Non‐alcoholic fatty liver disease in a sample of individuals with bipolar disorders: results from the FACE‐BD cohort

Abstract

ObjectiveNon‐Alcoholic fatty liver disease (NAFLD) is becoming the most common liver disease in Western populations. While obesity and metabolic abnormalities are highly frequent in bipolar disorders (BD), no studies have been performed to estimate the prevalence of NALFD in individuals with BD. The aim of our study is to estimate the prevalence of NAFLD and to identify the potential associated risk factors in a large sample of BD individuals.MethodsBetween 2009 and 2019, 1969 BD individuals from the FACE‐BD cohort were included. Individuals with liver diseases, Hepatitis B or C, and current alcohol use disorders were excluded from the analyses. A blood sample was drawn from participants. Screening of NAFLD was determined using fatty liver index (FLI). Individuals with FLI> 60 were considered as having NAFLD.ResultsThe prevalence of NAFDL in this sample was estimated at 28.4%. NAFLD was observed in 40% of men and 21% of women. NAFLD was independently associated with older age, male gender, sleep disturbances, and current use of atypical antipsychotics or anxiolytics. As expected, the prevalence of NALFD was also higher in individuals with overweight and in those with metabolic syndrome.ConclusionsThis study reinforces the view that individuals with BD are highly vulnerable to metabolic and cardiovascular diseases. The prevalence of NAFLD in individuals with BD was two times higher than the prevalence reported in the general population. The regular screening of the MetS in individuals with BD should be therefore complemented by the additional screening of NAFLD among these vulnerable individuals.

The development of the Metabolic-associated Fatty Liver Disease during pharmacotherapy of mental disorders - a review

“…Obtaining FLI score ≥60 indicates NAFLD. In the same study, the increased risk of having NAFLD was associated with current use of atypical antipsychotics or anxiolytics [20].…”

“…Uzyskanie wartości FLI ≥60 wskazuje na NAFLD. W tym samym badaniu, wzrost ryzyka wystąpienia NAFLD był związany z aktualnym stosowaniem atypowych leków przeciwpsychotycznych oraz leków anksjolitycznych [20].…”

Key findings on bipolar disorders from the longitudinal FondaMental Advanced Center of Expertise-Bipolar Disorder (FACE-BD) cohort

“…In summary, findings are consistent with the available literature showing a high prevalence of somatic and cardio-vascular comorbidities in BD 24,25 . Importantly, the network provided new data regarding the NAFLD prevalence in this cohort 20 , which has not been studied so far in BD and was reported as a high level in this cohort (40% of men and 21% of women).…”

“…We also estimated the prevalence of non-alcoholic fatty liver disease (NAFLD) on blood samples using the fatty liver index (FLI), showing a NAFLD prevalence of 28.4% which is two time higher than in the general population in France. NAFLD was independently associated with older age, male gender, sleep disturbances, and current use of atypical antipsychotics or anxiolytics, being overweight and having MetS 20 .…”

The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management

“…Multiple physical comorbidities occur at a higher rate in bipolar disorder, including -but not limited to -obesity, type 2 diabetes mellitus, metabolic syndrome, cardiovascular disease, thyroid dysfunction, and inflammatory bowel disease [255][256][257] . Moreover, there is increasing awareness of the higher rate of non-alcoholic fatty liver disease in persons with bipolar disorder, which is associated with obesity, exposure to psychotropic medication, and number of prior mood episodes 258 .…”