Diabetes mellitus and first episode mania associated with cardiovascular diseases in patients with older-age bipolar disorder

Chen, Pao Huan; Chang, Chi Kang; Chiang, Shuo-Ju; Lin, Yen‐Kuang; Tsai, Shang‐Ying; Huang, Shou-Hung

doi:10.1016/j.psychres.2017.01.004

Cited by 12 publications

(5 citation statements)

References 36 publications

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“…The cut‐off points used to define diabetes mellitus and impaired fasting glucose were serum fasting glucose levels above 126 mg/dL and between 100 mg/dL and 125 mg/dL, respectively [24,25]. The cut‐off points used to define dyslipidemia were as follows: serum triglyceride level above 200 mg/dL; total cholesterol above 240 mg/dL; low‐density lipoprotein above 160 mg/dL; or high‐density lipoprotein below 40 mg/dL and 50 mg/dL for men and women, respectively [24,25]. Subjects who received regular treatment for diabetes mellitus or dyslipidemia were also recorded as having these two metabolic diseases, even if the results of blood tests were within the normal range.…”

Section: Methodssupporting

confidence: 84%

Section: Methodsmentioning

confidence: 90%

“…In this study, obesity was defined as a body mass index (BMI) over 27 kg/m 2 and overweight as a BMI between 24 and 27 kg/m 2 [24,25]. The cut‐off points used to define diabetes mellitus and impaired fasting glucose were serum fasting glucose levels above 126 mg/dL and between 100 mg/dL and 125 mg/dL, respectively [24,25]. The cut‐off points used to define dyslipidemia were as follows: serum triglyceride level above 200 mg/dL; total cholesterol above 240 mg/dL; low‐density lipoprotein above 160 mg/dL; or high‐density lipoprotein below 40 mg/dL and 50 mg/dL for men and women, respectively [24,25].…”

Section: Methodsmentioning

confidence: 92%

“…In a previous study, Chen et al. found that the first‐episode mania and diabetes mellitus were associated with CVDs in older patients with BD [25]. The findings are of interest because it has been recently proposed that patients with BD may have dysfunctional allostasis across multiple organ systems beginning with their first mood episode [29].…”

Section: Discussionmentioning

confidence: 99%

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Dysregulation of glucose metabolism since young adulthood increases the risk of cardiovascular diseases in patients with bipolar disorder

Chen

Lin

Chang

et al. 2017

The Kaohsiung J of Med Scie

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Aging patients with bipolar disorder (BD) are at a high risk of cardiovascular diseases (CVDs). However, few studies have directly examined the association between metabolic risks and CVDs in patients with BD across the lifespan. Therefore, the aim of this study was to determine lifetime metabolic risk factors for CVDs in patients with BD. We recruited BD-I patients who were more than 50 years old and had had at least one psychiatric hospitalization. Patients who had a cardiologist-confirmed CVD diagnosis (ICD-9 code 401-414) were assigned to the case group. Fifty-five cases were matched with 55 control patient without CVDs based on age and sex. Clinical data were obtained by retrospectively reviewing 30 years of hospital records. Compared to control subjects, a significantly higher proportion of cases had impaired fasting glucose between ages 31 and 40 (44.0% versus 17.4%, p = 0.046), diabetes mellitus between ages 41 and 50 (25.6% versus 8.6%, p = 0.054), and diabetes mellitus after age 51 (36.3% versus 12.7%, p = 0.005). No significant difference was found in overweight, obesity, or dyslipidemia. After adjusting for years of education, first episode as mania, and second generation antipsychotic use, lifetime diabetes mellitus remained a risk factor for CVDs (OR = 4.45, 95% CI = 1.89-10.66, p = 0.001). The findings suggest that glucose dysregulation across the adult age span is probably the major metabolic risk contributing to CVDs in patients with BD. Clinicians therefore have to notice the serum fasting glucose levels of BD patients since young adulthood.

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Section: Methodssupporting

confidence: 84%

Section: Methodsmentioning

confidence: 90%

Section: Methodsmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Dysregulation of glucose metabolism since young adulthood increases the risk of cardiovascular diseases in patients with bipolar disorder

Chen

Lin

Chang

et al. 2017

The Kaohsiung J of Med Scie

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“…First, we could not measure the severity of bipolar affective symptoms in the NHIRD. Considering that previous studies have found that the mood burden in bipolar disorder can increase the risk of vascular risk, 25 , 26 further research is needed to explore whether bipolar affective symptoms responding to treatment with mood stabilisers could modulate the risk of stroke.…”

Section: Discussionmentioning

confidence: 99%

Mood stabilisers and risk of stroke in bipolar disorder

et al. 2018

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BackgroundResearch on the risk of stroke following the use of mood stabilisers specific to patients with bipolar disorder is limited.AimsIn this study, we investigated the risk of stroke following the exposure to mood stabilisers in patients with bipolar disorder.MethodData for this nationwide population-based study were derived from the Taiwan National Health Insurance Research Database. Among a retrospective cohort of patients with bipolar disorder (n = 19 433), 609 new-onset cases of stroke were identified from 1999 to 2012. A case–crossover study design utilising 14-day windows was applied to assess the acute exposure effect of individual mood stabilisers on the risk of ischaemic, haemorrhagic and other types of stroke in patients with bipolar disorder.ResultsMood stabilisers as a group were significantly associated with the increased risk of stroke in patients with bipolar disorder (adjusted risk ratio, 1.26; P = 0.041). Among individual mood stabilisers, acute exposure to carbamazepine had the highest risk of stroke (adjusted risk ratio, 1.68; P = 0.018), particularly the ischaemic type (adjusted risk ratio, 1.81; P = 0.037). In addition, acute exposure to valproic acid elevated the risk of haemorrhagic stroke (adjusted risk ratio, 1.76; P = 0.022). In contrast, acute exposure to lithium and lamotrigine did not significantly increase the risk of any type of stroke.ConclusionsUse of carbamazepine and valproic acid, but not lithium and lamotrigine, is associated with increased risk of stroke in patients with bipolar disorder.Declaration of interestNone.

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Psychosocial Risk Factors

Heyland,

Geis

2024

Preventive Cardiovascular Nursing

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Diabetes mellitus and first episode mania associated with cardiovascular diseases in patients with older-age bipolar disorder

Cited by 12 publications

References 36 publications

Dysregulation of glucose metabolism since young adulthood increases the risk of cardiovascular diseases in patients with bipolar disorder

Dysregulation of glucose metabolism since young adulthood increases the risk of cardiovascular diseases in patients with bipolar disorder

Mood stabilisers and risk of stroke in bipolar disorder

Psychosocial Risk Factors

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