Insulin resistance in bipolar disorder: A systematic review of illness course and clinical correlates

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dc.coverageDOI: 10.1016/j.jad.2023.04.068
dc.creatorMiola, Alessandro
dc.creatorAlvarez-Villalobos, Neri A.
dc.creatorRuiz-Hernandez, Fernando Gerardo
dc.creatorDe Filippis, Eleanna
dc.creatorVeldic, Marin
dc.creatorPrieto, Miguel L.
dc.creatorSingh, Balwinder
dc.creatorSanchez Ruiz, Jorge A.
dc.creatorNunez, Nicolas A.
dc.creatorResendez, Manuel Gardea
dc.creatorRomo-Nava, Francisco
dc.creatorMcElroy, Susan L.
dc.creatorOzerdem, Aysegul
dc.creatorBiernacka, Joanna M.
dc.creatorFrye, Mark A.
dc.creatorCuellar-Barboza, Alfredo B.
dc.date2023
dc.date.accessioned2025-11-18T19:42:32Z
dc.date.available2025-11-18T19:42:32Z
dc.description<p>Background: Although insulin resistance (IR) and cardiometabolic syndrome are prevalent in patients with bipolar disorder (BD), only a few studies have attempted to precisely assess the degree and clinical impact of IR in BD. Methods: A comprehensive search was conducted from multiple research databases through May 2022, following a pre-defined protocol (PROSPERO: CRD42022359259). We extracted neuroimaging, cognition, illness course, and treatment response findings from individuals with BD with evidence of IR compared with euglycemic BD individuals. Results: Of 1436 identified articles, 10 reports fulfilling inclusion criteria were included (n = 1183). BD patients with IR displayed worse composite verbal memory scores and worse executive function and exhibited smaller hippocampal volumes along with prefrontal neurochemical alterations compared to euglycemic BD patients. Fixed-effect meta-analysis revealed that BD patients with impaired glucose metabolism (IGM) were more likely to develop a chronic and rapid cycling course when compared with euglycemic BD patients (k = 2, OR = 2.96, 95 % CI 1.69–5.17, OR = 2.88, 95 % CI 1.59–5.21, p &lt; 0.001, respectively), with a trend for significantly lower Global Assessment of Functioning scores (k = 5, MD = −4, 95 % CI −8.23–0.23, p = 0.06). BD patients with IGM displayed a higher rate of poor response to mood stabilizers when compared with euglycemic BD patients (k = 2, OR = 6.74, 95 % CI 1.04–43.54, p = 0.04). Limitations: Cross-sectional design and small sample sizes of studies included limit the generalizability of results. Conclusion: IR is associated with worse clinical outcomes of BD and inadequate treatment response. Implementing strategies to prevent and treat IR in BD is crucial to improve the prognosis of such a difficult-to-treat population.</p>eng
dc.identifierhttps://investigadores.uandes.cl/en/publications/c77a52ad-6979-4c55-a50f-7d1ddf29e996
dc.identifier.urihttps://repositorio.uandes.cl/handle/uandes/52398
dc.languageeng
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.sourcevol.334 (2023) date: 2023-08-01 p.1-11
dc.subjectBipolar disorder
dc.subjectClinical course
dc.subjectInsulin resistance
dc.subjectSystematic review
dc.subjectTreatment response
dc.subjectSDG 3 - Good Health and Well-being
dc.titleInsulin resistance in bipolar disorder: A systematic review of illness course and clinical correlateseng
dc.typeReview articleeng
dc.typeArtículo de revisiónspa
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