Posttraumatic stress disorder appears to have a significant relationship with the development of metabolic syndrome, Pia S. Heppner, Ph.D., and her colleagues have reported.
Their observational study of 253 male and female veterans found that the risk for metabolic syndrome increased by 1% for each point scored on the Clinician Administered PTSD Scale (CAPS). The association between the disorders remained robust even after controlling for multiple demographic and medical factors, wrote Dr. Heppner of the Veterans Affairs San Diego Health Care System research service and her coauthors.
“The importance of the association becomes apparent when one considers the fact that metabolic syndrome has been shown to predict cardiovascular disease-related morbidity and mortality,” they wrote in BioMed Central Medicine (doi:10.1186/1741–7015–7–1).
The study subjects were mostly male (92%) and white (76%). Their mean age was 51 years; most of them (71%) had served in Vietnam. According to both the CAPS scale and DSM-IV diagnostic criteria, PTSD of at least moderate criteria was present in 55%, while another 24% expressed symptoms at a subthreshold level. An additional 64% had a current or past history of depression.
The overall prevalence of metabolic syndrome was 40%. Among those with PTSD only, 34% met the criteria for metabolic syndrome; the prevalence among those with major depressive disorder (MDD) was 29%. Prevalence was significantly higher in those with both disorders (46%).
A logistic regression analysis controlled for age, sex, race, education, drug and alcohol use/abuse, nicotine use, and a current or past diagnosis of MDD. The total CAPS score was a significant predictor of metabolic syndrome, but MDD was not, they wrote.
Dr. Heppner and her colleagues said that their findings are in line with previous studies in populations vulnerable to PTSD. For example, one study found that metabolic syndrome was three times more likely in police officers with severe PTSD symptoms, compared with officers in the “lowest PTSD severity category” (Int. J. Emerg. Mental Health 2006;8:227–37). Still, the current study “extends the current knowledge of PTSD and diminished health status.”
The study's cross-sectional design prevented Dr. Heppner and her colleagues from fully establishing a causal relationship between PTSD and metabolic syndrome. “Prospective studies are clearly needed in this area to fully examine the long-term health risk related to PTSD,” they wrote.