Increase In Abdominal Obesity Research Articles

Analysis of significant weight gain in patients using alectinib for ALK-positive lung cancer.

e21138 Background: Alectinib is standard of care for metastatic anaplastic lymphoma kinase positive (ALK+) nonsmall cell lung cancer (NSCLC). Weight gain is an unexplored side effect reported in ~10%. To prevent or intervene alectinib-induced weight gain, more insight in its extent and etiology is needed. Methods: Change in body composition was analyzed in a prospective series of 46 patients with ALK+ NSCLC, treated with alectinib. Waist circumference, skeletal muscle (SM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were quantified using sliceOmatic software on computed tomography (CT) images at baseline, three months (3M) and one year (1Y). To investigate an exposure-toxicity relationship, alectinib plasma concentrations were quantified. Four patients with > 10 kg weight gain were referred to Erasmus MC Obesity Center for in-depth analysis (dietary habits, metabolic/endocrine assessment). Results: Mean increase in waist circumference was 9 cm (9.7%, p < 0.001) in 1Y with a 40% increase in abdominal obesity (p = 0.014). VAT increased 10.8 cm2 (15.0%, p = 0.003) in 3M and 35.7 cm2 (39.0%, p < 0.001) in 1Y. SAT increased 18.8 cm2 (12.4%, p < 0.001) in 3M and 45.4 cm2 (33.3%, p < 0.001) in 1Y. The incidence of sarcopenic obesity increased from 23.7% to 47.4% during 1Y of treatment. Baseline waist circumference was a positive predictor of increase in VAT (p = 0.037). No exposure-toxicity relationship was found. In-depth analysis showed increased appetite in two patients and metabolic syndrome in all four patients. Conclusions: Alectinib caused significant increased abdominal obesity, sarcopenic obesity, SAT and VAT quickly after initiation. This may lead to serious metabolic disturbances in long-surviving patients.[Table: see text]

Analysis of Serious Weight Gain in Patients Using Alectinib for ALK-Positive Lung Cancer

IntroductionAlectinib is a standard-of-care treatment for metastatic ALK+ NSCLC. Weight gain is an unexplored side effect reported in approximately 10%. To prevent or intervene alectinib-induced weight gain, more insight in its extent and etiology is needed. MethodsChange in body composition was analyzed in a prospective series of 46 patients with ALK+ NSCLC, treated with alectinib. Waist circumference, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and skeletal muscle were quantified using sliceOmatic software on computed tomography images at baseline, 3 months (3M), and 1 year (1Y). To investigate an exposure-toxicity relationship, alectinib plasma concentrations were quantified. Four patients with more than 10 kg weight gain were referred to Erasmus MC Obesity Center CGG for in-depth analysis (e.g., assessments of appetite, dietary habits, other lifestyle, medical and psychosocial factors, and extensive metabolic and endocrine assessments, including resting energy expenditure). ResultsMean increase in waist circumference was 9 cm (9.7%, p < 0.001) in 1Y with a 40% increase in abdominal obesity (p = 0.014). VAT increased to 10.8 cm2 (15.0%, p = 0.003) in 3M and 35.7 cm2 (39.0%, p < 0.001) in 1Y. SAT increased to 18.8 cm2 (12.4%, p < 0.001) in 3M and 45.4 cm2 (33.3%, p < 0.001) in 1Y. The incidence of sarcopenic obesity increased from 23.7% to 47.4% during 1Y of treatment. Baseline waist circumference was a positive predictor of increase in VAT (p = 0.037). No exposure-toxicity relationship was found. In-depth analysis (n = 4) revealed increased appetite in two patients and metabolic syndrome in all four patients. ConclusionsAlectinib may cause relevant increased sarcopenic abdominal obesity, with increases of both VAT and SAT, quickly after initiation. This may lead to many serious metabolic, physical, and mental disturbances in long-surviving patients.

The global agenda on obesity: what does this mean for Singapore?

The global agenda on obesity: what does this mean for Singapore?

Prevalence of general and abdominal obesity in 2015–2016 and 8-year longitudinal weight and waist circumference changes in adults and elderly: the Tromsø Study

ObjectivesTo describe the prevalence of general (body mass index (BMI) ≥30 kg/m2) and abdominal (waist circumference women >88 cm, men >102 cm) obesity in Tromsø 7 (2015–2016), and the secular...

Waist-height ratio in children of 7 to 11 years with high weight at birth and its relationship with gender, age and diet

IntroductionObesity (OB), considered as one of the Non-Transmissible Chronic Diseases, has as its fundamental characteristics that of being prevalent at a global level, increasing in number, affecting developed and developing countries, affecting both genders, and all ages and social groups. ObjectiveTo identify if high birth weight is a predictive factor (risk factor) for abdominal obesity in children 7–11 years old, and its relationship to gender and age. MethodA case-control descriptive study was carried out with children born between January 1992 and December 1995, in order to identify early risk factors (atherosclerotic accelerators) such as abdominal obesity in children aged 7–11, and who have a history of macrosomia or high birth weight, as well as their relationship with gender and age. ResultsIt was observed that the waist/height value was normal in 60.8% of the study group and in 64.00% in the control group. The difference between groups, gender, and age was not significant (p=0.6859). As regards the diet in the study group (macrosomic), there was no significant association between the type of diet and waist circumference/height values, with an χ2=0.223 and p=0.6373 (not significant). In the control group (with normal weight at birth), it was found that there is a significant statistical association between the type of diet and waist circumference/height values. This means that it can be stated, with 95% reliability, that the type of diet is associated with waist/height values. ConclusionsHigh birth weight is not a predictive factor (risk factor) for abdominal obesity (increased waist/height index). Gender and age are independent for abdominal obesity (macrosomic and normal weight at birth). The diet in high birth weight children is not related to the index waist–height index, which is not the case in those born with normal weight under the same conditions. The marked increase in abdominal obesity (waist/height index) in children between 7 and 11 years old in both groups is worrying.

Índice cintura/estatura en niños de 7 a 11 años con alto peso al nacer y su relación con el sexo, la edad y la dieta

IntroductionObesity (OB), considered as one of the Non-Transmissible Chronic Diseases, has as its fundamental characteristics that of being prevalent at a global level, increasing in number, affecting developed and developing countries, affecting both genders, and all ages and social groups. ObjectiveTo identify if high birth weight is a predictive factor (risk factor) for abdominal obesity in children 7 to 11 years old, and its relationship to gender, age and diet. MethodA case-control descriptive study was carried out with children born between January 1992 and December 1995, in order to identify early risk factors (atherosclerotic accelerators) such as abdominal obesity in children aged 7 to 11, and who have a history of macrosomia or high birth weight, as well as their relationship with gender, age and diet. ResultsIt was observed that the waist/height value was normal in 60.8% of the study group and in 64.00% in the control group. The difference between groups, gender, and age was not significant (P=.6859). As regards the diet in the study group (macrosomic), there was no significant association between the type of diet and waist circumference/height values, with an χ2=0.223 and P=.6373 (not significant). In the control group (with normal weight at birth), it was found that there is a significant statistical association between the type of diet and waist circumference/height values. This means that it can be stated, with 95% reliability, that the type of diet is associated with waist/height values. ConclusionsHigh birth weight is not a predictive factor (risk factor) for abdominal obesity (increased waist/height index). Gender and age are independent for abdominal obesity (macrosomic and normal weight at birth). The diet in high birth weight children is not related to the index waist-height index, which is not the case in those born with normal weight under the same conditions. The marked increase in abdominal obesity (Waist/height index) in children between 7 and 11 years old in both groups is worrying.

Cardio-metabolic and socio-environmental correlates of waist-to-height ratio in German primary schoolchildren: a cross-sectional exploration

BackgroundControversial messages of childhood obesity emerge: Levelling off in terms of body mass index (BMI) is foiled by increases in abdominal obesity. Waist-to-height ratio (WHtR) may be used as a screening tool for abdominal obesity in children. The aim of this study was to investigate clinical and socio-environmental correlates of abdominal obesity in primary schoolchildren.MethodsCross-sectional data from 753 children participating in baseline assessments of the outcome evaluation of a school-based prevention program were analysed. Abdominal obesity was defined as WHtR ≥0.5. According to German age and sex-specific BMI-percentiles, overweight (>90th percentile) and obesity (>97th percentile) were determined. Anthropometric and sonographic measurements, blood pressure and blood samples were taken by clinical staff in a standardized manner. Socio-environmental and lifestyle data were assessed via parental questionnaires. Differences between abdominally obese children and others, and correlations of WHtR with clinical data were tested. Socio-environmental correlates of abdominal obesity were explored in a logistic regression analysis.ResultsAt the time of the examination children were 7.57 ± 0.42 years old. Abdominal obesity was observed in 132 (17.5%) children. According to BMI-percentiles, 22.9% of these children were obese, 38.2% overweight, and 38.2% normal weight. Affected children more often used screen media and less often participated in club sports. Abdominal obesity was associated with higher blood pressure, lower HDL- and higher LDL-cholesterol. WHtR significantly correlated with intra-abdominal fat thickness (IAF). The logistic regression model revealed migration background (odds ratio (OR) 2.12, 95% confidence interval (CI) [1.41, 3.19]), smoking during pregnancy (OR 2.30, 95% CI [1.37, 3.86]), parental obesity (OR 1.95, 95% CI [1.22, 3.10]) and higher educational level (OR 0.64, 95% CI [0.42, 0.98]) to be significantly associated with abdominal obesity in children.ConclusionWHtR correlates strongly with IAF. Abdominal obesity in primary schoolchildren is associated with cardio-metabolic risk factors and also occurs in otherwise normal weight children. Against the background of rising numbers of abdominal obesity in children, targeted preventive measures are long overdue. The focus of such measures should be used on children with migration background and involve parents, especially those who are obese and those with lower educational levels.

Changes in Waist Circumference and Abdominal Obesity among Chinese Adults over a Ten-year Period

ObjectiveThe aim of this study was to describe changes in waist circumference (WC) and prevalence of abdominal obesity over a period of 10 years among Chinese adults in different socio-economic status (SES). MethodsData derived from the China Nutrition and Health Surveillance during 2002 and 2010-2012. We calculated the mean WC and the prevalence of abdominal obesity by gender, place of residence, SES indicators (education, income, and marital status), and body mass index (BMI) categoriesand used pooled t-tests to assess the differences between the two time periods. Results26.0% of men and 25.3% of women had abdominal obesity in 2010-2012. The age-adjusted mean WC increased by 2.7 cm among men and 2.1 cm among women; the age-adjusted prevalence of abdominal obesity increased by 7.7% among men and 5.3% among women. The rising trends were observed in all subgroups except for a negative growth in high-income women. People living in rural areas with low education and income and with a BMI of 18.5 to 23.9 kg/m2 had a greater absolute and relative increase in WC. People living in rural areas with low income had a greater relative increase in abdominal obesity. ConclusionThe mean WC and prevalence of abdominal obesity among Chinese adults have increased during the past 10 years. Gender differences were noted using various SES indicators.

EVALUACIÓN DE LA ADIPOSIDAD CORPORAL SEGÚN ÍNDICE DE MASA CORPORAL Y CIRCUNFERENCIA DE CINTURA EN JÓVENES UNIVERSITARIOS

Objective: To analyze the differences in body adiposity determined by the Body Mass Index (BMI) and the Circumference of the Waist (WC) according to age groups in university students of both sexes. Material and method: 330 university students, 152 male and 178 female, from a University of the Central Zone of Chile, were evaluated. Three groups were formed according to age (18 to 20 years, 21 to 23 years and 24 to 26 years) and the prevalence of overweight and obesity was determined according to BMI and WC. Results: In women, both for BMI and WC there were no significant differences between the three age groups. In men there were no significant differences in the three age groups by BMI, however there were differences in WC, since the group of 18 to20 years had lower WC than the other 2 age groups (p 0.05). Conclusion: WC appears to be a more accurate indicator than BMI, since it reflects significant increases in abdominal obesity at older ages, at least in male university students, although more confirmatory studies are needed.

Latent autoimmune diabetes in adults (LADA) in Asian and European populations.

Diabetes mellitus is a chronic disorder caused by relative or absolute insulin deficiency and characterized by chronic hyperglycaemia. It is expected that by year 2025, 80% of all type 2 diabetic patients will be living in developing or low- and middle-income countries. Among Asians, there has been an overall increase in abdominal obesity; however, the risk of diabetes in these populations starts at much lower body mass index as compared to Caucasians. A significant proportion of diabetic patients with adult-onset, initially nonrequiring insulin treatment, have diabetes-associated autoantibodies in their sera. A new subclass of diabetes with the designation of latent autoimmune diabetes of adult-onset (LADA) has been proposed for this category of subjects. Studies have demonstrated that patients with autoimmune diabetes, characterized by the presence of glutamic decarboxylase autoantibodies display a different clinical phenotype from classical type 2 diabetes without glutamic decarboxylase autoantibodies. This subset of phenotypic type 2 diabetes subjects with islet autoantibodies tend to have sulphonylurea failure and need insulin treatment earlier in the disease process. Diagnosing LADA at an initial stage will be important so that insulin can be initiated earlier, facilitating improved glycemic control sooner as well as the preservation of residual beta-cell function in adult-onset autoimmune diabetes. Because of differences in dietary habits, environmental factors, and phenotypic characteristics between European and Asian populations, there may be heterogeneity in the prevalence and other characteristics of LADA in these two populations.

Obesity and related consequences to ageing.

Obesity has become a major public health problem. Given the current increase in life expectancy, the prevalence of obesity also raises steadily among older age groups. The increase in life expectancy is often accompanied with additional years of susceptibility to chronic ill health associated with obesity in the elderly. Both obesity and ageing are conditions leading to serious health problems and increased risk for disease and death. Ageing is associated with an increase in abdominal obesity, a major contributor to insulin resistance and the metabolic syndrome. Obesity in the elderly is thus a serious concern and comprehension of the key mechanisms of ageing and age-related diseases has become a necessary matter. Here, we aimed to identify similarities underlying mechanisms related to both obesity and ageing. We bring together evidence that age-related changes in body fat distribution and metabolism might be key factors of a vicious cycle that can accelerate the ageing process and onset of age-related diseases.

Prevalence and risk factors of abdominal obesity in Polish rural children

Secular trends of body mass index (BMI) and waist circumference indicate greater increase in abdominal obesity compared to general obesity. Determinants of obesity described by BMI are relatively well documented in various populations, unlike abdominal obesity described by waist-to-height ratio (WHtR). The aim of the study was to determine prevalence and abdominal obesity (WHtR) risk factors in a cohort of 3048 rural children aged 7–12 years from southern Poland. Biological, socio-demographic and lifestyle factors were analysed, and odds ratio and 95% confidence interval were calculated using a logistic regression analysis. The prevalence of abdominal obesity in rural boys and girls in the sample was 11% and 9% respectively. Obesity in both parents, irregular breakfasts, irregular meals during the day and regularly consumed tea were significant factors of abdominal obesity risks in rural girls. Being the only child, low number of people in a household, obesity in both parents, high energy-dense food index and no exercise significantly increased the risk of abdominal obesity in rural boys. The study demonstrated tendencies similar to other European countries in the prevalence of abdominal obesity among sexes. Lifestyle behaviours should be changed and adapted to each sex since risk factors differ between the sexes and indicate higher eco-sensitivity in boys.

Clinical characteristics of metabolic syndrome in Korea, and its comparison with other Asian countries.

Metabolic syndrome is referred to as syndrome X or insulin resistance syndrome, and is primarily composed of abdominal obesity, diabetes, glucose intolerance, dyslipidemia and high blood pressure. Asians have a lower frequency of obesity than Caucasians, but have an increasing tendency toward metabolic syndrome. Thus, metabolic syndrome poses a major challenge for public health professionals, and is set to become a social and economic problem in Asian populations. Most data on metabolic syndrome are based on studies from Western countries with only limited information derived from Asian populations. Recently, several studies were carried out on a large scale that represents the general Korean population. The prevalence of metabolic syndrome in Korean adults has varied depending on the study designs and different criteria, but shows a distinct increasing trend of metabolic syndrome driven by an increase in abdominal obesity and dyslipidemia. Given the rapid economic progression of Korea over the past 30 years along with a rise of the aged population, it is expected that the prevalence of metabolic syndrome will further increase. Therefore, a proactive strategy at the governmental level for metabolic syndrome prevention should be implemented, reducing abdominal obesity and dyslipidemia. Healthy dietary habits and regular exercise should be emphasized as a part of such a strategy.

Prevalence and association of physical activity with obesity: an urban, community-based, cross-sectional study.

Aim:To study levels of physical activity and various measures of obesity and their association in an urban population.Study Design:Cross sectional.Materials and Methods:One thousand and forty-seven individuals between the ages 25-64 years systematically sampled from a community-based population database were contacted through a house-to-house survey. We adopted the WHO STEPS guidelines for conducting this study. Anthropological measures collected were height, weight, and waist and hip circumference.Results:Physical Activity (PA) levels declined with age and the decline was greater among females. The Pearson's correlation coefficient for age against PA among males was found to be negative and weak (r = –0.104) and that among females was found to be similar (r = –0.206). The prevalence of obesity was higher among females (28.8 %) than among males (13.3 %) and the difference was statistically significant. There was a progressive increase in abdominal obesity with age in both genders. The prevalence of overweight and obesity was higher among individuals with low levels of PA as compared to those with high levels of PA.Conclusion:Sedentary behavior is prevalent in more than half of the current study sample. This was more so with increasing age, female gender and increasing obesity. PA is an important component on long-term weight control, and therefore adequate levels of activity should be prescribed to combat the obesity epidemic. Habitual moderate physical activity may be beneficial in preventing excess accumulation of fat.

Early increase of abdominal adiposity in patients with spondyloarthritis receiving anti-tumor necrosis factor-α treatment.

Patients with spondyloarthritis (SpA) receiving anti-TNF-α treatment have an increase in fat mass. This may be relevant to cardiovascular risk. The aim of this study was to estimate visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) changes by dual-energy x-ray absorptiometry (DEXA) in patients with SpA under anti-TNF-α therapy. We used an ancillary protocol to an open, prospective 2-year followup study of patients with SpA. Waist circumference (WC), body weight, body mass index, VAT, and SAT were measured at baseline, 6 months, and 1 and 2 years. Univariate and multivariate analyses were performed to assess variables associated with VAT and SAT changes. A total of 85 patients were analyzed. Patients were 39.3 ± 11.4 years old and mean baseline Bath Ankylosing Spondylitis Disease Activity Index was 55.0 ± 20.2. Treatment was effective according to clinical and biological variables, and body weight increased by 0.9 ± 1.7 kg over 2 years. There was a significant gain in VAT after 6 months (13.7 ± 20.6 cm(2), p < 0.0001), 1 year (21.0 ± 26.6 cm(2), p < 0.0001), and after 2 years (29.1 ± 33.4 cm(2), p < 0.0001); and in SAT after 6 months (12.5 ± 27.4 cm(2), p < 0.0001), 1 year (27.1 ± 38.2 cm(2), p < 0.0001), and after 2 years (31.9 ± 53.2 cm(2), p < 0.0001). We could not find any determinant of these changes by multivariate analysis. In patients with SpA receiving anti-TNF-α therapy, there is an early significant increase in abdominal obesity with significant increase in both VAT and SAT after 1 and 2 years of treatment. Prospective studies are required to investigate the relationship between these changes and cardiovascular risk.

Future Cardiovascular Risk

Cardiovascular (CV) disease is the leading cause of death in women over the age of 50. Risk factors related to the increase in CV disease after transition into menopause include an increase in abdominal obesity, dyslipidemia, insulin resistance, and hypertension.1 Recent studies indicate that a history of preeclampsia increases future CV risk.2–4 Based on these findings, the National Institutes of Health sponsored a workshop in 2010 entitled, “Bridging Preeclampsia and Future Cardiovascular Disease.”5 The aims of the workshop were to “identify knowledge gaps and research opportunities” to facilitate the prevention of future CV risk in women who develop preeclampsia during pregnancy.5 Recommendations provided to the National Heart, Lung and Blood Institute from the workshop initiated with an aim to use “already established cohort studies.” It was suggested that studies or trials with well-defined diagnoses of preeclampsia could be used to prospectively follow patients long-term to assess CV outcome and to determine the progression of chronic disease. Article see p 681 In this issue of Circulation , Mannisto and colleagues6 present a large population-based prospective study with the use of the Northern Finland Birth Cohort 1966 that elegantly addresses the first recommended initiative from the National Heart, Lung and Blood Institute Workshop on preeclampsia and future CV risk. The Northern Finland Birth Cohort 1966 initiated with routine prenatal visits …

Trends in overweight and obesity over 22 years in a large adult population: the HUNT Study, Norway.

Some reports indicate that the obesity epidemic may be slowing down or halting. We followed body mass index (BMI) and waist circumference (WC) in a large adult population in Norway (n = 90 000) from 1984–1986 (HUNT1) through 1995–1997 (HUNT2) to 2006–2008 (HUNT3) to study whether this is occurring in Norway. Height and weight were measured with standardized and identical methods in all three surveys; WC was also measured in HUNT2 and HUNT3. In the three surveys, mean BMI increased from 25.3 to 26.5 and 27.5 kg m−2 in men and from 25.1 to 26.2 and 26.9 kg m−2 in women. Increase in prevalence of obesity (BMI ≥ 30 kg m−2) was greater in men (from 7.7 to 14.4 and 22.1%) compared with women (from 13.3 to 18.3 and 23.1%). In contrast, women had a greater increase in abdominal obesity (WC ≥ 102 cm for men and WC ≥ 88 cm for women). There was a continuous shift in the distribution curve of BMI and WC to the right, demonstrating that the increase in body weight was occurring in all weight groups, but the increase of obesity was greatest in the youngest age groups. Our data showed no signs of a halt in the increase of obesity in this representative Norwegian population.

Longitudinal Relationship of Depressive and Anxiety Symptoms With Dyslipidemia and Abdominal Obesity

Previous research indicates that patients with severe symptoms of depression or anxiety are prone toward the development of dyslipidemia and abdominal obesity. We sought to study these associations longitudinally. Among 2126 Netherlands Study of Depression and Anxiety participants, we studied whether severity of depressive (Inventory of Depressive Symptoms) or anxiety (Beck Anxiety Inventory) symptoms at baseline was associated with changes in lipids (i.e., total, high-density lipoprotein [HDL] or low-density lipoprotein cholesterol, and triglycerides) or waist circumference during a 2-year follow-up period. We also examined whether changes in severity of symptoms were associated with changes in lipid or waist circumference levels over these 2 years. Multivariate linear regression analyses were adjusted for age, sex, education, and tobacco consumption. Baseline symptoms of depression or anxiety predicted a decrease in HDL cholesterol (adjusted β = -.062 [p = .003] and β = -.050 [p = .02], respectively) and an increase in waist circumference (adjusted β = .060 [p = .01] and β = .053 [p = .02], respectively) for 2 years. Reduction of symptoms of depression or anxiety over time did not coincide with an amelioration of lipid or waist circumference values. People with initially severe symptoms of depression or anxiety showed a subsequent decrease in HDL cholesterol levels and an increase in abdominal obesity over time, independent of a potential reduction in symptom severity in this period. Therefore, such people are at elongated and increasing risk for dyslipidemia and obesity, predisposing them to cardiovascular disease.

Do women with PCOS have a unique predisposition to obesity?

Women with PCOS are often obese and there is debate in the literature regarding whether women are obese because of their PCOS status or if those who become obese are more predisposed to PCOS. There is support for a predisposition to obesity by some data indicating impaired metabolism in PCOS women compared to weight matched controls but this data is limited. Contrary data also exist that adiposity rates do not vary between women with PCOS and those without, and that differences in obesity rates between countries are more likely due to environmental and lifestyle factors. Until further data are available, lifestyle recommendations for weight reduction in women with PCOS should be similar to those for women without PCOS.

Ziprasidone with adjunctive mood stabilizer in the maintenance treatment of bipolar I disorder: Long-term changes in weight and metabolic profiles

This analysis was conducted to compare the effects of adjunctive ziprasidone or placebo on metabolic parameters among patients receiving maintenance treatment with lithium or valproate. We also tested whether metabolic syndrome (MetS) and other risk factors were associated with baseline characteristics and treatment response. In the stabilization phase (Phase 1), 584 bipolar I disorder (DSM-IV) patients received 2.5–4 months of open label ziprasidone (80–160 mg/d) plus lithium or valproic acid (ZIP + MS). Patients who achieved at least 8 weeks of clinical stability were subsequently randomized into Phase 2 to 6-months of double-blind treatment with ZIP + MS (n = 127) vs. placebo + MS (n = 113). At baseline of Phase 1, MetS was found in 111 participants (23%). Participants with MetS (vs. non-MetS participants) were more likely to be aged 40 years or older, had significantly more severe manic symptoms, higher abdominal obesity, and higher BMI. Increase in abdominal obesity was associated with lower manic symptom improvement (p < 0.05, as assessed by MRS change score) during Phase 1, while symptom improvement differed across racial groups. In the Phase 2 double-blind phase, the ZIP + MS group had similar weight and metabolic profiles compared to the placebo + MS group across visits. These results corroborate existing findings on ziprasidone which exhibits a neutral weight and metabolic profile in the treatment of schizophrenia and bipolar patients. Our findings suggest that MetS is highly prevalent in patients with bipolar disorder, may be associated with greater manic symptom severity, and may predict treatment outcomes.