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Metabolic Syndrome Among People with PTSD: Epidemiological Overview

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Comprehensive Guide to Post-Traumatic Stress Disorder

Abstract

Previous reports highlighted that traumatic stress exposure may have a key role on both mental and physical health. People suffering from post-traumatic stress disorder (PTSD) may have a shorter life expectancy than general population, mainly due to a higher risk of cardiovascular diseases. Several factors may explain this association, but, in recent years, there has been a growing concern on the relationship between metabolic syndrome and PTSD. According to previous reports on both community and special populations’ samples, e.g., war veterans, PTSD is associated with a higher risk of suffering from metabolic syndrome as well as obesity, diabetes, hypertension, and dyslipidemia. Clinicians and mental health professionals should regularly assess and screen metabolic alterations among people with PTSD. The potential role of factors and mediators that might explain the nature of the co-occurrence of PTSD and metabolic syndrome – as well as specific interventions addressed to prevent and treat this comorbid condition – need further research.

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Abbreviations

95%CI:

95 % confidence interval

OR:

Odds ratio

PTSD:

Post-traumatic stress disorder

RR:

Relative risk

References

  • Abouzeid M, Kelsall HL, Forbes AB, et al. Posttraumatic stress disorder and hypertension in Australian veterans of the 1991 Gulf War. J Psychosom Res. 2012;72:33–8.

    Article  PubMed  Google Scholar 

  • Agyemang C, Goosen S, Anujuo K, Ogedegbe G. Relationship between post-traumatic stress disorder and diabetes among 105,180 asylum seekers in the Netherlands. Eur J Public Health. 2012;22:658–62.

    Article  PubMed  Google Scholar 

  • Ahmadi N, Hajsadeghi F, Mirshkarlo HB, et al. Post-traumatic stress disorder, coronary atherosclerosis, and mortality. Am J Cardiol. 2011;108:29–33.

    Article  PubMed  Google Scholar 

  • Ahmadi N, Arora R, Vaidya N, et al. Post-traumatic stress disorder is associated with increased incidence of insulin resistance and metabolic syndrome. J Am Coll Cardiol. 2013;61:E1347.

    Article  Google Scholar 

  • Alberti KG, Zimmet P, Shaw J. IDF epidemiology task force consensus group. The metabolic syndrome – a new worldwide definition. Lancet. 2005;366:1059–62.

    Article  PubMed  Google Scholar 

  • Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15:539–53.

    Article  PubMed  Google Scholar 

  • American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care. 2004;27:596–601.

    Article  Google Scholar 

  • Babic R, Maslov B, Babic D, Vasilj I. The prevalence of metabolic syndrome in patient with posttraumatic stress disorder. Psychiatr Danub. 2013;25(Suppl1):45–50.

    PubMed  Google Scholar 

  • Balkau B, Charles MA, Drivsholm T, European Group For The Study Of Insulin Resistance (EGIR), et al. Frequency of the WHO metabolic syndrome in European cohorts, and an alternative definition of an insulin resistance syndrome. Diabetes Metab. 2002;28:364–76.

    PubMed  Google Scholar 

  • Bartoli F, Carrà G, Crocamo C, et al. Metabolic syndrome in people suffering from posttraumatic stress disorder: a systematic review and meta-analysis. Metab Syndr Relat Disord. 2013;11:301–8.

    Article  PubMed  Google Scholar 

  • Boscarino JA. Posttraumatic stress disorder and physical illness: results from clinical and epidemiologic studies. Ann NY Acad Sci. 2004;1032:141–53.

    Article  PubMed  Google Scholar 

  • Boscarino JA. Posttraumatic stress disorder and mortality among U.S. Army veterans 30 years after military service. Ann Epidemiol. 2006;16:248–56.

    Article  PubMed  Google Scholar 

  • Boscarino JA. A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: implications for surveillance and prevention. Psychosom Med. 2008;70:668–76.

    Article  PubMed Central  PubMed  Google Scholar 

  • Boyko EJ, Jacobson IG, Smith B, Ryan MA, Hooper TI, Amoroso PJ, Gackstetter GD, Barrett-Connor E, Smith TC; Millennium Cohort Study Team. Risk of diabetes in U.S. military service members in relation to combat deployment and mental health. Diabetes Care. 2010;33:1771–7.

    Article  PubMed Central  PubMed  Google Scholar 

  • Chwastiak LA, Rosenheck RA, Kazis LE. Association of psychiatric illness and obesity, physical inactivity, and smoking among a national sample of veterans. Psychosomatics. 2011;52:230–6.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cohen BE, Marmar C, Ren L, et al. Association of cardiovascular risk factors with mental health diagnoses in Iraq and Afghanistan war veterans using VA health care. JAMA. 2009;302:489–92.

    Article  PubMed  Google Scholar 

  • Coughlin SS. Post-traumatic stress disorder and cardiovascular disease. Open Cardiovasc Med J. 2011;5:164–70.

    Article  PubMed Central  PubMed  Google Scholar 

  • De Hert M, Correll CU, Bobes J, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011;10:52–77.

    Google Scholar 

  • Dedert EA, Calhoun PS, Watkins LL, et al. Posttraumatic stress disorder, cardiovascular, and metabolic disease: a review of the evidence. Ann Behav Med. 2010;39:61–78.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ford ES, Li C, Zhao G. Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. J Diabetes. 2010;2:180–93.

    Article  PubMed  Google Scholar 

  • Gami AS, Witt BJ, Howard DE, et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007;49:403–14.

    Article  PubMed  Google Scholar 

  • Glaesmer H, Brähler E, Gündel H, Riedel-Heller SG. The association of traumatic experiences and posttraumatic stress disorder with physical morbidity in old age: a German population-based study. Psychosom Med. 2011;73:401–6.

    Article  PubMed  Google Scholar 

  • Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol. 2008;28:629–36.

    Article  PubMed  Google Scholar 

  • Grundy SM, Cleeman JI, Daniels SR, American Heart Association, National Heart, Lung, and Blood Institute, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112:2735–52.

    Article  PubMed  Google Scholar 

  • Heppner PS, Crawford EF, Haji UA, et al. The association of posttraumatic stress disorder and metabolic syndrome: a study of increased health risk in veterans. BMC Med. 2009;7:1.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hirth JM, Rahman M, Berenson AB. The association of posttraumatic stress disorder with fast food and soda consumption and unhealthy weight loss behaviors among young women. J Womens Health (Larchmt). 2011;20:1141–9.

    Article  Google Scholar 

  • Hu G, Qiao Q, Tuomilehto J, Balkau B, DECODE Study Group, et al. Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med. 2004;164:1066–76.

    Article  PubMed  Google Scholar 

  • Isomaa B, Almgren P, Tuomi T, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001;24:683–9.

    Article  PubMed  Google Scholar 

  • Jakovljevic M, Babic D, Crncevic Z, et al. Metabolic syndrome and depression in war veterans with post-traumatic stress disorder. Psychiatr Danub. 2008;20:406–10.

    PubMed  Google Scholar 

  • Jendricko T, Vidović A, Grubisić-Ilić M, et al. Homocysteine and serum lipids concentration in male war veterans with posttraumatic stress disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2009;33:134–40.

    Article  PubMed  Google Scholar 

  • Jin H, Lanouette NM, Mudaliar S, et al. Association of posttraumatic stress disorder with increased prevalence of metabolic syndrome. J Clin Psychopharmacol. 2009;29:210–5.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kang HK, Bullman TA, Taylor JW. Risk of selected cardiovascular diseases and posttraumatic stress disorder among former World War II prisoners of war. Ann Epidemiol. 2006;16:381–6.

    Article  PubMed  Google Scholar 

  • Kibler JL, Joshi K, Ma M. Hypertension in relation to posttraumatic stress disorder and depression in the US National Comorbidity Survey. Behav Med. 2009;34:125–32.

    Article  PubMed  Google Scholar 

  • Lakka HM, Laaksonen DE, Lakka TA, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002;288:2709–16.

    Article  PubMed  Google Scholar 

  • Leslie DL, Mohamed S, Rosenheck RA. Off-label use of antipsychotic medications in the department of Veterans Affairs health care system. Psychiatr Serv. 2009;60:1175–81.

    Article  PubMed  Google Scholar 

  • Levine AB, Levine LM, Levine TB. Posttraumatic stress disorder and cardiometabolic disease. Cardiology. 2014;127:1–19.

    Article  PubMed  Google Scholar 

  • Linnville S, Hoyt RE, Moore JL, et al. Posttraumatic stress disorder and metabolic syndrome: retrospective study of repatriated prisoners of war. Mil Med. 2011;176:369–74.

    Article  PubMed  Google Scholar 

  • Lukaschek K, Baumert J, Kruse J, KORA Investigators, et al. Relationship between posttraumatic stress disorder and type 2 diabetes in a population-based cross-sectional study with 2970 participants. J Psychosom Res. 2013;74:340–5.

    Article  PubMed  Google Scholar 

  • Maguen S, Madden E, Cohen B, et al. The relationship between body mass index and mental health among Iraq and Afghanistan veterans. J Gen Intern Med. 2013;28(Suppl2):S563–70.

    Article  PubMed  Google Scholar 

  • Maia DB, Marmar CR, Mendlowicz MV, et al. Abnormal serum lipid profile in Brazilian police officers with post-traumatic stress disorder. J Affect Disord. 2008;107:259–63.

    Article  PubMed Central  PubMed  Google Scholar 

  • Maslov B, Jakovljevic M, Crncevic Z, et al. Metabolic syndrome and schizophrenia from integrative medicine perspective. Psychiatr Danub. 2008;20:384–9.

    PubMed  Google Scholar 

  • Maslov B, Marcinko D, Milicevic R, Babić D, Dordević V, Jakovljević M. Metabolic syndrome, anxiety, depression and suicidal tendencies in post-traumatic stress disorder and schizophrenic patients. Coll Antropol. 2009;33(Suppl2):7–10.

    PubMed  Google Scholar 

  • McFarlane AC. The long-term costs of traumatic stress: intertwined physical and psychological consequences. World Psychiatry. 2010;9:3–10.

    PubMed Central  PubMed  Google Scholar 

  • McIntyre RS, Park KY, Law CW, et al. The association between conventional antidepressants and the metabolic syndrome: a review of the evidence and clinical implications. CNS Drugs. 2010;24:741–53.

    Article  PubMed  Google Scholar 

  • Mitchell AJ, Vancampfort D, Sweers K, et al. Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders – a systematic review and meta-analysis. Schizophr Bull. 2013;39:306–18.

    Article  PubMed Central  PubMed  Google Scholar 

  • Newcomer JW. Second-generation (atypical) antipsychotics and metabolic effects: A comprehensive literature review. CNS Drugs. 2005;19(Suppl1):1–93.

    PubMed  Google Scholar 

  • Pagoto SL, Schneider KL, Bodenlos JS, et al. Association of post-traumatic stress disorder and obesity in a nationally representative sample. Obesity (Silver Spring). 2012;20:200–5.

    Article  Google Scholar 

  • Pan A, Keum N, Okereke OI, et al. Bidirectional association between depression and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies. Diabetes Care. 2012;35:1171–80.

    Article  PubMed Central  PubMed  Google Scholar 

  • Pasquali R, Vicennati V, Cacciari M, Pagotto U. The hypothalamic-pituitary-adrenal axis activity in obesity and the metabolic syndrome. Ann N Y Acad Sci. 2006;1083:111–28.

    Article  PubMed  Google Scholar 

  • Pyykkonen AJ, Raikkonen K, Tuomi T, et al. Stressful life events and the metabolic syndrome: the prevalence, prediction and prevention of diabetes (PPP)-Botnia Study. Diabetes Care. 2010;33:378–84.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rasmusson AM, Schnurr PP, Zukowska Z, Scioli E, Forman DE. Adaptation to extreme stress: post-traumatic stress disorder, neuropeptide Y and metabolic syndrome. Exp Biol Med (Maywood). 2010;235:1150–62.

    Article  Google Scholar 

  • Reaven GM. Role of insulin resistance in human disease (syndrome X): an expanded definition. Annu Rev Med. 1993;44:121–31.

    Article  PubMed  Google Scholar 

  • Rosmond R. Role of stress in the pathogenesis of the metabolic syndrome. Psychoneuroendocrinology. 2005;30:1–10.

    Article  PubMed  Google Scholar 

  • Schwenke DC, Siegel D. Posttraumatic stress disorder and metabolic syndrome: more questions than answers. Metab Syndr Relat Disord. 2013;11:297–300.

    Article  PubMed  Google Scholar 

  • Scott KM, McGee MA, Wells JE, et al. Obesity and mental disorders in the adult general population. J Psychosom Res. 2008;64:97–105.

    Article  PubMed  Google Scholar 

  • National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143–421.

    Google Scholar 

  • Vancampfort D, Vansteelandt K, Correll CU, et al. Metabolic syndrome and metabolic abnormalities in bipolar disorder: a meta-analysis of prevalence rates and moderators. Am J Psychiatry. 2013;170:265–74.

    Article  PubMed  Google Scholar 

  • Violanti JM, Fekedulegn D, Hartley TA, et al. Police trauma and cardiovascular disease: association between PTSD symptoms and metabolic syndrome. Int J Emerg Ment Health. 2006;8:227–37.

    PubMed  Google Scholar 

  • Von Känel R, Kraemer B, Saner H, et al. Posttraumatic stress disorder and dyslipidemia: previous research and novel findings from patients with PTSD caused by myocardial infarction. World J Biol Psychiatry. 2010;11:141–7.

    Article  Google Scholar 

  • Weiss T, Skelton K, Phifer J, et al. Posttraumatic stress disorder is a risk factor for metabolic syndrome in an impoverished urban population. Gen Hosp Psychiatry. 2011;33:135–42.

    Article  PubMed Central  PubMed  Google Scholar 

  • Wu SH, Liu Z, Ho SC. Metabolic syndrome and all-cause mortality: a meta-analysis of prospective cohort studies. Eur J Epidemiol. 2010;25:375–84.

    Article  PubMed  Google Scholar 

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Correspondence to Francesco Bartoli .

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Bartoli, F., Lax, A., Carrà, G., Clerici, M. (2015). Metabolic Syndrome Among People with PTSD: Epidemiological Overview. In: Martin, C., Preedy, V., Patel, V. (eds) Comprehensive Guide to Post-Traumatic Stress Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-08613-2_55-1

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  • DOI: https://doi.org/10.1007/978-3-319-08613-2_55-1

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