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

Published online by Cambridge University Press:  18 April 2016

E. J. Wolf ,
M. J. Bovin ,
J. D. Green ,
K. S. Mitchell ,
T. B. Stoop ,
K. M. Barretto ,
C. E. Jackson ,
L. O. Lee ,
S. C. Fang  and
F. Trachtenberg
...Show all authors
E. J. Wolf*
Affiliation:
National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
M. J. Bovin
Affiliation:
National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
J. D. Green
Affiliation:
Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA VA Boston Healthcare System, Research Service, Boston, MA, USA
K. S. Mitchell
Affiliation:
National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
T. B. Stoop
Affiliation:
Boston VA Research Institute, Boston, MA, USA
K. M. Barretto
Affiliation:
VA Boston Healthcare System, Research Service, Boston, MA, USA
C. E. Jackson
Affiliation:
Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA VA Boston Healthcare System, Geriatric Research, Education and Clinical Center, Boston, MA, USA VA Boston Healthcare System, Translational Research Center for TBI and Stress Disorders, Boston, MA, USA
L. O. Lee
Affiliation:
Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA VA Boston Healthcare System, Research Service, Boston, MA, USA
S. C. Fang
Affiliation:
New England Research Institutes, Watertown, MA, USA
F. Trachtenberg
Affiliation:
New England Research Institutes, Watertown, MA, USA
R. C. Rosen
Affiliation:
New England Research Institutes, Watertown, MA, USA
T. M. Keane
Affiliation:
National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
B. P. Marx*
Affiliation:
National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
*
*Address for correspondence: E. Wolf, PhD & Brian Marx, PhD, National Center for PTSD (116B-2), VA Boston Healthcare System, 150 South Huntington Ave., Boston, MA 02130, USA. (Email: erika.wolf@va.gov; brian.marx@va.gov)
*Address for correspondence: E. Wolf, PhD & Brian Marx, PhD, National Center for PTSD (116B-2), VA Boston Healthcare System, 150 South Huntington Ave., Boston, MA 02130, USA. (Email: erika.wolf@va.gov; brian.marx@va.gov)
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Abstract

Background

Post-traumatic 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.

Method

A total of 1355 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 = 0.08, p = 0.002), 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.

Keywords

Accelerated agingcross-lagged designlongitudinalmetabolic syndromePTSDveterans
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 10 , July 2016 , pp. 2215 - 2226
Copyright
Copyright © Cambridge University Press 2016 

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