Increased metabolic variability in Korean patients with new onset bipolar disorder: a nationwide cohort study

Ji Hyun Baek; Kyungdo Han; Hyewon Kim; Kyojin Yang; Hong Jin Jeon

doi:10.3389/fpsyt.2023.1256458

Increased metabolic variability in Korean patients with new onset bipolar disorder: a nationwide cohort study

Front Psychiatry. 2024 Jan 8:14:1256458. doi: 10.3389/fpsyt.2023.1256458. eCollection 2023.

Authors

Ji Hyun Baek^{1

2}, Kyungdo Han³, Hyewon Kim¹, Kyojin Yang¹, Hong Jin Jeon^{1

4}

Affiliations

¹ Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
² Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, United States.
³ Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
⁴ Department of Health Sciences & Technology, Department of Medical Device Management & Research, and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.

Abstract

Introduction: The aim of this study was to determine associations between changes of metabolic parameters and the development of BD using nationally representative data.

Methods: We used health examination data provided by the South Korean National Health Insurance System (NHIS) (n = 8,326,953). The variability of each metabolic parameter including weight circumference, blood pressure, fasting blood glucose, high-density lipoprotein cholesterol, and triglyceride levels was caculated using variability independent of mean (VIM) indices. The presence of metabolic syndrome was associated with new onset BD. Each metabolic parameter with high variability was associated with a higher risk of new onset BD compared to those with low variability after adjusting for age, sex, smoking, alcohol drinking, regular exercise, income status, baseline diabetes, hypertension, and dyslipidemia.

Results: As the number of highly variable metabolic parameters increased, the risk for new onset depression also increased even after covariates adjustment. The associations between new onset BD and metabolic variability were greater in populations with age > 50 years. In addition, these associations remained significant after adjusting for the presence of depression prior to diagnoses of BD.

Discussion: Our results suggest possibility of metabolic variability as an independent environmental risk factor for BD even after adjusting for the presence of metabolic syndrome.

Keywords: bipolar disorder; metabolic syndrome; metabolic variability; modifiable risk factor; old age onset bipolar disorder.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Technology Innovation Program (or Industrial Strategic Technology Development Program-Source Technology Development and Commercialization of Digital Therapeutics) (20014967, Development of Digital Therapeutics for Depression from COVID19) funded by the Ministry of Trade, Industry & Energy (MOTIE, Korea). It was also supported by a grant (HR21C0885) of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI) funded by the Ministry of Health & Welfare, Republic of Korea.