chang, Hui Hua; Chou, Chen Hsi; Chen, Po See; Gean, Po Wu; Huang, Hui Chun; Lin, Chih-Hsien; Yang, Yen Kuang; Lu, Ru Band

doi:10.1016/j.jad.2008.12.018

Cited by 66 publications

(57 citation statements)

References 55 publications

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“…[26][27][28] Previous findings on the prevalence of comorbid general medical conditions in BD have reported alarming high rates of cardiovascular risk factors such as obesity (20-32%), 34 hypertension (34-60%), 10,35 diabetes (2-26%), 9 and dyslipidemia (23-41%). 8 Furthermore, studies investigating the prevalence of the metabolic syndrome in BD patients have reported varying rates as low as 18-25.3% in Belgium 36 and Italy, 37 33.9% in Taiwan, 38 and as high as 40-49% in the United States. 39,40 A recent report on cardiovascular risk factors in BD patients 41 has also pointed out differences between prevalence rates not only among different countries, but also according to the cardiovascular risk estimation method used.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular risk factors in outpatients with bipolar disorder: a report from the Brazilian Research Network in Bipolar Disorder

Gomes

Almeida

Magalhães

et al. 2013

Rev. Bras. Psiquiatr.

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Objective: Bipolar disorder (BD) is associated with significant morbidity and mortality due to comorbid general medical conditions, particularly cardiovascular disease. This study is the first report of the Brazilian Research Network in Bipolar Disorder (BRN-BD) that aims to evaluate the prevalence and clinical correlates of cardiovascular risk factors among Brazilian patients with BD. Methods: A cross-sectional study of 159 patients with DSM-IV BD, 18 years or older, consecutively recruited from the Bipolar Research Program (PROMAN) in Sã o Paulo and the Bipolar Disorder Program (PROTAHBI) in Porto Alegre. Clinical, demographic, anthropometric, and metabolic variables were systematically assessed. Results: High rates of smoking (27%), physical inactivity (64.9%), alcohol use disorders (20.8%), elevated fasting glucose (26.4%), diabetes (13.2%), hypertension (38.4%), hypertriglyceridemia (25.8%), low HDL-cholesterol (27.7%), general (38.4%) and abdominal obesity (59.1%) were found in the sample. Male patients were more likely to have alcohol use disorders, diabetes, and hypertriglyceridemia, whereas female patients showed higher prevalence of abdominal obesity. Variables such as medication use pattern, alcohol use disorder, and physical activity were associated with selected cardiovascular risk factors in the multivariable analysis. Conclusion: This report of the BRN-BD provides new data regarding prevalence rates and associated cardiovascular risk factors in Brazilian outpatients with BD. There is a need for increasing both awareness and recognition about metabolic and cardiovascular diseases in this patient population.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular risk factors in outpatients with bipolar disorder: a report from the Brazilian Research Network in Bipolar Disorder

Gomes

Almeida

Magalhães

et al. 2013

Rev. Bras. Psiquiatr.

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“…Several studies have reported that metabolic syndrome tends to be associated with certain characteristics of bipolar disorder (Chang 2009;McIntyre 2010):…”

Section: Bipolar Disorder and Metabolic Syndromementioning

confidence: 99%

Metabolic syndrome in psychiatry: advances in understanding and management

Ho¹,

Zhang²,

Mak³

et al. 2014

Adv. psychiatr. treat

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SummaryMetabolic syndrome comprises a number of cardiovascular risk factors that increase morbidity and mortality. The increase in incidence of the syndrome among psychiatric patients has been unanimously demonstrated in recent studies and it has become one of the greatest challenges in psychiatric practice. Besides the use of psychotropic drugs, factors such as genetic polymorphisms, inflammation, endocrinopathies and unhealthy lifestyle contribute to the association between metabolic syndrome and a number of psychiatric disorders. In this article, we review the current diagnostic criteria for metabolic syndrome and propose clinically useful guidelines for psychiatrists to identify and monitor patients who may have the syndrome. We also outline the relationship between metabolic syndrome and individual psychiatric disorders, and discuss advances in pharmacological treatment for the syndrome, such as metformin.LEARNING OBJECTIVES•Be familiar with the definition of metabolic syndrome and its parameters of measurement.•Appreciate how individual psychiatric disorders contribute to metabolic syndrome and vice versa.•Develop a framework for the prevention, screening and management of metabolic syndrome in psychiatric patients.

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“…Established causes for secondary dyslipidemia include inappropriate lifestyle, liver disease, renal disease and thyroid disease (7,9). The various drugs that are known to affect lipid metabolism include hormones (glucocorticoids, estrogens and androgens), beta-blockers, and diuretics (3,7,(32)(33)(34)(35)(36)(37)(38)(39)(40). Several psychotropic drugs were reported to cause secondary hyperlipidemia, especially carbamazepine, phenobarbital, tricyclic antidepresants (in particular amitriptyline), secondgeneration antipsychotic medication, mainly olanzapine but also risperidone and ziprasidone.…”

Section: Methylphenidate and Dyslipidemiamentioning

confidence: 99%

“…lithium, valproate, 34-38). According to current concepts, appetite and feeding are regulated by a complex of neurotransmitters, neuromodulators, cytokines and hormones interacting with the hypothalamus, including leptin and tumor necrosis factor system (37)(38)(39). The pharmacologic mechanisms underlying weight gain are presently poorly understood: possibly the various activities at some receptor systems may induce it, but also genetic predisposition plays an important role.…”

Section: Methylphenidate and Dyslipidemiamentioning

confidence: 99%

“…Weight gain has been described since the discovery and the use of the first psychotropic drugs, but seems to intensify especially with some of the second generation antipsychotic medications. Understanding of the side effects of psychotropic drugs, including their metabolic consequences (weight gain, diabetes, dyslipidemia) is essential in order to avoid, firstly, a risk of lack of compliance with the ensuing risk of relapse and re-hospitalization, and secondly, the acute, life threatening events (diabetic ketoacidocetosis and non ketotic hyperosmolar coma) and long term risk complications of diabetes and overweight (31,37,39).…”

Section: Methylphenidate and Dyslipidemiamentioning

confidence: 99%

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