Metabolic Syndrome in Patients With Bipolar Disorder

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Sir: We previously reported a 30% prevalence of the metabolic syndrome in the first 171 participants in our Bipolar Disorder Center for Pennsylvanians study.1 However, the American Heart Association and the National Heart, Lung, and Blood Institute have recently issued a scientific statement that has suggested a modification of the diagnostic criteria for the metabolic syndrome as follows: (1) the threshold for serum levels of impaired fasting glucose should be reduced from 110 to 100 mg/dL; (2) the low high-density lipoprotein (HDL) cholesterol criterion should be considered as endorsed also when HDL cholesterol is within normal limits if the patient is undergoing drug treatment for reduced HDL cholesterol; and (3) the hypertension criterion is endorsed also if only the systolic blood pressure or only the diastolic blood pressure is elevated (≥ 130 and ≥ 85 mm Hg, respectively).2 Therefore, we decided to reevaluate the prevalence of the metabolic syndrome using the new diagnostic criteria in a considerably expanded sample of 441 subjects (mean age = 44.4 years, SD = 15.3 years) with bipolar I disorder (N = 321), bipolar II disorder (N = 95), bipolar disorder not otherwise specified (N = 15), or schizoaffective disorder bipolar type (N = 10).​

J Clin Psychiatry 2008;69(4):678-679 [letter]