A recent study found that people with bipolar disorder are up to twice as likely as the general population to have metabolic syndrome, which is a cluster of symptoms that increase a person's risk of stroke, heart problems, and diabetes.

 

The study, published in the Journal of Affective Disorders, also found that "co-occurrence of metabolic syndrome in the bipolar population is associated with a more complex illness presentation, less favorable response to treatment, and adverse course and outcome." In other words, for people who have bipolar disorder, both are apt to be more serious and harder to treat.

Why are people with bipolar disorder more likely to have metabolic syndrome? Some reasons are obvious: many medications for the disorder can cause significant weight gain which greatly increases the likelihood of developing metabolic syndrome.  Also, people with bipolar disorder tend to not take good care of their diet and health during episodes.

Other reasons are harder to pin down. There may be a biological or genetic connection between bipolar disorder and metabolic syndrome, for example.  Also, the stress of bipolar moods, emotions, anger, etc., may make the person's body more susceptible to metabolic syndrome.

One of the main messages of this study is that people with bipolar disorder need to be monitored for high blood pressure, elevated "bad" and total cholesterol, low "good" cholesterol, triglycerides and blood sugar, and fat around the abdomen and waistline. Then the symptoms need to be checked up on regularly and treated promptly as well. As the study authors say, this should all be part of the "routine care of the bipolar patient."

 

Metabolic syndrome is a grouping of cardiac risk factors that include insulin resistance, obesity (especially abdominal obesity), abnormalities in blood clotting, high blood pressure, elevated LDL cholesterol and triglycerides, and reduced HDL cholesterol. In the late 1990's, it was introduced as a useful concept by diabetes specialists, since it was found that patients with metabolic syndrome (who have a greatly elevated risk of heart disease) often go on to develop diabetes.

Metabolic syndrome tends to run in families, along with the tendency for type 2 diabetes. Metabolic syndrome will occur in susceptible people who become overweight and sedentary. However, metabolic syndrome (like type 2 diabetes) can most often be prevented with exercise and maintaining a healthy body weight.

Anyone with a family history of type 2 diabetes who is overweight and sedentary should be evaluated for metabolic syndrome, especially if they are on bipolar medications that can cause weight gain.