TY - JOUR
T1 - Body mass index and blood pressure in bipolar patients
T2 - Target cardiometabolic markers for clinical practice
AU - Cuellar-Barboza, Alfredo B.
AU - Cabello-Arreola, Alejandra
AU - Winham, Stacey J.
AU - Colby, Colin
AU - Romo-Nava, Francisco
AU - Nunez, Nicolas A.
AU - Morgan, Robert J.
AU - Gupta, Ruchi
AU - Bublitz, Joshua T.
AU - Prieto, Miguel L.
AU - De Filippis, Elena A.
AU - Lopez-Jimenez, Francisco
AU - McElroy, Susan L.
AU - Biernacka, Joanna M.
AU - Frye, Mark A.
AU - Veldic, Marin
N1 - Funding Information:
This study was supported, in part, by the Marriott Family Foundation and the Mayo Clinic Center for Individualized Medicine.
Funding Information:
Funding for this study was provided by the Marriott Foundation. The foundation had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Publisher Copyright:
© 2020
PY - 2021/3/1
Y1 - 2021/3/1
N2 - Objective: To evaluate the association between cardiometabolic markers and bipolar disorder (BD), examining the impact of sex and cardiometabolic medication use, from a large case-control biorepository of more than 1300 participants. Patients and Methods: Recruited from July 2009 through September 2017, cardiometabolic markers were harvested from electronic health records (EHR) of participants (n=661) from the Mayo Clinic Individualized Medicine Biobank for Bipolar Disorder and Mayo Clinic Biobank age-sex-matched controls (n=706). Markers were compared between cases and controls using logistic regression, stratified by sex, adjusting for cardiometabolic medications and current smoking status. We studied the effect of psychotropics in case-only analyses. Results: The mean age of the sample was 52.5 ± 11.6 years and 55% were female. BD patients had higher rates of smoking, but lower utilization of lipid-lowering medication compared with controls. After adjustment, BD was associated with obesity [Odds ratio (CI) 1.62 (1.22-2.15)], elevated systolic blood pressure (SBP) [2.18 (1.55-3.06)] and elevated triglycerides [1.58 (1.13-2.2)]. When stratified by sex, obesity [1.8 (1.23-2.66)] and systolic blood pressure [2.32 (1.46-3.7)] were associated with BD females compared to female controls; however, only systolic blood pressure [2.04 (1.23-3.42)] was associated with male bipolars compared to male controls. Psychotropics were marginally associated with mean BMI, abnormal triglycerides, and HbA1c. Limitations: EHR cross-sectional data Conclusion: To our knowledge, this is the largest case controlled study to date to explore the association between cardiometabolic markers and bipolar disorder adjusting for utilization of cardiometabolic medication. Identification of significant, non-laboratory based cardiometabolic markers that are associated with increased risk of major cardiovascular adverse events in patients with bipolar disorder, underscores, both the utility and importance of risk monitoring that can be easily done in community mental health centers.
AB - Objective: To evaluate the association between cardiometabolic markers and bipolar disorder (BD), examining the impact of sex and cardiometabolic medication use, from a large case-control biorepository of more than 1300 participants. Patients and Methods: Recruited from July 2009 through September 2017, cardiometabolic markers were harvested from electronic health records (EHR) of participants (n=661) from the Mayo Clinic Individualized Medicine Biobank for Bipolar Disorder and Mayo Clinic Biobank age-sex-matched controls (n=706). Markers were compared between cases and controls using logistic regression, stratified by sex, adjusting for cardiometabolic medications and current smoking status. We studied the effect of psychotropics in case-only analyses. Results: The mean age of the sample was 52.5 ± 11.6 years and 55% were female. BD patients had higher rates of smoking, but lower utilization of lipid-lowering medication compared with controls. After adjustment, BD was associated with obesity [Odds ratio (CI) 1.62 (1.22-2.15)], elevated systolic blood pressure (SBP) [2.18 (1.55-3.06)] and elevated triglycerides [1.58 (1.13-2.2)]. When stratified by sex, obesity [1.8 (1.23-2.66)] and systolic blood pressure [2.32 (1.46-3.7)] were associated with BD females compared to female controls; however, only systolic blood pressure [2.04 (1.23-3.42)] was associated with male bipolars compared to male controls. Psychotropics were marginally associated with mean BMI, abnormal triglycerides, and HbA1c. Limitations: EHR cross-sectional data Conclusion: To our knowledge, this is the largest case controlled study to date to explore the association between cardiometabolic markers and bipolar disorder adjusting for utilization of cardiometabolic medication. Identification of significant, non-laboratory based cardiometabolic markers that are associated with increased risk of major cardiovascular adverse events in patients with bipolar disorder, underscores, both the utility and importance of risk monitoring that can be easily done in community mental health centers.
KW - Bipolar disorder
KW - Cardiometabolic markers
KW - High blood pressure
KW - Obesity
KW - Triglycerides
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U2 - 10.1016/j.jad.2020.12.121
DO - 10.1016/j.jad.2020.12.121
M3 - Article
C2 - 33445086
AN - SCOPUS:85099233356
SN - 0165-0327
VL - 282
SP - 637
EP - 643
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -