ACC: PTSD Linked to Metabolic Syndrome

SAN FRANCISCO -- Patients diagnosed with post-traumatic stress disorder (PTSD) have a higher incidence of insulin resistance and metabolic syndrome than people without the disorder, increasing their risk of heart disease and diabetes, researchers reported here.

In a large retrospective study, the adjusted incidence rates of insulin resistance and metabolic syndrome were 14.2% and 12.07% in patients with PTSD, compared with patients without the disorder (P<0.05). The model was adjusted for age, gender, and conventional risk factors, according to Ramin Ebrahimi, MD, professor of medicine at the University of California in Los Angeles, and colleagues.

Ebrahimi stressed that the study shows only an association between PTSD, insulin resistance, and metabolic syndrome and that further research is needed.

"At this point, it is speculative," he said here at the American College of Cardiology's 62nd Annual Scientific Sessions. "Is PTSD really related to these conditions, or is it leading to some other behavior such as overeating that explains the association?"

Ebrahimi said he became interested in the topic after noticing that a disparate number of patients being treated in the cath lab at a VA hospital where he worked had PTSD. A subsequent study showed that the prevalence of cardiovascular disease was higher in patients with PTSD than in other patients.

The current study was designed to determine whether PTSD patients also had a higher incidence of risk factors for cardiovascular disease, he said.

He and his colleagues analyzed data on 207,954 patients in the VA database. They had a mean age of 60, 14.93% were men, and none had coronary artery disease or diabetes at baseline.

Of the total, 11,420 patients had PTSD. There were no differences in age, gender, lipid profile, fasting blood glucose and conventional risk factors among patients with and without PTSD at baseline (P>0.05).

At a median follow-up of 2 years, 34.8% of patients with PTSD had insulin resistance, defined as triglycerides over HDL cholesterol ratio ≥3.8. Just 19.3% of patients without PTSD had a ratio that high. The difference between the groups was significant at P=0.00001.

Similarly, significantly more patients with PTSD had metabolic syndrome compared with patients without PTSD (52.5% versus 37.3%, P=0.0001).

Asked about a potential mechanism, Ebrahimi said that inflammation, vascular dysfunction, and variations in hormone levels may be involved, but that much more research is needed.

Commenting on the findings, former American Heart Association president Clyde Yancy, MD, chief of cardiology at Northwestern University, said, "The findings reinforce that PTSD is not just a psychological issue, it is a physical issue as well. The fact it is associated with insulin resistance really brings the point home."

Nearly 8 million Americans have PTSD, according to the National Institute of Mental Health.

Source: www.medpagetoday.com