PMID- 28521179
OWN - NLM
STAT- MEDLINE
DCOM- 20180403
LR  - 20180816
IS  - 1873-3360 (Electronic)
IS  - 0306-4530 (Linking)
VI  - 82
DP  - 2017 Aug
TI  - Biological predictors of insulin resistance associated with posttraumatic stress 
      disorder in young military veterans.
PG  - 91-97
LID - S0306-4530(16)30750-8 [pii]
LID - 10.1016/j.psyneuen.2017.04.016 [doi]
AB  - Posttraumatic stress disorder (PTSD) is associated with increased risk for Type 2 
      diabetes and cardiovascular disease (cardiometabolic disease), warranting 
      research into targeted prevention strategies. In the present case-control study 
      of 160 young (mean age 32.7 years) male military veterans, we aimed to assess 
      whether PTSD status predicted increased markers of cardiometabolic risk in 
      otherwise healthy individuals, and further, to explore biological pathways 
      between PTSD and these increased markers of cardiometabolic risk. Toward these 
      aims, we compared measures of cardiometabolic risk, namely insulin resistance 
      (IR) (HOMA-IR), metabolic syndrome (MetS) and prediabetes, between 80 PTSD cases 
      and 80 controls without PTSD. We then determined whether PTSD-associated 
      increases in HOMA-IR were correlated with select biological variables from 
      pathways previously hypothesized to link PTSD with cardiometabolic risk, 
      including systemic inflammation (increased C-reactive protein, interleukin-6, and 
      tumor necrosis factor alpha), sympathetic over-activity (increased resting heart 
      rate), and neuroendocrine dysregulation (increased plasma cortisol or serum 
      brain-derived neurotrophic factor (BDNF)). We found PTSD diagnosis was associated 
      with substantially higher HOMA-IR (cases 4.3+/-4.3 vs controls 2.4+/-2.0; p<0.001), 
      and a higher frequency of MetS (cases 21.3% vs controls 2.5%; p<0.001), but not 
      prediabetes (cases 20.0% vs controls 18.8%; p>0.05). Cases also had increased 
      pro-inflammatory cytokines (p<0.01), heart rate (p<0.001), and BDNF (p<0.001), 
      which together predicted increased HOMA-IR (adjusted R(2)=0.68, p<0.001). Results 
      show PTSD diagnosis in young male military veterans without cardiometabolic 
      disease is associated with increased IR, predicted by biological alterations 
      previously hypothesized to link PTSD to increased cardiometabolic risk. Findings 
      support further research into early, targeted prevention of cardiometabolic 
      disease in individuals with PTSD.
CI  - Copyright (c) 2017 Elsevier Ltd. All rights reserved.
FAU - Blessing, Esther M
AU  - Blessing EM
AD  - Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic 
      Brain Injury, Department of Psychiatry, New York University Langone Medical 
      Center, United States. Electronic address: esther.blessing@nyumc.org.
FAU - Reus, Victor
AU  - Reus V
AD  - Department of Psychiatry, University of California, San Francisco (UCSF), School 
      of Medicine, San Francisco, CA, United States.
FAU - Mellon, Synthia H
AU  - Mellon SH
AD  - Department of Psychiatry, University of California, San Francisco (UCSF), School 
      of Medicine, San Francisco, CA, United States; Department of OB/GYN and 
      Reproductive Sciences, University of California, San Francisco (UCSF), School of 
      Medicine, San Francisco, CA, United States.
FAU - Wolkowitz, Owen M
AU  - Wolkowitz OM
AD  - Department of Psychiatry, University of California, San Francisco (UCSF), School 
      of Medicine, San Francisco, CA, United States.
FAU - Flory, Janine D
AU  - Flory JD
AD  - Department of Psychiatry, Icahn School of Medicine at Mount Sinai (ISMMS)/James 
      J. Peters Veterans Affairs Medical Center, NY, United States.
FAU - Bierer, Linda
AU  - Bierer L
AD  - Department of Psychiatry, Icahn School of Medicine at Mount Sinai (ISMMS)/James 
      J. Peters Veterans Affairs Medical Center, NY, United States.
FAU - Lindqvist, Daniel
AU  - Lindqvist D
AD  - Department of Psychiatry, University of California, San Francisco (UCSF), School 
      of Medicine, San Francisco, CA, United States; Lund University, Faculty of 
      Medicine, Department of Clinical Sciences, Lund, Psychiatry, Sweden.
FAU - Dhabhar, Firdaus
AU  - Dhabhar F
AD  - Department of Psychiatry and Behavioral Sciences, Sylvester Comprehensive Cancer 
      Center, University of Miami, FL, United States.
FAU - Li, Meng
AU  - Li M
AD  - Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic 
      Brain Injury, Department of Psychiatry, New York University Langone Medical 
      Center, United States.
FAU - Qian, Meng
AU  - Qian M
AD  - Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic 
      Brain Injury, Department of Psychiatry, New York University Langone Medical 
      Center, United States.
FAU - Abu-Amara, Duna
AU  - Abu-Amara D
AD  - Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic 
      Brain Injury, Department of Psychiatry, New York University Langone Medical 
      Center, United States.
FAU - Galatzer-Levy, Isaac
AU  - Galatzer-Levy I
AD  - Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic 
      Brain Injury, Department of Psychiatry, New York University Langone Medical 
      Center, United States.
FAU - Yehuda, Rachel
AU  - Yehuda R
AD  - Department of Psychiatry, Icahn School of Medicine at Mount Sinai (ISMMS)/James 
      J. Peters Veterans Affairs Medical Center, NY, United States.
FAU - Marmar, Charles R
AU  - Marmar CR
AD  - Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic 
      Brain Injury, Department of Psychiatry, New York University Langone Medical 
      Center, United States.
LA  - eng
PT  - Journal Article
DEP - 20170501
PL  - England
TA  - Psychoneuroendocrinology
JT  - Psychoneuroendocrinology
JID - 7612148
RN  - 0 (Biomarkers)
RN  - 0 (Brain-Derived Neurotrophic Factor)
RN  - 0 (IL6 protein, human)
RN  - 0 (Interleukin-6)
RN  - 7171WSG8A2 (BDNF protein, human)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - WI4X0X7BPJ (Hydrocortisone)
SB  - IM
MH  - Adult
MH  - Biomarkers/*analysis/blood
MH  - Body Mass Index
MH  - Body Weights and Measures
MH  - Brain-Derived Neurotrophic Factor/analysis/blood
MH  - C-Reactive Protein/analysis
MH  - Cardiovascular Diseases/blood/diagnosis
MH  - Case-Control Studies
MH  - Humans
MH  - Hydrocortisone/analysis/blood
MH  - Insulin Resistance/*physiology
MH  - Interleukin-6/analysis/blood
MH  - Male
MH  - Metabolic Syndrome/blood/diagnosis
MH  - Predictive Value of Tests
MH  - Risk Factors
MH  - Stress Disorders, Post-Traumatic/blood/*complications
MH  - Veterans
OTO - NOTNLM
OT  - Brain derived neurotrophic factor
OT  - Inflammation
OT  - Insulin resistance
OT  - PTSD
OT  - Prediabetes
OT  - Sympathetic
EDAT- 2017/05/19 06:00
MHDA- 2018/04/04 06:00
CRDT- 2017/05/19 06:00
PHST- 2016/10/02 00:00 [received]
PHST- 2017/04/24 00:00 [revised]
PHST- 2017/04/24 00:00 [accepted]
PHST- 2017/05/19 06:00 [pubmed]
PHST- 2018/04/04 06:00 [medline]
PHST- 2017/05/19 06:00 [entrez]
AID - S0306-4530(16)30750-8 [pii]
AID - 10.1016/j.psyneuen.2017.04.016 [doi]
PST - ppublish
SO  - Psychoneuroendocrinology. 2017 Aug;82:91-97. doi: 10.1016/j.psyneuen.2017.04.016. 
      Epub 2017 May 1.