Higher Prevalence of Metabolic Syndrome in Child-adolescent Patients with Bipolar Disorder
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective: Previous studies have indicated a convergent and bidirectional relationship between metabolic syndrome (MetS) and bipolar disorder (BD). As most of these studies focused mainly on adults diagnosed with BD, our study aims to investigate and characterize metabolic disturbances in child-adolescents diagnosed with BD. Methods: We retrospectively examined the medical records of psychiatric hospitalizations with admitting diagnosis of BD in child-adolescents (age < 18 years). Body mass index (BMI), lipid profile, fasting blood glucose, and blood pressure were primary variables. National Cholesterol Education Program criteria were used to define MetS. Reference group data was obtained from the National Health and Nutrition Examination Survey study. Statistical analyses included t tests, chi-square tests, and Fisher’s exact tests. Results: We identified 140 child-adolescent patients with BD (mean age = 15.12 ± 1.70 years, 53% male). MetS was significantly more common in BD compared to the reference group: 14% (95% confidence interval [95% CI] 8−20) vs. 6.7% (95% CI 4.1−9.2), p = 0.001 with no significant difference by sex. MetS components were higher in the BD group, particularly BMI ≥ 95% (25% vs. 11.8%, p < 0.001) and high blood pressure (17% vs. 8%, p = 0.05). Moreover, female patients had lower odds of high blood pressure (odds ratio = 0.24 [95% CI 0.08−0.69], p = 0.005). Conclusion: Compared with the general child-adolescent population, the prevalence of MetS was significantly higher in patients with BD of same age. This reiterates the notion of an increased risk of MetS in patients diagnosed with BD; and thus, further exploration is warranted.
Abstract
Objective: Previous studies have indicated a convergent and bidirectional relationship between metabolic syndrome (MetS) and bipolar disorder (BD). As most of these studies focused mainly on adults diagnosed with BD, our study aims to investigate and characterize metabolic disturbances in child-adolescents diagnosed with BD. Methods: We retrospectively examined the medical records of psychiatric hospitalizations with admitting diagnosis of BD in child-adolescents (age < 18 years). Body mass index (BMI), lipid profile, fasting blood glucose, and blood pressure were primary variables. National Cholesterol Education Program criteria were used to define MetS. Reference group data was obtained from the National Health and Nutrition Examination Survey study. Statistical analyses included t tests, chi-square tests, and Fisher’s exact tests. Results: We identified 140 child-adolescent patients with BD (mean age = 15.12 ± 1.70 years, 53% male). MetS was significantly more common in BD compared to the reference group: 14% (95% confidence interval [95% CI] 8−20) vs. 6.7% (95% CI 4.1−9.2), p = 0.001 with no significant difference by sex. MetS components were higher in the BD group, particularly BMI ≥ 95% (25% vs. 11.8%, p < 0.001) and high blood pressure (17% vs. 8%, p = 0.05). Moreover, female patients had lower odds of high blood pressure (odds ratio = 0.24 [95% CI 0.08−0.69], p = 0.005). Conclusion: Compared with the general child-adolescent population, the prevalence of MetS was significantly higher in patients with BD of same age. This reiterates the notion of an increased risk of MetS in patients diagnosed with BD; and thus, further exploration is warranted.
참고문헌 (83)
- Walther A, "Bipolar spectrum disorders in male youth : the interplay between symptom severity, inflammation, steroid secretion, and body composition", Front Psychiatry, 8, pp.207~ (2017)
- Van Meter AR, "Meta-analysis of epidemiologic studies of pediatric bipolar disorder", J Clin Psychiatry, 72, pp.1250~1256 (2011)
- Merikangas KR, "Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A)", J Am Acad Child Adolesc Psychiatry, 49, pp.980~989 (2010)
- Faedda GL, "Pediatric bipolar disorder : phenomenology and course of illness", Bipolar Disord, 6, pp.305~313 (2004)
- El-Badri SM, "Electrophysiological and cognitive function in young euthymic patients with bipolar affective disorder", Bipolar Disord, 3, pp.79~87 (2001)
- Pavuluri MN, "Neurocognitive function in unmedicated manic and medicated euthymic pediatric bipolar patients", Am J Psychiatry, 163, pp.286~293 (2006)
- Perlis RH, "Long-term implications of early onset in bipolar disorder : data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder(STEP-BD)", Biol Psychiatry, 55, pp.875~881 (2004)
- Cook S, "Prevalence of a metabolic syndrome phenotype in adolescents : findings from the third National Health and Nutrition Examination Survey, 1988-1994", Arch Pediatr Adolesc Med, 157, pp.821~827 (2003)
- Grover S, "Metabolic syndrome in bipolar disorders", Indian J Psychol Med, 34, pp.110~118 (2012)
- McIntyre RS, "Bipolar disorder and metabolic syndrome : an international perspective", J Affect Disord, 126, pp.366~387 (2010)
- Vancampfort D, "Metabolic syndrome and metabolic abnormalities in bipolar disorder : a meta-analysis of prevalence rates and moderators", Am J Psychiatry, 170, pp.265~274 (2013)
- Goldstein BI, "Correlates of overweight and obesity among adolescents with bipolar disorder in the National Comorbidity Survey-Adolescent Supplement(NCS-A)", J Am Acad Child Adolesc Psychiatry, 55, pp.1020~1026 (2016)
- Taylor V, "Associations between bipolar disorder and metabolic syndrome : a review", J Clin Psychiatry, 67, pp.1034~1041 (2006)
- Fagiolini A, "Bipolar disorder and the metabolic syndrome : causal factors, psychiatric outcomes and economic burden", CNS Drugs, 22, pp.655~669 (2008)
- Maciukiewicz M, "Analysis of genetic association and epistasis interactions between circadian clock genes and symptom dimensions of bipolar affective disorder", Chronobiol Int, 31, pp.770~778 (2014)
- Ellingrod VL, "Risk factors associated with metabolic syndrome in bipolar and schizophrenia subjects treated with antipsychotics : the role of folate pharmacogenetics", J Clin Psychopharmacol, 32, pp.261~265 (2012)
- Mansur RB, "Is there a"metabolicmood syndrome"? A review of the relationship between obesity and mood disorders", Neurosci Biobehav Rev, 52, pp.89~104 (2015)
- Avila C, "An overview of links between obesity and mental health", Curr Obes Rep, 4, pp.303~310 (2015)
- Jerrell JM, "A cohort study of the prevalence and impact of comorbid medical conditions in pediatric bipolar disorder", J Clin Psychiatry, 71, pp.1518~1525 (2010)
- Rankin SM, "Eotaxin and eosinophil recruitment : implications for human disease", Mol Med Today, 6, pp.20~27 (2000)
- Moreira MA, "Effect of the treatment with methylprednisolone on the cerebrospinal fluid and serum levels of CCL2 and CXCL10chemokines in patients with active multiple sclerosis", Acta Neurol Scand, 114, pp.109~113 (2006)
- Teruya-Feldstein J, "Differential chemokine expression in tissues involved by Hodgkin’s disease : direct correlation of eotaxin expression and tissue eosinophilia", Blood, 93, pp.2463~2470 (1999)
- National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), "Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report", Circulation, 106, pp.3143~3421 (2002)
- Cheal KL, "Relationship to insulin resistance of the adult treatment panel III diagnostic criteria for identification of the metabolic syndrome", Diabetes, 53, pp.1195~1200 (2004)
- de Ferranti SD, "Prevalence of the metabolic syndrome in American adolescents : findings from the Third National Health and Nutrition Examination Survey", Circulation, 110, pp.2494~2497 (2004)
- Drexhage RC, "The mononuclear phagocyte system and its cytokine inflammatory networks in schizophrenia and bipolar disorder", Expert Rev Neurother, 10, pp.59~76 (2010)
- National Health and Nutrition Examination Survey (NHANES), 1999-2000, "United States Department of Health and Human Services", Inter-university Consortium for Political and Social Research (ICPSR), ~, pp.ICPSR 25501 (2012)
- IBM Corporation, "IBM SPSS statistics base 20. Armonk, NY" (2011), IBM Co
- Fagiolini A, "Metabolic syndrome in bipolar disorder : findings from the Bipolar Disorder Center for Pennsylvanians", Bipolar Disord, 7, pp.424~430 (2005)
- Vancampfort D, "Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder : a systematic review and meta-analysis", World Psychiatry, 14, pp.339~347 (2015)
- Goldstein BI, "Preliminary findings regarding overweight and obesity in pediatric bipolar disorder", J Clin Psychiatry, 69, pp.1953~1959 (2008)
- Naiberg MR, "Elevated triglycerides are associated with decreased executive function among adolescents with bipolar disorder", Acta Psychiatr Scand, 134, pp.241~248 (2016)
- Sundvall J, "Systematic error of serum triglyceride measurements during three decades and the effect of fasting on serum triglycerides in population studies", Clin Chim Acta, 397, pp.55~59 (2008)
- Lee WY, "Effects of smoking, alcohol, exercise, education, and family history on the metabolic syndrome as defined by the ATP III", Diabetes Res Clin Pract, 67, pp.70~77 (2005)
- Liese AD, "Familial components of the multiple metabolic syndrome : the ARIC study", Diabetologia, 40, pp.963~970 (1997)
- Barzin M, "Gender differences time trends for metabolic syndrome and its components among Tehranian children and adolescents", Cholesterol, 2012, pp.804643~ (2012)
- Goldstein BI, "Preliminary findings regarding proinflammatory markers and brain-derived neurotrophic factor among adolescents with bipolar spectrum disorders", J Child Adolesc Psychopharmacol, 21, pp.479~484 (2011)
- Goldstein BI, "Inflammatory markers among adolescents and young adults with bipolar spectrum disorders", J Clin Psychiatry, 76, pp.1556~1563 (2015)
- McElroy SL, "Prevalence and correlates of eating disorders in 875 patients with bipolar disorder", J Affect Disord, 128, pp.191~198 (2011)
- Wildes JE, "Prevalence and correlates of eating disorder co-morbidity in patients with bipolar disorder", Psychiatry Res, 161, pp.51~58 (2008)
- Martin K, "Binge eating and emotional eating behaviors among adolescents and young adults with bipolar disorder", J Affect Disord, 195, pp.88~95 (2016)
- Keck PE, "Bipolar disorder, obesity, and pharmacotherapy-associated weight gain", J Clin Psychiatry, 64, pp.1426~1435 (2003)
- Gonzalo JA, "Eosinophil recruitment to the lung in a murine model of allergic inflammation. The role of T cells, chemokines, and adhesion receptors", J Clin Invest, 98, pp.2332~2345 (1996)
- Vasudevan AR, "Eotaxin and obesity", J Clin Endocrinol Metab, 91, pp.256~261 (2006)
- Mattoli S, "Eotaxin expression and eosinophilic inflammation in asthma", Biochem Biophys Res Commun, 236, pp.299~301 (1997)
- Kitaura M, "Molecular cloning of human eotaxin, an eosinophil-selective CC chemokine, and identification of a specific eosinophil eotaxin receptor, CC chemokine receptor 3", J Biol Chem, 271, pp.7725~7730 (1996)
- Patel NC, "Open-label lithium for the treatment of adolescents with bipolar depression", J Am Acad Child Adolesc Psychiatry, 45, pp.289~297 (2006)
- Blanchard C, "Eotaxin-3 and a uniquely conserved gene-expression profile in eosinophilic esophagitis", J Clin Invest, 116, pp.536~547 (2006)
- McElroy SL, "Obesity in bipolar disorder : an overview", Curr Psychiatry Rep, 14, pp.650~658 (2012)
- Correll CU, "Weight gain and metabolic effects of mood stabilizers and antipsychotics in pediatric bipolar disorder : a systematic review and pooled analysis of short-term trials", J Am Acad Child Adolesc Psychiatry, 46, pp.687~700 (2007)
- Almandil NB, "Weight gain and other metabolic adverse effects associated with atypical antipsychotic treatment of children and adolescents : a systematic review and meta-analysis", Paediatr Drugs, 15, pp.139~150 (2013)
- Fraguas D, "Efficacy and safety of second-generation antipsychotics in children and adolescents with psychotic and bipolar spectrum disorders : comprehensive review of prospective head-to-head and placebo-controlled comparisons", Eur Neuropsychopharmacol, 21, pp.621~645 (2011)
- De Hert M, "Metabolic and endocrine adverse effects of second-generation antipsychotics in children and adolescents : a systematic review of randomized, placebo controlled trials and guidelines for clinical practice", Eur Psychiatry, 26, pp.144~158 (2011)
- Vitiello B, "Antipsychotics in children and adolescents : increasing use, evidence for efficacy and safety concerns", Eur Neuropsychopharmacol, 19, pp.629~635 (2009)
- Leonardi A, "Tear and mucus eotaxin-1 and eotaxin-2 in allergic keratoconjunctivitis", Ophthalmology, 110, pp.487~492 (2003)
- Ben Amor L, "Antipsychotics in pediatric and adolescent patients:a review of comparative safety data", J Affect Disord, 138(Suppl), pp.S22~S30 (2012)
- Gálvez JF, "Premorbid obesity and metabolic disturbances as promising clinical targets for the prevention and early screening of bipolar disorder", Med Hypotheses, 84, pp.285~293 (2015)
- Kovacs M, "Bipolar disorder and comorbid conduct disorder in childhood and adolescence", J Am Acad Child Adolesc Psychiatry, 34, pp.715~723 (1995)
- Geller B, "Child and adolescent bipolar disorder : a review of the past 10 years", J Am Acad Child Adolesc Psychiatry, 36, pp.1168~1176 (1997)
- Chen MH, "Higher risk of developing mood disorders among adolescents with comorbidity of attention deficit hyperactivity disorder and disruptive behavior disorder : a nationwide prospective study", J Psychiatr Res, 47, pp.1019~1023 (2013)
- Duffy A, "Adolescent substance use disorder during the early stages of bipolar disorder : a prospective high-risk study", J Affect Disord, 142, pp.57~64 (2012)
- Bitter SM, "Neurofunctional changes in adolescent cannabis users with and without bipolar disorder", Addiction, 109, pp.1901~1909 (2014)
- Deng H, "Hospital stay in synthetic cannabinoid users with bipolar disorder, schizophrenia, or other psychotic disorders compared with cannabis users", J Stud Alcohol Drugs, 80, pp.230~235 (2019)
- Bonar EE, "Synthetic cannabinoid use among patients in residential substance use disorder treatment : prevalence, motives, and correlates", Drug Alcohol Depend, 143, pp.268~271 (2014)
- Mehta JJ, "Myocardial ischemia with cannabinoid use in an adolescent", Cureus, 9, pp.e1899~ (2017)
- Castellanos D, "Synthetic cannabinoids 2015 : an update for pediatricians in clinical practice", World J Clin Pediatr, 5, pp.16~24 (2016)
- Ransohoff RM, "The chemokine system in neuroinflammation : an update", J Infect Dis, 186(Suppl 2), pp.S152~S156 (2002)
- Teixeira AL Jr, "Increased serum concentrations of monokine induced by interferongamma", CXCL9 and interferon-gamma-inducible protein 10, J Neuroimmunol, pp.2004, 150[DOI]
- Teixeira AL, "Increased serum levels of CCL11", eotaxin in schizophrenia, 2008, pp.32, 710~714
- Biber K, "Chemokines in the brain : neuroimmunology and beyond", Curr Opin Pharmacol, 2, pp.63~68 (2002)
- Müller N, "The role of inflammation in schizophrenia", Front Neurosci, 9, pp.372~ (2015)
- Kirkpatrick B, "Inflammation and schizophrenia", Schizophr Bull, 39, pp.1174~1179 (2013)
- Alberti KG, "Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation", Diabet Med, 15, pp.539~553 (1998)
- Balkau B, "Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR)", Diabet Med, 16, pp.442~443 (1999)
- Zimmet P, "The metabolic syndrome : a global public health problem and a new definition", J Atheroscler Thromb, 12, pp.295~300 (2005)
- Jessup A, "The metabolic syndrome: look for it in children and adolescents, too!", Clin Diabetes, 23, pp.26~32 (2005)
- Asayama K, "Relationships between biochemical abnormalities and anthropometric indices of overweight, adiposity and body fat distribution in Japanese elementary school children", Int J Obes Relat Metab Disord, 19, pp.253~259 (1995)
- Valle M, "Relationship between high plasma leptin concentrations and metabolic syndrome in obese pre-pubertal children", Int J Obes Relat Metab Disord, 27, pp.13~18 (2003)
- Boyraz M, "Relationship of adipokines(adiponectin, resistin and RBP4)with metabolic syndrome components in pubertal obese children", Biomark Med, 7, pp.423~428 (2013)
- Pradhan AD, "Sex differences in the metabolic syndrome : implications for cardiovascular health in women", Clin Chem, 60, pp.44~52 (2014)
- Regitz-Zagrosek V, "Gender differences in the metabolic syndrome and their role for cardiovascular disease", Clin Res Cardiol, 95, pp.136~147 (2006)
- Syme C, "Intra-abdominal adiposity and individual components of the metabolic syndrome in adolescence : sex differences and underlying mechanisms", Arch Pediatr Adolesc Med, 162, pp.453~461 (2008)
- Gurka MJ, "A confirmatory factor analysis of the metabolic syndrome in adolescents : an examination of sex and racial", ethnic differences, 2012, pp.11, 128~
