By McNamara, Damian
Clinical Psychiatry News , Vol. 37, No. 9
HOLLY WOOD, FLA. -- Bipolar disorder is an independent risk factor for lipid disorders among patients without other known risk factors, according to a large, retrospective, managed care claims database study.
When a patient also had thyroid disorder or diabetes mellitus, for example, the association was no longer significant.
Dr. Quinton E. Moss and his associates also found the association between bipolar disorder and elevated risk remained after they controlled for current use of antipsychotic and lipid-lowering medications. This finding was important because treatments for bipolar disorder, particularly some atypical antipsychotics, can increase lipid abnormalities, he said in an interview at his poster at a meeting of the New Clinical Drug Evaluation Unit sponsored by the National Institute of Mental Health.
The risk for lipid disorders was greatest among bipolar patients in their 20s and 30s. This means the increased risk for dyslipidemia, hypercholesterolemia, or hypertriglyceridemia was independent of lipid changes typically associated with aging, said Dr. Moss, CNS assistant medical director, medical and scientific affairs, at i3 Research in Basking Ridge, N.J.
It is widely accepted that there is a greater risk of metabolic syndrome and cardiovascular disease among people with bipolar disorder, Dr. Moss said (Ann. Clin. Psychiatry 2008;20:131-7). "What we are trying to do is look at the effect of various comorbidities such as thyroid disorders and diabetes mellitus. Do these disorders increase the risk?"
Dr. Moss and his colleagues compared 33,019 enrollees of a U.S. health insurer who had bipolar disorder and a diagnosis of a lipid disorder, thyroid disorder, or diabetes with an additional 1 million controls with no Axis I mood or psychosis diagnoses.
Patients were aged 20-55 years (mean age, 39 years in both groups). …