Comorbidity Of Bipolar Disorder With Metabolic Diseases And Related Factors

Objective:This study attempted to explore the comorbidity of bipolar disorder(BPD)and metabolic diseases and related factors,including metabolic syndrome(MetS)and purine metabolism.By analyzing factors such as disease course,disease subgroups,and drug use,we can understand factors that may affect metabolism and provide supporting evidence for clinical intervention.Methods:In this study,182 outpatients with BPD and 182 healthy controls participated.The demographic and clinical information were collected.The body weight,height,waist circumference(WC),hip circumference(HC)and blood pressure(BP)were measured.The serum uric acid(SUA),triglyceride(TG),high density lipoprotein(HDL-C),fasting blood glucose(FBG)were also detected by means of biochemical experiment.Demographic data and laboratory results were analyzed using an independent samples t-test or chi-squared-test.The variables with P-values of<0.05 in the univariate analysis were included in the unconditional logistic regression model for further analysis.Results:BPD patients had a significantly higher prevalence of hyperuricemia(HUA)and metabolic syndrome(MetS)than healthy controls(40.7%vs.30.2%,P=0.037;21.4%vs.9.4%,P=0.001).Results of univariate analysis showed that the systolic blood pressure(119.02±13.92mmHg vs.115.29±12.54mmHg),pulse pressure difference(45.53mmHg±9.90mmHg vs.38.28±11.41mmHg),fasting blood glucose(5.36 ±1.39mmol/Lvs.5.10±0.64mmo1/L),serum uric acid level(377.87±102.15 μmol/L vs.356.04±100.22μmol/L),and body mass index(24.83±4.15kg/m2 vs.22.74 ±2.74kg/m2)were higher in the BPD group compared with those in the control group(P<0.05),while diastolic blood pressure(73.49±10.86mmHg vs.77.01±8.41mmHg)and high-density lipoprotein(1.40±0.37mmol/L vs.1.68±0.51mmol/L)were lower in BPD patients.(P<0.05).There were significant differences in terms of age(38.87±12.80y vs.28.93±9.62y),disease duration(104.62±76.30m vs.56.47 ±42.95m),body mass index(28.60±3.81kg/m2 vs.23.80±3.61kg/m2),hip circumference(28.60±3.81cm vs.23.80±3.61cm),waist circumference(95.22±11.79cm vs.81.84 ±9.38cm),systolic blood pressure(129.64±15.04mmHvs.116.12±12.12mmHg),diastolic blood pressure(80.49±10.80mmHvs.71.58±10.10mmHg),triglyceride(2.11±0.86mmol/L vs.1.25±0.87mmol/L),high density lipoprotein(1.18 ±0.24mmol/Lvs.1.46±0.37mmol/L),fasting blood glucose(6.07±2.07mmol/L vs.5.16±1.07mmol/L),serum uric acid level(412.38±112.96μmol/Lvs.368.45 ±100.63(μmol/L)between MetS group and non-MetS group(P<0.05)in BPD patients.The prevalence of HUA was higher in BPD patients who used antipsychotics combined with mood stabilizers than that in BPD subjects receiving the mood stabilizers alone(P<0.001).The prevalence of HUA and increased serum UA levels were higher in the manic group(62.1%,425.4±102.8μmol/L)than in the depressive(34.3%,361.9±110.9μmol/L)or euthymia group(17.0%,335.3 ± 70.2μmol/L)(P<0.001).Additionally,the severity of mania was positively correlated with the SUA level(r=0.410,P<0.001).There were significant differences in terms of body mass index(26.67±4.16kg/m2vs.23.57±3.66kg/m2),hip circumference(99.97±6.60cm vs.94.66±6.29cm),waist circumference(89.68±11.48cmvs.81.29±9.93cm),triglyceride(1.76±1.17mmol/Lvs.1.22±0.65mmol/L),high density lipoprotein level(1.32±0.31mmol/Lvs.1.45±0.39mmol/L)between HUA group and non-HUA group(p<0.05)in BPD patients.The unconditional Logistic regression analysis showed that high BMI(OR=1.210;95%CI,1.100-1.331)and high TG(OR=1.652;95%CI,1.058-2.580)were the major risk factors for HUA in BPD patients.Conclusion:Our study suggests that BPD patients are susceptible to metabolic diseases such as HUA and MetS.It is essential to evaluate regularly weight,SUA levels,blood pressure,blood glucose,blood lipids and other metabolic indicators in BPD patients.The age and the course of disease are associated with higher the incidence of MetS.Controlling TG levels and BMI may prevent HUA in patients with bipolar disorder.