INTRODUCTION & OBJECTIVE: People with severe mental illnesses such as schizophrenia, depression or bipolar disorder have worse physical health and a shorter life expectancy than the general population. Although in literature HbA1c is included amongst independent risk factors for the development of cardiovascular disease it is less well researched in psychiatric disorders. In this study, we aimed to investigate the relationship between glycemic control and serum lipid profile in patients with depression, bipolar disorder and schizophrenia, and the effect of HbA1c on dyslipidemia between disease groups.
METHOD: The study included 129 patients from Bakirköy Prof. Dr. Mazhar Osman Mental Health and Neurological Diseases Training and Research Hospital, 15th Women's Psychiatry Clinic, who were hospitalized between October 2016 - February 2017 and according to DSM-5 diagnosis criteria, diagnosed with depressive disorder (n=28;21.7%), bipolar disorder (n=50;38.8%) and schizophrenia (n=51;39.5%). Patients were measured for height (cm), weight (kg), body mass index (kg / m2), systolic and diastolic blood pressure (mmHg) Blood was taken after fasting for 8-12 hours; and glucose, HbA1c, lipid panel (cholesterol, LDL, HDL, triglyceride) were studied. The mean age of patients was calculated as 39±12,4; total number of hospitalizations: 3 ± 3.2; total length of stay: 54.3 ± 58.8 days; mean disease duration: 88.1 ± 103.4 months. No significant difference between HbA1c, cholesterol, LDL, HDL, triglyceride values were observed when the patient groups were compared. When a correlation analysis was applied on all patients, a meaningful correlation between HbA1c values and cholesterol (+0.254), LDL (+0.250), HDL (-0.217), triglyceride (+0.350), weight (+0.358), body mass index (BMI) (+0.370), systolic (+0.204) and diastolic blood pressure (+0.207) values was found. When examined individually, no correlation was found between HbA1c values and lipid panels for depression patients; and for schizophrenia, a meaningful correlation was found between HbA1c and triglyceride (+0.320), HDL (-0.343), weight (+0.481) and BMI (+0.467) values and for bipolar patients a meaningful correlation was found between HbA1c and triglyceride (+0.578), cholesterol (+0.434), LDL (+0.327), diastolic blood pressure (+0.427) and BMI (+0.334) values.
DISCUSSION & CONCLUSION: We can conclude that HbA1c is associated with lipid profile in psychiatric patients, especially in patients with schizophrenia and bipolar disorder. Patients who were first hospitalized also showed that the correlation between HbA1c and lipid profile was not significant for the three psychiatric disorders. This suggests that the psychotropics used in chronic diseases such as schizophrenia and bipolar disorder have a similar correlation between HbA1c and lipid profile, almost similar to those of type 2 diabetes patients. Serum HbA1c levels in psychiatric patients may be useful in the prediction, detection and management of metabolic and cardiovascular events.