Posttraumatic stress disorder, alone or additively with early life adversity, is associated with obesity and cardiometabolic risk

Abstract

Background and Aims There is some evidence that posttraumatic stress disorder (PTSD) and early life adversity may influence metabolic outcomes such as obesity, diabetes, and cardiovascular disease. However, whether and how these interact is not clear. Methods We analyzed data from a cross-sectional and a longitudinal study to determine how PTSD severity influences obesity, insulin sensitivity, and key measures and biomarkers of cardiovascular risk. We then looked at how PTSD and early life adversity may interact to impact these same outcomes. Results PTSD severity is associated with increasing risk of obesity, diabetes, and cardiovascular disease, with higher symptoms correlating with higher values of BMI, leptin, fibrinogen, and blood pressure, and lower values of insulin sensitivity. PTSD and early life adversity have an additive effect on these metabolic outcomes. The longitudinal study confirmed findings from the cross sectional study and showed that fat mass, leptin, CRP, ICAM, and TNFRII were significantly increased with higher PTSD severity during a 2.5 year follow-up period. Conclusions Individuals with early life adversity and PTSD are at high risk and should be monitored carefully for obesity, insulin resistance, and cardiometabolic risk.

Adverse childhood experiences and risk of type 2 diabetes: A systematic review and meta-analysis

“…In particular, evidence has shown a strong connection of PTSD with the development of obesity, diabetes, cardiovascular diseases as well as metabolic disease [70][71][72]. On the other hand, ACEs and unpleasant childhood have a profound influence on a person's psycho-social development with regard to personal life styles and habits, paving the way to developing type 2 diabetes.…”

Cardiovascular Disease Risk Factors in Patients With Posttraumatic Stress Disorder (Ptsd): A Narrative Review

“…Hypertension was the most frequent component of MetS in veterans with PTSD, with the prevalence of alarmingly high 77% (Rosenbaum et al 2015), which was significantly higher for an average prevalence of hypertension in general population of about 40%. In civilian subjects with PTSD, severity of cardiovascular symptoms was positively correlated with body mass index (BMI), waist circumference, fibrinogen, and leptin values, and negatively correlated with insulin sensitivity (Farr et al 2015).…”

“…Several studies reported an association between PTSD and elevated CRP levels (Canetti et al 2014, Farr et al 2015, particularly with re-experiencing CVD and denying symptoms (Canetti et al 2014), and a correlation with CVD manifestations with overall PTSD severity (Farr et al 2015, Michopoulos et al 2015.…”

Cross-Sectional and Longitudinal Associations of Chronic Posttraumatic Stress Disorder With Inflammatory and Endothelial Function Markers in Women

“…Fewer studies have investigated associations of trauma and PTSD with endothelial function biomarkers. Although some evidence suggests that PTSD is associated with elevated levels of endothelial cell adhesion molecules that play an early role in the accumulation of lipids within the arterial wall(14), including intercellular adhesion molecule-1 (ICAM-1)(19–21) and vascular cell adhesion molecule-1 (VCAM-1)(20), findings have been inconsistent(19,22). …”