Özet:

Objective: Metabolic disturbances and diagnosis of metabolic syndrome are more prevalent in bipolar disorder patients than general population. The underlying biological pathway regarding this high rate of metabolic syndrome compared to general population in bipolar disorder is still unknown. The side effects of second generation antipsychotics causing weight gain and insulin resistance are considered as one of the main factors. However, this knowledge is not sufficient to understand the association between bipolar disorder and metabolic syndrome entirely. The aim of this study was to investigate the seasonal variation in prevalence of the metabolic syndrome criteria and diagnosis in type 1 bipolar disorder. Methods: With that purpose 69 clinically remitted type 1 bipolar disorder patients, who also met inclusion criteria for the study, were recruited. Metabolic syndrome was diagnosed by using the International Diabetes Federation (IDF) criteria. Young Mania Rating Scale and Hamilton Depression Rating Scale with 17 items were used in clinical interview in each visit to assess mood. All patients were assessed in four visits during one year, with one visit per each season. To evaluate patients for metabolic syndrome criteria, blood sampling, blood pressure, and waist circumference measures were carried out. The data of 49 patients, who were evaluated in all four visits and met inclusion criteria in each visit, were analyzed. These data were used in investigation of the seasonal variation in the prevalence of metabolic syndrome criteria and metabolic syndrome diagnosis. Results: In the group of type 1 bipolar patients recruited to the study, the prevalence of metabolic syndrome diagnosis was 42.9%, 42.9%, 34.7% and 34.7% in winter, spring, summer, and autumn, respectively. Although metabolic syndrome diagnosis was more prevalent in winter and in spring, the difference was not statistically significant. Among the metabolic syndrome criteria, prevalence of low- HDL criterion, that was found lowest in spring, showed seasonal variation. Discussion: Although the results of this study do not support that the prevalence of metabolic syndrome diagnosis has a seasonal variation in type 1 bipolar patients, it shows that the prevalence of one of the metabolic syndrome criteria, low-HDL criterion, has seasonal variation among patients with bipolar disorder. Long term, large sample-sized follow-up studies are still required to investigate the seasonal variation in prevalence of metabolic syndrome criteria and metabolic syndrome diagnosis in bipolar disorder patients. Metabolic syndrome, which is more prevalent in individuals with major mental disorders such as schizophrenia and bipolar disorder than in general population, is an important health issue considering its association with cardiovascular diseases and high mortality and morbidity rates. Due to possible seasonal variation of metabolic disturbances, clinicians should monitor metabolic changes beside the mood changes in bipolar disorder patients.

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