Metabolic syndrome in Italian patients with bipolar disorder: a 2-year follow-up study

Metabolic syndrome (MetS) is highly prevalent in patients with bipolar disorder (BD). Few prospective studies have demonstrated an increase of MetS prevalence over time in patients with BD, but no study has tried to unveil the characteristics of patients with BD eventually developing the MetS. In our study we assessed the prevalence of MetS and its criteria over a period of 2-years; then, we identified the baseline clinical features of patients who developed the MetS during the follow-up with the intent to identify potential predictors for developing the MetS.

Subjects with BD consecutively admitted from April 2006 to September 2008 were included. MetS was diagnosed according to NCEP ATP-III modified criteria at baseline and after 2 years. We then selected patients without MetS at baseline and analyzed the association between clinical characteristics at baseline and the presence of MetS at follow-up by means of logistic regression analysis.

70 patients underwent all baseline and follow-up analyses. MetS prevalence significantly increased from 28.6 to 44.3% during the 2-years naturalistic follow-up (p=0.027). Significant predictors of MetS at follow-up were older age, higher BMI, and baseline exposure to antipsychotics.

Lack of a healthy control group.

MetS can rapidly develop in patients with BD, especially if antipsychotics are prescribed. Our paper highlights the importance of regularly screening the MetS in patients with BD despite the presence of metabolic disturbances at baseline.