Metabolic Syndrome in Patients With Bipolar Disorder

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Sir: We previously reported a 30% prevalence of themetabolic syndrome in the first 171 participants in our BipolarDisorder Center for Pennsylvanians study.¹ However, theAmerican Heart Association and the National Heart, Lung, andBlood Institute have recently issued a scientific statement thathas suggested a modification of the diagnostic criteria for themetabolic syndrome as follows: (1) the threshold for serumlevels of impaired fasting glucose should be reduced from 110to 100 mg/dL; (2) the low high-density lipoprotein (HDL) cholesterolcriterion should be considered as endorsed also whenHDL cholesterol is within normal limits if the patient is undergoingdrug treatment for reduced HDL cholesterol; and (3) thehypertension criterion is endorsed also if only the systolicblood pressure or only the diastolic blood pressure is elevated(≥ 130 and ≥ 85 mm Hg, respectively).2 Therefore, we decidedto reevaluate the prevalence of the metabolic syndrome usingthe new diagnostic criteria in a considerably expanded sampleof 441 subjects (mean age = 44.4 years, SD = 15.3 years) withbipolar I disorder (N = 321), bipolar II disorder (N = 95), bipolardisorder not otherwise specified (N = 15), or schizoaffectivedisorder bipolar type (N = 10).' ‹