Metabolic Syndrome in People Suffering from Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis

Bartoli, Francesco; Carrà, Giuseppe; Crocamo, Cristina; Carretta, Daniele; Clerici, Massimo

doi:10.1089/met.2013.0010

Cited by 83 publications

(69 citation statements)

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“…Similarly, 19%-26% of the patients with schizophrenia met at least two criteria and 23%-26% of the patients fulfilled at least one criterion of metabolic syndrome. The prevalence of metabolic syndrome in these patients is close to the 36% of 1 PTSD patients with metabolic syndrome reported by Bartoli et al 6 Thus, it remains unclear whether PTSD confers any special risk for metabolic syndrome when compared with other psychiatric disorders.…”

supporting

confidence: 54%

“…1 The importance of metabolic syndrome is that it confers at least a two-fold increased risk of cardiovascular disease and at least five-fold increased risk for subsequent diabetes. [2][3][4][5] In their report in Metabolic Syndrome and Related Disorders, Bartoli et al 6 study the association of posttraumatic stress disorder (PTSD) and metabolic syndrome. The authors found six studies that met their criteria for inclusion in their meta-analysis involving 528 subjects with PTSD and 846 comparison patients; 5 of these had at least a trend toward a positive association.…”

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Posttraumatic Stress Disorder and Metabolic Syndrome: More Questions Than Answers

Schwenke

Siegel²

2013

Metabolic Syndrome and Related Disorders

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T he criteria for metabolic syndrome as identified by the modified National Cholesterol Education PanelAdult Treatment Panel (NCEP-ATP III) include abdominal obesity, an atherogenic dyslipidemia manifest as elevated levels of triglycerides (TGs) and low levels of high density lipoprotein-cholesterol (HDL-C), raised blood pressure, and impaired fasting glucose. 1 The importance of metabolic syndrome is that it confers at least a two-fold increased risk of cardiovascular disease and at least five-fold increased risk for subsequent diabetes. [2][3][4][5] In their report in Metabolic Syndrome and Related Disorders, Bartoli et al. 6 study the association of posttraumatic stress disorder (PTSD) and metabolic syndrome. The authors found six studies that met their criteria for inclusion in their meta-analysis involving 528 subjects with PTSD and 846 comparison patients; 5 of these had at least a trend toward a positive association. The studies included both men and women (although two of the studies were exclusively and one 92% men) with mean ages of 43.7-61 years of age (one study reported age as < 40 or ‡ 40 years of age). Four studies were of war veterans, one was of police officers, and one was of subjects recruited from the waiting rooms of primary care clinics at a busy inner city hospital. Four papers were from the United States and two were from Europe (Bosnia and Herzegovina). Individuals suffering from PTSD were more likely (36%) than the general population (28%) to have dyslipidemia, hypertension, diabetes, and obesity. The pooled odds ratio [95% confidence intervals (CI)] for metabolic syndrome in people suffering from PTSD was 1.37 (1.03-1.82) compared with those without PTSD.The findings in this meta-analysis are of interest, but several questions remain. Much remains to be learned concerning whether the relationship between PTSD and metabolic syndrome is independent of other factors that have been associated with metabolic syndrome or metabolic syndrome components. For example, lower socioeconomic class, 7 poor dietary quality, 8 physical inactivity/increased sedentary behavior, 9 active smoking, 10 increased alcohol consumption, 11 and specific symptoms of insomnia, including difficulty falling asleep and unrefreshing sleep, 12 have been associated with metabolic syndrome or metabolic syndrome components in individuals without psychiatric disorders. One of the most commonly reported symptoms of PTSD is insomnia. 13 PTSD is also associated with poor dietary quality, physical inactivity, higher rates of smoking, and increased alcohol consumption. 14 Importantly, several behavioral factors that are more prevalent in individuals with PTSD, including poor dietary quality, 15 active smoking, 10 and higher alcohol consumption 11 are prospectively associated with metabolic syndrome/metabolic syndrome components incidence. Among Iraq combat veterans, worsening insomnia during deployment predicted worsening PTSD symptoms, whereas worsening PTSD did not predict worsening insomnia, 16 suggesting that insomnia may pla...

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Posttraumatic Stress Disorder and Metabolic Syndrome: More Questions Than Answers

Schwenke

Siegel²

2013

Metabolic Syndrome and Related Disorders

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“…Key words used were "metabolic syndrome" AND "posttraumatic stress disorder" in the title, abstract or index term fields. Manual searches were also conducted using the reference lists from recovered articles and the meta-analysis of Bartoli et al [19]. After the removal of duplicates, both reviewers screened the titles and abstracts of all potentially eligible articles.…”

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confidence: 99%

The prevalence and risk of metabolic syndrome and its components among people with posttraumatic stress disorder: a systematic review and meta-analysis

Rosenbaum¹,

Stubbs²,

Ward³

et al. 2015

Metabolism

190

105

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The prevalence and risk of metabolic syndrome and its components among people with posttraumatic stress disorder: A systematic review and meta-analysis, Metabolism (2015Metabolism ( ), doi: 10.1016Metabolism ( /j.metabol.2015 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.A C C E P T E D M A N U S C R I P T Random effects meta-analysis with a relative risk, subgroups and meta-regression analyses were employed.Results: Overall, 9 studies met the inclusion criteria including 9,254 individuals in midlife with PTSD and 6,852 general population controls. Conclusions: MetS is highly prevalent in people with PTSD. Routine screening and multidisciplinary management of medical and behavioral conditions is needed. Future A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPTresearch should focus on how cardio-metabolic outcomes are moderated by clinical and treatment characteristics and genetic factors.

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“…Early life and chronic stress may have a negative impact on feeding behaviours leading to poor dietary habits and low exercise activity via altering hypothalamic-pituitary-adrenal (HPA) axis response and orexigenic or anorexigenic hypothalamic neuropeptides [3][4][5]. Indeed, it has been shown that individuals with the history of childhood trauma and those with a diagnosis of post-traumatic stress disorder (PTSD) are characterized by increased cardio-metabolic risk [6][7][8]. Although the relationship between stress and metabolic dysregulation has been widely investigated in the general population and PTSD cases, these issues have been addressed only in one study on first-episode psychosis patients [9].…”

Section: Introductionmentioning

confidence: 99%

The history of childhood trauma is associated with lipid disturbances and blood pressure in adult first-episode schizophrenia patients

Misiak

Kiejna

Frydecka

2015

General Hospital Psychiatry

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Metabolic Syndrome in People Suffering from Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis

Cited by 83 publications

References 51 publications

Posttraumatic Stress Disorder and Metabolic Syndrome: More Questions Than Answers

Posttraumatic Stress Disorder and Metabolic Syndrome: More Questions Than Answers

The prevalence and risk of metabolic syndrome and its components among people with posttraumatic stress disorder: a systematic review and meta-analysis

The history of childhood trauma is associated with lipid disturbances and blood pressure in adult first-episode schizophrenia patients

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