Impact of metabolic syndrome and clinical features on functioning in patients with bipolar disorder: a cross-sectional study

Objective: The metabolic syndrome (MS) is highly prevalent among patients with bipolar disorder (BD), and may affect progression, functioning, and comorbid conditions in BD. The aim of this study was to investigate the effect of clinical variables and MS on overall functioning and specific areas of functioning in patients with BD. Methods: A total of 210 participants (140 participants with BD I and BD II in remission and 70 non-psychiatric control subjects) were included. The investigators administered the Young Mania Rating Scale (YMRS), the Bipolar Depression Rating Scale (BDRS), the Global Assessment of Functioning Scale (GAF), and the Bipolar Disorder Functioning Scale (BDFS). The participants completed the Beck Depression Scale (BDS) and the Beck Anxiety Scale (BAS). MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Hierarchical regression analysis was used to investigate potential correlations of comorbid MS with clinical variables and level of functioning. Results: Level of functioning did not differ between patients with and without MS. However, there were significant correlations between the level of functioning subscales and the number of depressive episodes (p = 0.033), level of general functioning (p = 0.012), duration of illness (p = 0.012), BDS (p = 0.005), BDRS (p = 0.021), BAS total scores (p = 0.021), number of hypomanic episodes (p = 0.022), number of hospitalizations (p = 0.003), employment status (p = 0.032), and diagnosis of BD I (p = 0.007) and BD II (p = 0.044). Conclusion: Our findings suggest that clinical variables had a greater effect on functioning than MS in BD patients.

Metabolic syndrome in bipolar disorder: prevalence, demographics and clinical correlates in individuals with bipolar I, bipolar II, and healthy controls

Abstract Background: The metabolic syndrome is a growing global public health problem and highly prevalent in patiens with bipolar disorder. There are a few studies about relationship between metabolic syndrome and bipolar disorder subtypes. Objective: The aim of this study was to investigate the prevalence of metabolic syndrome (MS) and its individual components in subjects with bipolar I (BD I) and bipolar II (BD II) disorder compared with non-psychiatric controls, and to determine the variables affecting MS. Methods: A total of 210 individuals (mean age 42.5 ± 11.87, 58.1% female) of whom 70 had BD I, 70 BD II, and 70 controls, were included in this study. MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the adapted ATP III (ATP III-A) and the International Diabetes Federation (IDF) criteria. Results: Participants with BD I had a significantly higher prevalence of MS when compared to individuals BD II and non-psychiatric controls according to the NCEP-ATP III, ATP III-A, and IDF criteria (ps < 0.01). In individuals with MS, increased waist circumference was the most common abnormality. Logistic regression analysis revealed that the presence of physical illness, age and number of cigarettes smoked significantly predicted the presence of MS. Discussion: This study showed that MS was more prevalent among BD I individuals compared to BD II and controls, and highlighted the importance of regular screening for MS in individuals with BD.

Simple markers for subclinical inflammation in the different phases of bipolar affective disorder

Abstract Background: Recently, a growing number of publications have suggested that the immune-inflammatory system may be involved in the etiology of bipolar disorder (BD). Objective: The aim of this study was to investigate neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and red cell distribution width (RDW) in the three different phases of BD patients compared to each other and controls. Methods: One hundred eighty-seven bipolar patients (78 euthymic, 53 manic/hypomanic and 56 depressed), and 62 age and sex matched controls were enrolled. Sociodemographic variables and complete blood count parameters of the patients and the control group were recorded. Results: The groups did not differ from each other on the hematological parameters, except for NLR and RDW. Post-hoc analyses revealed that NLR values were significantly higher in the euthymic and manic/hypomanic bipolar groups compared to control group. In addition, post-hoc analyses revealed that RDW values were significantly higher in the manic/hypomanic bipolar group relative to the control group. Discussion: Longitudinal studies evaluating the levels of inflammatory markers in the early phases of the disorder, and their relationship with the development of different episodes and medical comorbidities may be useful to understand the role of inflammation in BD.