Obesity and metabolic comorbidity in bipolar disorder: do patients on lithium comprise a subgroup? A naturalistic study

Abstract Background Bipolar disorders (BD) are associated with increased prevalence of obesity and metabolic syndrome (MetS). Nevertheless, there is a wide range in prevalence estimates, with little known about the contributions of pharmacotherapy. It has been suggested that lithium might have a more favorable metabolic profile. We hypothesized that lithium use is associated with less increased body mass index (BMI), MetS, and type II diabetes, when compared with non-lithium users (those on anticonvulsants, second-generation antipsychotics). Methods Cross-sectional study of 129 patients aged 18–85 with bipolar disorder, followed at tertiary care clinics in Montreal. Patients using lithium were compared with those not on lithium, for body mass index and metabolic syndrome. Results The prevalence of obesity and metabolic syndrome in the sample of lithium-using patients with BD was 42.4 and 35.7% respectively, with an average BMI of 29.10 (+/− 6.70). Lithium and non-lithium groups did not differ in BMI or prevalence of MetS. However, compared to the non-lithium group, lithium users had lower hemoglobin A1C (5.24 +/− 0.53 versus 6.01 +/− 1.83, U = 753.5, p = 0.006) and lower triglycerides (1.46 +/− 0.88 versus 2.01 +/− 1.25, U = 947, p = 0.020). Conclusions There is a high prevalence of obesity and metabolic syndrome among patients with bipolar disorder. However, this did not appear to be associated with lithium use, when compared to those not on lithium. The lithium subgroup was also associated with lower prevalence of type II diabetes. Future prospective and intervention studies with larger sample sizes are necessary to further explore the association between lithium and insulin resistance, as well as its underlying mechanisms.

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Obesity and metabolic comorbidity in bipolar disorder: Do patients on lithium comprise a subgroup? A naturalistic study.

10.21203/rs.3.rs-95636/v2 ◽

2021 ◽

Author(s):

Jake Prillo ◽

Jocelyn Fotso Soh ◽

Haley Park ◽

Serge Beaulieu ◽

Outi Linnaranta ◽

...

Keyword(s):

Metabolic Syndrome ◽

Body Mass Index ◽

Bipolar Disorder ◽

Body Mass ◽

Type Ii Diabetes ◽

Tertiary Care ◽

Type Ii ◽

Cross Sectional ◽

Wide Range ◽

Prevalence Of Obesity

Abstract Background: Bipolar disorders (BD) are associated with increased prevalence of obesity and metabolic syndrome (MetS). Nevertheless, there is a wide range in prevalence estimates, with little known about the contributions of pharmacotherapy. It has been suggested that lithium might have a more favorable metabolic profile. We hypothesized that lithium use is associated with less increased body mass index (BMI), MetS, and type II diabetes, when compared with non-lithium users (those on anticonvulsants, second-generation antipsychotics). Methods: Cross-sectional study of 129 patients aged 18-85 with bipolar disorder, followed at tertiary care clinics in Montreal. Patients using lithium were compared with those not on lithium, for body mass index and metabolic syndrome. Results: The prevalence of obesity and metabolic syndrome in the sample of lithium-using patients with BD was 42.4% and 35.7 % respectively, with an average BMI of 29.10 (+/-6.70). Lithium and non-lithium groups did not differ in BMI or prevalence of MetS. However, compared to the non-lithium group, lithium users had lower hemoglobin A1C (5.24 +/- 0.53 versus 6.01 +/- 1.83, U=753.5, p=0.006) and lower triglycerides (1.46 +/- 0.88 versus 2.01 +/-1.25, U=947, p=0.020). Conclusions: There is a high prevalence of obesity and metabolic syndrome among patients with bipolar disorder. However, this did not appear to be associated with lithium use, when compared to those not on lithium. The lithium subgroup was also associated with lower prevalence of type II diabetes. Future prospective and intervention studies with larger sample sizes are necessary to further explore the association between lithium and insulin resistance, as well as its underlying mechanisms.

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Obesity and Metabolic Comorbidity in Bipolar Disorder: Do Patients on Lithium Comprise A Subgroup? A Naturalistic Study.

10.21203/rs.3.rs-95636/v1 ◽

2020 ◽

Author(s):

Jake Prillo ◽

Jocelyn Fotso Soh ◽

Annemick Dols ◽

Haley Park ◽

Serge Beaulieu ◽

...

Keyword(s):

Metabolic Syndrome ◽

Body Mass Index ◽

Bipolar Disorder ◽

Body Mass ◽

Type Ii Diabetes ◽

Tertiary Care ◽

Type Ii ◽

Wide Range ◽

Prevalence Of Obesity ◽

Bipolar Patients

Abstract Background: Bipolar disorders (BD) are associated with increased prevalence of obesity and metabolic syndrome (MetS). Nevertheless, there is a wide range in prevalence estimates, and little is known about the relative contributions of medications, especially lithium. We hypothesized that lithium use is not associated with increased body mass index (BMI), metabolic syndrome, and type II diabetes (DM II), when compared to non-lithium users (those on anticonvulsants (ACs) or second-generation antipsychotics (APs)). Methods: Cross-sectional study of 129 patients aged 18-85 with bipolar disorder, followed at tertiary care clinics in Montreal. Patients using lithium were compared with those not on lithium, for body mass index and metabolic syndrome. Results: The prevalence of obesity and MetS in the sample of lithium-using bipolar patients was 42.4% and 34.9%, respectively, with an average BMI of 29.10 (+/-6.70). Lithium and non-lithium groups did not differ in BMI or prevalence of MetS. However, compared to the non-lithium group, lithium users had lower hemoglobin A1C (5.24 +/- 0.53 versus 6.01 +/- 1.83, U=753.5, p=0.006) and lower triglycerides (1.46 +/- 0.88 versus 2.01 +/-1.25, U=947, p=0.020). Conclusions: There is a high prevalence of obesity and metabolic syndrome among bipolar disorder patients. However, this did not appear to be associated with lithium use, when compared to those not on lithium. The lithium subgroup was also associated with lower prevalence of type II diabetes. Future prospective and intervention studies with larger sample sizes are necessary to further explore the association between lithium and insulin resistance, as well as its underlying mechanisms.

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EFFECT OF LEPR AND GR GENE POLYMORPHISMS ON HEALTH STATUS OF MOTHERS WITH METABOLIC DISORDERS AND THEIR NEWBORNS

Актуальні проблеми сучасної медицини Вісник Української медичної стоматологічної академії ◽

10.31718/2077-1096.20.3.20 ◽

2020 ◽

Vol 20 (3) ◽

pp. 20-25

Author(s):

V.I. Pokhуlko ◽

Yu.I. Cherniavska ◽

S.M. Tsvirenko ◽

Z.I. Rossokha ◽

Yu.Yu. Klymchiuk

Keyword(s):

Metabolic Syndrome ◽

Body Mass Index ◽

Body Mass ◽

Gene Polymorphisms ◽

Metabolic Disorders ◽

Cross Sectional Study ◽

Control Group ◽

Genetic Determinants ◽

Cross Sectional ◽

Prevalence Of Obesity

The high prevalence of obesity and metabolic syndrome throughout the world over the past two decades provided the grounds to the WHO to consider overweight as a non-infectious pandemic. Among the factors that negatively affect the metabolism, result in metabolic disorders and obesity there are genetic, prenatal, diet-related, somatic, psychogenic and others. Analysis of LEPR and GR gene polymorphisms among mothers and their newborns can be an important component in the prediction of metabolic disorders and obesity. The aim of this study was to analyze the presence of clinical and genetic determinants of metabolic syndrome in mothers and their newborns. Materials and methods. A cross-sectional study of 42 pairs of mothers and newborns was performed; we analyzed their anthropometric, clinical and laboratory parameters and, in particular, 2 types of genetic polymorphisms (LEPR rs1137101 and GR, BClI polymorphism). The main group consisted of 15 mother-child pairs, where the woman was clinically obese (body mass index more than 30), the comparison group included 27 mother-child pairs, where the women were overweight (body mass index more than 25). Results. Obese mothers were significantly more likely to have a miscarriage (p = 0.01). Children from obese mothers had significantly higher percentiles of birth weight compared to the control group (60.9 ± 7.7 and 49.75 ± 4.5, respectively, p = 0.05). The GG genotype of the GR gene was associated with more common indications for hospitalization (p = 0.012), rapid delivery (p = 0.01), umbilical cord entanglement around the neck of the foetus (p = 0.012). Among the children- carriers of the GG BclI genotype GR, cardio-metabolic disorders detected by the auscultation of the heart (arrhythmia, functional noise) were found out as significantly more frequent (p = 0.003). Conclusion. The study did not find the associations between LEPR and GR gene polymorphism in obese mothers and the development of overweight in their children, but the study revealed an adverse effect of polymorphic variants on obstetric and gynaecological status of mothers, labour and adaptation of infants in the early neonatal period.

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PREVALENCE OF SILENT CARDIAC ISCHEMIA IN TYPE II DIABETES MELLITUS

Pakistan Heart Journal ◽

10.47144/phj.v54i2.2093 ◽

2021 ◽

Vol 54 (2) ◽

pp. 162-166

Author(s):

Nosheen Zia ◽

Sabeen Aftab ◽

Nauman Ismat Butt ◽

Fahmina Ashfaq ◽

Aniqa Anser ◽

...

Keyword(s):

Diabetes Mellitus ◽

Body Mass Index ◽

Body Mass ◽

Type Ii Diabetes ◽

Tertiary Care ◽

Care Facility ◽

Type Ii Diabetes Mellitus ◽

Cardiac Ischemia ◽

Type Ii ◽

Tertiary Care Facility

Objectives: To determine the frequency of silent cardiac ischemia in type II diabetes mellitus patients presenting to tertiary care facility. Methodology: This cross-sectional study was conducted from 20th October 2017 to 20th April 2018 at Department of Medicine Jinnah Hospital Lahore. After a detailed history, measurement of height, blood pressure, weight, fasting blood sugar, body mass index of 237 patients were recorded, and electrocardiography (ECG) was done before and after exercise tolerance testing (ETT). Changes in ECG were assessed and person labeled as having silent cardiac ischemia or not depending on the outcome of the ECG. Results: Mean age was 54.9 ± 5.9 (range: 45 – 63) years. There were 144 male patients and 93 female patients The mean duration of type II diabetes mellitus in the study population was 10.0 ± 2.6 (range: 6 – 15) years. The frequency of silent cardiac ischemia was found to be 45.1%. Increasing age, prolonged duration of diabetes mellitus, history of smoking and hypertension, and increased body mass index were significantly related to silent cardiac ischemia (p-value< 0.05). Conclusion: Silent cardiac is quite prevalent in our population that demands urgent efforts to diagnose this condition earlier for better future outcomes.

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To Determine the Prevalence of Obesity in Breast Cancer Patients

Liaquat National Journal of Cancer Care ◽

10.37184/lnjcc.2789-0112.2.1 ◽

2021 ◽

Keyword(s):

Breast Cancer ◽

Body Mass Index ◽

Cancer Patients ◽

Body Mass ◽

Tertiary Care ◽

Overweight And Obesity ◽

World Health ◽

Care Hospital ◽

Breast Cancer Patients ◽

Prevalence Of Obesity

Background: Breast Cancer is one of the leading causes of death worldwide. Pakistan alone has the highest rate of Breast Cancer than any other Asian country as approximately 90000 new cases are diagnosed every year out of which 40000 dies. Obesity is also a critical public health problem growing with every passing year in Pakistan and worldwide. Research studies are being conducted worldwide regarding the relation between the two problems. Objective: The objective of this study is to determine the prevalence of obesity in breast cancer patients in a tertiary care hospital in Karachi, Pakistan. Methods: BMI is used as a screening tool for overweight and obesity. According to World Health Organization, a body mass index (BMI) over 25 is considered overweight, and over 30 is obese. A retrospective analysis of 262 patients diagnosed with Breast Cancer during 2019 and 2020 was performed. Patients’ hospital records in Oncology were reviewed. The weight in kilograms and height in centimeters of patients were reviewed. Their BMI was calculated and recorded using the SPSS system. Results: The median BMI was 28.25 kg/m2 with an interquartile range of 25.15 - 31.99 kg/m2. Nearly 80% of the study participants had body mass index higher than normal levels (n=203, 77.5%) and out of them approximately half were overweight (n=104, 51.2%) and the remaining were obese (n=99, 48.7%). Conclusion: We conclude from our study that body mass index is positively correlated with breast cancer occurrence and thus the proportion of females having BMI >= 25 was significantly higher among patients.

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Outcome of breast cancer patients regarding obesity and complications: Analysis of risk factors

Romanian Medical Journal ◽

10.37897/rmj.2021.1.14 ◽

2021 ◽

Vol 68 (1) ◽

pp. 77-86

Author(s):

Iuliana Pantelimon ◽

◽

Laurentia Nicoleta Gales ◽

Maria Daniela Tanasescu ◽

Irina Nita ◽

...

Keyword(s):

Breast Cancer ◽

Body Mass Index ◽

Prognostic Factors ◽

Disease Progression ◽

Body Mass ◽

Type Ii Diabetes ◽

The Body ◽

Proliferation Index ◽

Her2 Overexpression ◽

Type Ii

Introduction. Breast cancer is the leading cause of cancer death in Romania. In the context in which the treatments available for this pathology have increased curability, the identification of negative prognostic factors involved in the evolution of this disease seems essential to improve the overall survival as well as the time to disease progression. Aim. The aim of this study is to identify the role of prognostic factors such as ki67 proliferation index, the presence of tumour estrogen receptors, HER2 overexpression, the presence of secondary determinations at diagnosis, the association of obesity and type II diabetes. Methods. 50 patients diagnosed with breast cancer treated in the Elias University Emergency Hospital Bucharest were retrospectively followed, for which the progression was documented at the time of elaboration of this study. Thus, a database was developed in which data were entered on age, body mass index, immunohistochemical characteristics of breast tumours, the presence/absence of metastases at diagnosis and the association of type II diabetes. Statistical calculations were performed to highlight a possible correlation between obesity (quantified by measuring body mass index) and tumour aggressiveness (quantified by ki67 proliferation index) as well as statistical evaluation of potential prognostic factors that would influence time, until the disease progresses. Results. Within this group, no correlation could be established between the presence of an increased body mass index and the value of the ki67 proliferation index (p = 0.38). The mean value of the body mass index for this group of unselected patients was 28.76 ± 4.81 (DS) most patients are therefore overweight or obese. The factors involved in the evolution of breast cancer that influenced the early progression of the disease were: the proliferation index ki67 (p <0.05), the presence of metastases at diagnosis (p < 0.0001) and the association of type II diabetes (p = 0.0085). The value of the body mass index did not influence the time to disease progression according to statistical calculations in this group probably due to the small number of normal weight patients included (p = 0.34).

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Frequency of Dyslipidemia in Obese

10.53350/pjmhs2115102831 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2831-2832

Author(s):

Ambreen Asif ◽

Kashif Aziz Ahmad ◽

Sohaib Akbar ◽

Talha Munir

Keyword(s):

Body Mass Index ◽

Lipid Profile ◽

Body Mass ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Obese Subjects

Objective: frequency of dyslipidemia in obese subjects Methodology: In this was a cross sectional study, we included a total of 100 cases, between 30 and 70 years of age of either gender having body mass index >30 whereas we excluded all those cases who were already taking treatment of dyslipidemia. A fasting blood sample was followed for lipid profile from the hospital lab and results were followed for presence/absence of dyslipidemia. Results: In this trial, mean age was 44.57+8.52 years. Mean lipid profile was recorded as 210.17+36.73 total cholesterol, 178.83+12.10 triglycerides, 133.55+9.74 LDL and 34.42+6.58 HDL. Mean Body mass index was calculated as 34.11+7.25. Frequency of dyslipidemia in obese subjects was recorded as 51%(n=51) Conclusion: We concluded that frequency of dyslipidemia is higher in obese subjects coming to a tertiary care hospital Lahore. So, it is recommended that every patient who present with obesity, should be sort out for dyslipidemia. However, it is also required that every setup should have their surveillance in order to know the frequency of the problem Keywords: Obese, dyslipidemia, frequency

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