title: The association of posttraumatic stress disorder and metabolic syndrome: a study of increased health risk in veterans.
abstract: BACKGROUND
  There is accumulating evidence for a link between trauma exposure, posttraumatic stress disorder (PTSD) and diminished health status. To assess PTSD-related biological burden, we measured biological factors that comprise metabolic syndrome, an important established predictor of morbidity and mortality, as a correlate of long-term health risk in PTSD.
  
  
  METHODS
  We analyzed clinical data from 253 male and female veterans, corresponding to five factors linked to metabolic syndrome (systolic and diastolic blood pressure, waist-to-hip ratio and fasting measures of high-density lipoprotein (HDL) cholesterol, serum triglycerides and plasma glucose concentration). Clinical cut-offs were defined for each biological parameter based on recommendations from the World Health Organization and the National Cholesterol Education Program. Controlling for relevant variables including sociodemographic variables, alcohol/substance/nicotine use and depression, we examined the impact of PTSD on metabolic syndrome using a logistic regression model.
  
  
  RESULTS
  Two-fifths (40%) of the sample met criteria for metabolic syndrome. Of those with PTSD (n = 139), 43% met criteria for metabolic syndrome. The model predicted metabolic syndrome well (-2 log likelihood = 316.650, chi-squared = 23.731, p = 0.005). Veterans with higher severity of PTSD were more likely to meet diagnostic criteria for metabolic syndrome (Wald = 4.76, p = 0.03).
  
  
  CONCLUSIONS
  These findings provide preliminary evidence linking higher severity of PTSD with risk factors for diminished health and increased morbidity, as represented by metabolic syndrome.
authors.affiliation: Veterans Affairs San Diego Health Care System, Research Service, MC 151, La Jolla Village Drive, San Diego, CA 92161, USA. pheppner@ucsd.edu
authors.forename: Pia S
authors.initials: PS
authors.lastname: Heppner
authors.forename: Eric F
authors.initials: EF
authors.lastname: Crawford
authors.forename: Uzair A
authors.initials: UA
authors.lastname: Haji
authors.forename: Niloofar
authors.initials: N
authors.lastname: Afari
authors.forename: Richard L
authors.initials: RL
authors.lastname: Hauger
authors.forename: Boris A
authors.initials: BA
authors.lastname: Dashevsky
authors.forename: Paul S
authors.initials: PS
authors.lastname: Horn
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Nunnink
authors.forename: Dewleen G
authors.initials: DG
authors.lastname: Baker
mesh_terms: D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014728:Veterans