Modal subcomponents of metabolic syndrome in patients with bipolar disorder

Background: The metabolic syndrome is a growing global public health problem. Objective: To evaluate the prevalence rate and modal subcomponents of the metabolic syndrome in subjects treated at the West Los Angeles Veterans Administration Medical Center Bipolar Clinic. Methods: In this cross-sectional design study, using the National Cholesterol Education Program definition, metabolic syndrome prevalence rates were calculated. Results: 48/98 (49%) of subjects met criteria for metabolic syndrome. There was no difference in prevalence rate by gender or race. Almost 70% of the cohort met criteria for metabolic syndrome by the components of reduced HDL and increased waist circumference. Treatment with carbamazepine at study entry was associated with a lower prevalence rate of metabolic syndrome. Limitations and conclusions: This study is limited by its small size and non-structured assessment of Axis I diagnosis. Nonetheless, bipolar patients in this select cohort have high rates of metabolic syndrome; given this cardiovascular risk, close clinical monitoring for these parameters is recommended. While not controlling for genetics, environmental influences, and/or medical factors such as additional comorbidity and treatment duration, psychotropic drug use may confer differential risk for developing the metabolic syndrome.