**2.6 HOMA-IR determination**

Insulin resistance (IR) was estimated using the Homeostasis Model of Assessment equation: HOMA-IR = [fasting insulin (mU/L) × fasting glucose (mmol/L)]/22.5. IR was defined as the upper quartile of HOMA-IR. Values above 2.5 were taken as abnormal and reflect insulin resistance (Ozdemir et al., 2007). Bipolar patients with diabetes (n = 21) were excluded in the HOMA-IR analysis.
