Longitudinal associations between post-traumatic stress disorder and metabolic syndrome severity

Abstract

Background Posttraumatic stress disorder (PTSD) is associated with elevated risk for metabolic syndrome (MetS). However, the direction of this association is not yet established, as most prior studies employed cross-sectional designs. The primary goal of this study was to evaluate bidirectional associations between PTSD and MetS using a longitudinal design. Methods 1,355 male and female veterans of the conflicts in Iraq and Afghanistan underwent PTSD diagnostic assessments and their biometric profiles pertaining to MetS were extracted from the electronic medical record at two time points (spanning ~2.5 years, n = 971 at time 2). Results The prevalence of MetS among veterans with PTSD was just under 40% at both time points and was significantly greater than that for veterans without PTSD; the prevalence of MetS among those with PTSD was also elevated relative to age-matched population estimates. Cross-lagged panel models revealed that PTSD severity predicted subsequent increases in MetS severity (β = .08, p = .002), after controlling for initial MetS severity, but MetS did not predict later PTSD symptoms. Logistic regression results suggested that for every 10 PTSD symptoms endorsed at time 1, the odds of a subsequent MetS diagnosis increased by 56%. Conclusions Results highlight the substantial cardiometabolic concerns of young veterans with PTSD and raise the possibility that PTSD may predispose individuals to accelerated aging, in part, manifested clinically as MetS. This demonstrates the need to identify those with PTSD at greatest risk for MetS and to develop interventions that improve both conditions.

Sex Differences in Obesity and Mental Health

“…In a separate analysis, PTSD was associated with 6-year weight gain, both independently and via higher rates of binge eating and loss of control eating, for both sexes [31]. A separate longitudinal study following veterans for 2.5 years also found cross-sectional and prospective associations between PTSD and both obesity and metabolic syndrome that did not differ by sex [32].…”

Contributions of polygenic risk for obesity to PTSD-related metabolic syndrome and cortical thickness

“…Two recent meta-analyses found that the prevalence of MetS was approximately two times higher in PTSD samples compared to controls, with an estimated prevalence of approximately 40% (Bartoli et al, 2013; Rosenbaum et al, 2015b). Moreover, a recent longitudinal study of young veterans returning from the wars in Iraq and/or Afghanistan found evidence of premature development of MetS among those with PTSD and suggested that PTSD severity was associated with increasing metabolic risk over time (Wolf et al, 2016a). …”

Letter to the Editor: Posttraumatic stress disorder has genetic overlap with cardiometabolic traits

“…Growing research links posttraumatic stress disorder (PTSD) to a range of cardiometabolic conditions, including metabolic syndrome, heart disease, stroke, and type 2 diabetes (Heppner et al , 2009, Koenen et al , 2017, Roberts et al , 2015, Sumner et al , 2015, Wolf et al , 2016). A number of behavioral (e.g., poor diet, physical inactivity, cigarette smoking, substance use) and physiological (e.g., dysregulation of biological stress response systems, such as the hypothalamic-pituitary-adrenal axis, autonomic nervous system, and immune system) pathways have been proposed to underlie associations between PTSD and cardiometabolic risk (Dedert et al , 2010, Koenen et al , 2017, van Liempt et al ., 2013; Wentworth et al , 2013).…”