Abstract：
BACKGROUND: Although several meta-analyses have examined the association between bipolar disorder (BD) and its comorbid health outcomes, this evidence has not been comprehensively assembled.
OBJECTIVE: We aimed to systematically review existing meta-analyses based on multiple physical outcomes and validate the evidence level by examining the existing certainty of evidence.
METHODS: We systematically searched databases, including PubMed/MEDLINE, Embase, Google Scholar, and CINAHL, for articles published up to July 2023. We included meta-analyses of cohort, case-control, and/or cross-sectional studies investigating any comorbid health outcomes in patients with BD. We conducted quality assessments of the included meta-analysis using AMSTAR2. The credibility of findings was categorized into five levels of class and quality of evidence (CE), including convincing, highly suggestive, suggestive, weak, or not significant.
RESULTS: We analyzed 12 meta-analyses, including 145 original articles, covering 14 unique health outcomes with over 60 million participants across 29 countries and five continents. Among 14 health outcomes, BD was significantly associated with eight comorbid health outcomes, including dementia (equivalent odds ratio [eOR], 2.96 [95 % confidence intervals {CI}, 1.69-5.17]; CE=suggestive), Parkinson\'s disease (3.35 [1.72-6.53]; CE=suggestive), asthma (1.86 [1.42-2.42]; CE=weak), toxoplasmosis (1.69 [1.21-2.37]; CE=weak), hypertension (1.28 [1.02-1.60]; CE=convincing), breast cancer (1.33 [1.15-1.55]; CE=weak), obesity (1.64 [1.30-1.99]; CE=suggestive), and type 2 diabetes mellitus (1.98 [1.55-2.52]; CE=weak).
CONCLUSIONS: Individuals with BD are predisposed to numerous comorbid physical conditions, though these links are supported by various evidence levels and necessitate further studies. It is imperative that physicians be aware of these potential comorbidities in patients with BD and take proactive measures to manage them.
OBJECTIVE: We aimed to systematically review existing meta-analyses based on multiple physical outcomes and validate the evidence level by examining the existing certainty of evidence.
METHODS: We systematically searched databases, including PubMed/MEDLINE, Embase, Google Scholar, and CINAHL, for articles published up to July 2023. We included meta-analyses of cohort, case-control, and/or cross-sectional studies investigating any comorbid health outcomes in patients with BD. We conducted quality assessments of the included meta-analysis using AMSTAR2. The credibility of findings was categorized into five levels of class and quality of evidence (CE), including convincing, highly suggestive, suggestive, weak, or not significant.
RESULTS: We analyzed 12 meta-analyses, including 145 original articles, covering 14 unique health outcomes with over 60 million participants across 29 countries and five continents. Among 14 health outcomes, BD was significantly associated with eight comorbid health outcomes, including dementia (equivalent odds ratio [eOR], 2.96 [95 % confidence intervals {CI}, 1.69-5.17]; CE=suggestive), Parkinson\'s disease (3.35 [1.72-6.53]; CE=suggestive), asthma (1.86 [1.42-2.42]; CE=weak), toxoplasmosis (1.69 [1.21-2.37]; CE=weak), hypertension (1.28 [1.02-1.60]; CE=convincing), breast cancer (1.33 [1.15-1.55]; CE=weak), obesity (1.64 [1.30-1.99]; CE=suggestive), and type 2 diabetes mellitus (1.98 [1.55-2.52]; CE=weak).
CONCLUSIONS: Individuals with BD are predisposed to numerous comorbid physical conditions, though these links are supported by various evidence levels and necessitate further studies. It is imperative that physicians be aware of these potential comorbidities in patients with BD and take proactive measures to manage them.
摘要：
背景：尽管一些荟萃分析已经检查了双相情感障碍（BD）与其合并症健康结果之间的关联，这些证据还没有全面收集。
目的：我们旨在基于多种物理结果系统地回顾现有的荟萃分析，并通过检查现有证据的确定性来验证证据水平。
方法：我们系统地搜索了数据库，包括PubMed/MEDLINE,Embase,谷歌学者，和CINAHL，截至2023年7月发表的文章。我们纳入了队列的荟萃分析，病例控制，和/或横断面研究调查BD患者的任何合并症健康结果。我们使用AMSTAR2对纳入的荟萃分析进行了质量评估。调查结果的可信度分为证据类别和质量(CE)五个级别，包括令人信服，高度暗示性，暗示,弱,或者不重要。
结果：我们分析了12项荟萃分析，包括145篇原创文章，涵盖14个独特的健康结果，在29个国家和五大洲有超过6000万参与者。在14项健康结果中，BD与八种合并症健康结果显着相关，包括痴呆症(等效优势比[EOR]，2.96[95%置信区间{CI}，1.69-5.17]；CE=暗示性)，帕金森病（3.35[1.72-6.53]；CE=暗示性），哮喘（1.86[1.42-2.42]；CE=弱），弓形虫病（1.69[1.21-2.37]；CE=弱），高血压（1.28[1.02-1.60]；CE=令人信服），乳腺癌（1.33[1.15-1.55]；CE=弱），肥胖（1.64[1.30-1.99]；CE=暗示性），和2型糖尿病（1.98[1.55-2.52]；CE=弱）。
结论：患有BD的个体易患多种合并症的身体状况，尽管这些联系得到了各种证据水平的支持，需要进一步的研究。医生必须意识到BD患者的这些潜在合并症，并采取积极措施进行管理。
目的：我们旨在基于多种物理结果系统地回顾现有的荟萃分析，并通过检查现有证据的确定性来验证证据水平。
方法：我们系统地搜索了数据库，包括PubMed/MEDLINE,Embase,谷歌学者，和CINAHL，截至2023年7月发表的文章。我们纳入了队列的荟萃分析，病例控制，和/或横断面研究调查BD患者的任何合并症健康结果。我们使用AMSTAR2对纳入的荟萃分析进行了质量评估。调查结果的可信度分为证据类别和质量(CE)五个级别，包括令人信服，高度暗示性，暗示,弱,或者不重要。
结果：我们分析了12项荟萃分析，包括145篇原创文章，涵盖14个独特的健康结果，在29个国家和五大洲有超过6000万参与者。在14项健康结果中，BD与八种合并症健康结果显着相关，包括痴呆症(等效优势比[EOR]，2.96[95%置信区间{CI}，1.69-5.17]；CE=暗示性)，帕金森病（3.35[1.72-6.53]；CE=暗示性），哮喘（1.86[1.42-2.42]；CE=弱），弓形虫病（1.69[1.21-2.37]；CE=弱），高血压（1.28[1.02-1.60]；CE=令人信服），乳腺癌（1.33[1.15-1.55]；CE=弱），肥胖（1.64[1.30-1.99]；CE=暗示性），和2型糖尿病（1.98[1.55-2.52]；CE=弱）。
结论：患有BD的个体易患多种合并症的身体状况，尽管这些联系得到了各种证据水平的支持，需要进一步的研究。医生必须意识到BD患者的这些潜在合并症，并采取积极措施进行管理。
