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Obesity and metabolic syndrome in Brazilian patients with bipolar disorder

Published online by Cambridge University Press:  24 June 2014

Karla Mathias de Almeida*
Affiliation:
Bipolar Disorder Research Program (PROMAN), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Márcia B. de Macedo-Soares
Affiliation:
Bipolar Disorder Research Program (PROMAN), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Cilly Kluger Issler
Affiliation:
Bipolar Disorder Research Program (PROMAN), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
José Antonio Amaral
Affiliation:
Bipolar Disorder Research Program (PROMAN), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Sheila C. Caetano
Affiliation:
Bipolar Disorder Research Program (PROMAN), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Rodrigo da Silva Dias
Affiliation:
Bipolar Disorder Research Program (PROMAN), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Beny Lafer
Affiliation:
Bipolar Disorder Research Program (PROMAN), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
*
Karla Mathias de Almeida, Programa de Transtorno Bipolar (PROMAN), Rua Dr Oví dio Pires de Campos, 785, São Paulo, SP, 05403—010, Brazil. Tel/Fax: 55 11 3069-7928; E-mail: [email protected]

Abstract

Objective:

We aimed to determine the prevalence of obesity and metabolic syndrome (O/MetS) in a sample of Brazilian outpatients with bipolar disorder.

Methods:

Eighty-four patients with bipolar disorder were evaluated. We used the definition of MetS established in the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults, modified by the American Heart Association (AHA). Patients were classified as obese if their body mass index (BMI) was ≥ 30 kg/m2.

Results:

We found that 28.6% of our sample met the AHA criteria for MetS and 35.7% were obese. The percentage of patients meeting each criterion of the AHA was as follows: 46% for abdominal obesity; 44% for hypertriglyceridemia or cholesterol-lowering medication use; 26% for low high-density lipoprotein cholesterol or being on a lipid-lowering medication; 45% for hypertension; and 20% for high fasting glucose or anti-diabetic medication use.

Conclusions:

The prevalence of obesity in our sample of outpatients with bipolar disorder was higher than that observed for the general population of Brazil. The rate of MetS was similar to that observed for the general population. Our data indicate the need for prevention, early detection and treatment of O/MetS in patients with bipolar disorder.

Type
Research Article
Copyright
Copyright © 2009 Blackwell Munksgaard

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References

McElroy, SL, Kotwal, R, Malhotra, S, Nelson, EB, Keck, PE, Nemeroff, CB.Are mood disorders and obesity related? A review for the mental health professional. J Clin Psychiatry 2004;65:634651. CrossRefGoogle ScholarPubMed
Malhi, GS, Ivanovski, B, Hadzi-Pavlovic, D, Mitchell, PB, Vieta, E, Sachdev, P.Neuropsychological deficits and functional impairment in bipolar depression, hypomania and euthymia. Bipolar Disord 2007;9:114125. CrossRefGoogle ScholarPubMed
Michalak, EE, Yatham, LN, Lam, RW.Quality of life in bipolar disorder: a review of the literature. Health Qual Life Outcomes 2005;3:7288. CrossRefGoogle ScholarPubMed
Judd, LL, Akiskal, HS.The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases. J Affect Disord 2003;73:123131. CrossRefGoogle ScholarPubMed
Weissman, MM, Leaf, PJ, Tischler, GLet al. Affective disorders in five United States communities. Psychol Med 1998;18:141153. CrossRefGoogle Scholar
Kilbourne, AM, Cornelius, JR, Han, Xet al. Burden of general medical conditions among individuals with bipolar disorder. Bipolar Disord 2004;6:368373. CrossRefGoogle ScholarPubMed
McElroy, SL.Diagnosing and treating comorbid (complicated) bipolar disorder. J Clin Psychiatry 2004;65(Suppl. 15):3544. Google ScholarPubMed
McIntyre, RS, Konarski, JZ, Misener, VL, Kennedy, SH.Bipolar Disorder and Diabetes Mellitus: epidemiology, etiology and treatment implications. Ann Clin Psychiatry 2005;17:8393. CrossRefGoogle ScholarPubMed
Osby, U, Brandt, L, Correia, N, Ekbom, A, Sparén, P.Excess mortality in bipolar and unipolar disorder in Sweden. Arch Gen Psychiatry 2001;58:844850. CrossRefGoogle ScholarPubMed
Reilly, MP, Rader, DJ.The metabolic syndrome: more than the sum of its parts? Circulation 2003;108:15461551. CrossRefGoogle Scholar
Fagiolini, A, Frank, E, Scott, JA, Turkin, S, Kupfer, DJ.Metabolic syndrome in bipolar disorder: findings from the Bipolar Disorder Center for Pennsylvanians. Bipolar Disord 2005;7:424430. CrossRefGoogle ScholarPubMed
Yumru, M, Savas, HA, Kurt, Eet al. Atypical antipsychotics related metabolic syndrome in bipolar patients. J Affect Disord 2007;98:247252. CrossRefGoogle ScholarPubMed
Garcia-Portilla, MP, Saiz, PA, Benabarre, Aet al. The prevalence of metabolic syndrome in patients with bipolar disorder. J Affect Disord 2008;106:197201. CrossRefGoogle ScholarPubMed
Fagiolini, A, Frank, E, Scott, T, Houck, PR, Soreca, I, Kupfer, DJ.Metabolic syndrome in patients with bipolar disorder. J Clin Psychiatry 2008;69:678679. CrossRefGoogle ScholarPubMed
Slavi, V, Albert, U, Chiarle, A, Soreca, I, Bogetto, F, Maina, G.Metabolic syndrome in Italian patients with bipolar disorder. Gen Hosp Psychiatry 2008;30:318323. CrossRefGoogle Scholar
Cárdenas, J, Frye, MA, Marusak, SLet al. Modal subcomponents of metabolic syndrome in patients with bipolar disorder. J Affect Disord 2008;106:9197. CrossRefGoogle ScholarPubMed
Van Winkel, R, De Hert, M, Eyck, DVet al. Prevalence of diabetes and metabolic syndrome in a sample of patients with bipolar disorder. Bipolar Disord 2008;10:342348. CrossRefGoogle Scholar
Fiedorowicz, JG, Palagummi, NM, Forman-Hoffman, VL, Miller del, D, Haynes, WG.Elevated prevalence of obesity, metabolic syndrome, and cardiovascular risk factors in bipolar disorder. Ann Clin Psychiatry 2008;20:131137. CrossRefGoogle ScholarPubMed
Fagiolini, A, Kupfer, DJ, Houck, PR, Novick, DM, Frank, E.Obesity as a correlate of outcome in patients with bipolar I disorder. Am J Psychiatry 2003;160:112117. CrossRefGoogle ScholarPubMed
Kereiakes, DJ, Willerson, JT.Metabolic syndrome epidemic. Circulation 2003;108:15521553. CrossRefGoogle ScholarPubMed
Teixeira, PJR, Rocha, FL.The prevalence of metabolic syndrome among psychiatric inpatients in Brazil. Rev Bras Psiquiatr 2007;29:330336. CrossRefGoogle ScholarPubMed
Executive Summary: The Third Report of the National Cholesterol Education Program (ATPIII). Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:24862497. CrossRefGoogle Scholar
Grundy, MS, Cleeman, JI, Daniels, SRet al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung and Blood Institute Scientific Statement. Circulation 2005;112:27352752. CrossRefGoogle ScholarPubMed
Ford, ES, Giles, WH, Mokdad, AH.Increasing prevalence of the metabolic syndrome among U.S. adults. Diabetes Care 2004;27:24442449. CrossRefGoogle ScholarPubMed
Monteiro, CA, Conde, WL, Popkin, BM.Income-specific trends in obesity in Brazil: 1975–2003. Am J Public Health 2007;97:18081812. CrossRefGoogle ScholarPubMed
Brazilian Government. 2006. Available at: http://portal. saude.sp.gov.br/content/checroruri.mmp. Google Scholar
Salaroli, LB, Barbosa, GC, Mill, JG, Molina, MCB.Prevalence of metabolic syndrome in population-based study. Arq Bras Endocrinol Metabol. 2007;51:11431152. CrossRefGoogle ScholarPubMed