스타틴 사용과 양극성 장애 발병의 연관성
Association of Statin Use With Risk of Bipolar Disorder: A Nationwide Cohort Study
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Objectives The association between statin use and depression is well studied, but the studies on the association of statin use and bipolar disorders are limited. Thus, we aimed to investigate the effects of taking statin on risk of bipolar disorder using national claims data of South Korea. Methods A total of 5713871 subjects who did not take statin and were not diagnosed with bipolar disorder before the health examination were included. Among eligible subjects, 315537 subjects started taking statin within 1 year after taking the health examination and 5398334 subjects did not. After 9 years of follow-up, the incidence of bipolar disorder was determined for each group. Results Compared to subjects who were not exposed to statin, subjects who were exposed to statin showed a greater incidence of bipolar disorder and an increased risk of bipolar disorder (hazard ratio [HR]: 1.66; 95% confidence interval [CI]: 1.58 to 1.75), and after adjusting for age, sex, low income, regular exercise, smoking, drinking, diabetes mellitus, hypertension, body mass index, cholesterol and depression (adjusted HR: 1.32; 95% CI: 1.24 to 1.40). Conclusions This result showed an increased risk of bipolar disorder after taking statin, but the underlying biological mechanism needs further investigations. This study has clinical implications for patients taking statins, which require early assessment and response in addition to drug treatment and lifestyle modification, considering the possibility that unhealthy lifestyle habits may appear as part of the mood symptoms of bipolar disorder.
Abstract
Objectives The association between statin use and depression is well studied, but the studies on the association of statin use and bipolar disorders are limited. Thus, we aimed to investigate the effects of taking statin on risk of bipolar disorder using national claims data of South Korea. Methods A total of 5713871 subjects who did not take statin and were not diagnosed with bipolar disorder before the health examination were included. Among eligible subjects, 315537 subjects started taking statin within 1 year after taking the health examination and 5398334 subjects did not. After 9 years of follow-up, the incidence of bipolar disorder was determined for each group. Results Compared to subjects who were not exposed to statin, subjects who were exposed to statin showed a greater incidence of bipolar disorder and an increased risk of bipolar disorder (hazard ratio [HR]: 1.66; 95% confidence interval [CI]: 1.58 to 1.75), and after adjusting for age, sex, low income, regular exercise, smoking, drinking, diabetes mellitus, hypertension, body mass index, cholesterol and depression (adjusted HR: 1.32; 95% CI: 1.24 to 1.40). Conclusions This result showed an increased risk of bipolar disorder after taking statin, but the underlying biological mechanism needs further investigations. This study has clinical implications for patients taking statins, which require early assessment and response in addition to drug treatment and lifestyle modification, considering the possibility that unhealthy lifestyle habits may appear as part of the mood symptoms of bipolar disorder.
참고문헌 (25)
- McElroy SL, "Metabolic syndrome in bipolar disorder : a review with a focus on bipolar depression", J Clin Psychiatry, 75, pp.46~61 (2014)
- Fagiolini A, "Metabolic syndrome in bipolar disorder : findings from the Bipolar Disorder Center for Pennsylvanians", Bipolar Disord, 7, pp.424~430 (2005)
- Adhyaru BB, "Safety and efficacy of statin therapy", Nat Rev Cardiol, 15, pp.757~769 (2018)
- Yang Q, "Association of statin use with risk of depression and anxiety : a prospective large cohort study", Gen Hosp Psychiatry, 90, pp.108~115 (2024)
- Walker AJ, "Statins : neurobiological underpinnings and mechanisms in mood disorders", Neurosci Biobehav Rev, 128, pp.693~708 (2021)
- Shin DW, "Korean national health insurance database", JAMA Intern Med, 176, pp.138~ (2016)
- Lee J, "Cohort profile : the national health insurance service-national sample cohort(NHIS-NSC), South Korea", Int J Epidemiol, 46, pp.e15~ (2017)
- World Health Organizatio, "ICD-10: International Statistical Classification of Diseases and Health Related Problems" (2004), World Health Organization
- Cho IY, "Frequent drinking is more predictive of ischemic stroke than binge drinking, but not of myocardial infarction", Atherosclerosis, 350, pp.65~72 (2022)
- Kim YG, "Frequent drinking is a more important risk factor for new-onset atrial fibrillation than binge drinking : a nationwide population-based study", Europace, 22, pp.216~224 (2020)
- Moreira FP, "Metabolic syndrome and psychiatric disorders : a population-based study", Braz J Psychiatry, 41, pp.38~43 (2019)
- Schuster MP, "Increased prevalence of metabolic syndrome in patients with bipolar disorder compared to a selected control group-a Northern Netherlands LifeLines population cohort study", J Affect Disord, 295, pp.1161~1168 (2021)
- Muldoon MF, "Cholesterol reduction and non-illness mortality : meta-analysis of randomised clinical trials", BMJ, 322, pp.11~15 (2001)
- Kim SW, "Statins and inflammation : new therapeutic opportunities in psychiatry", Front Psychiatry, 10, pp.103~ (2019)
- Köhler-Forsberg O, "Statins in the treatment of depression : hype or hope?", Pharmacol Ther, 215, pp.107625~ (2020)
- Parsaik AK, "Statins use and risk of depression : a systematic review and meta-analysis", J Affect Disord, 160, pp.62~67 (2014)
- Yatham MS, "Do statins have an effect on depressive symptoms? A systematic review and metaanalysis", J Affect Disord, 257, pp.55~63 (2019)
- Ghanizadeh A, "Augmentation of fluoxetine with lovastatin for treating major depressive disorder, a randomized doubleblind placebo controlled-clinical trial", Depress Anxiety, 30, pp.1084~1088 (2013)
- Fotso Soh J, "The effect of atorvastatin on cognition and mood in bipolar disorder and unipolar depression patients : a secondary analysis of a randomized controlled trial", J Affect Disord, 262, pp.149~154 (2020)
- Avan R, "Update on statin treatment in patients with neuropsychiatric disorders", Life(Basel), 11, pp.1365~ (2021)
- Lilly SM, "Comparison of the risk of psychological and cognitive disorders between persistent and nonpersistent statin users", Am J Cardiol, 114, pp.1035~1039 (2014)
- Ghanizadeh A, "Lovastatin as an adjuvant to lithium for treating manic phase of bipolar disorder : a 4-week, randomized, doubleblind, placebo-controlled clinical trial", Depress Res Treat, 2014, pp.730505~ (2014)
- Tatley M, "Psychiatric adverse reactions with statins, fibrates and ezetimibe : implications for the use of lipid-lowering agents", Drug Saf, 30, pp.195~201 (2007)
- Park YM, "The association between serum lipid levels, suicide ideation, and central serotonergic activity in patients with major depressive disorder", J Affect Disord, 159, pp.62~65 (2014)
- Grundy SM, "2018 AHA", ACC, AAPA, pp.ABC, ACPM[DOI]