title: Posttraumatic stress disorder, alone or additively with early life adversity, is associated with obesity and cardiometabolic risk.
abstract: OBJECTIVE
  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 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, sICAM-1, and sTNFRII 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.
authors.affiliation: Section of Endocrinology, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA; Division of Endocrinology, Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. Electronic address: ofarr@bidmc.harvard.edu.
authors.forename: O M
authors.initials: OM
authors.lastname: Farr
authors.affiliation: Division of Endocrinology, Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: B-J
authors.initials: BJ
authors.lastname: Ko
authors.affiliation: Division of Endocrinology, Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Joung
authors.affiliation: Section of Endocrinology, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA; Division of Endocrinology, Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Zaichenko
authors.affiliation: Judge Baker Children's Center, Boston, MA 02120, USA.
authors.forename: N
authors.initials: N
authors.lastname: Usher
authors.affiliation: Section of Endocrinology, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA; Division of Endocrinology, Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Tsoukas
authors.affiliation: Section of Endocrinology, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA; Division of Endocrinology, Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Section of Endocrinology, Diabetes, and Nutrition, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Thakkar
authors.affiliation: Judge Baker Children's Center, Boston, MA 02120, USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Davis
authors.affiliation: Judge Baker Children's Center, Boston, MA 02120, USA; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Crowell
authors.affiliation: Section of Endocrinology, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA; Division of Endocrinology, Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Mantzoros
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D001900:Boston / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002657:Child Development; D015897:Comorbidity; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000150:complications / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D012307:Risk Factors; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology
chemical_list: D015415:Biomarkers
keywords: Adversity; Cardiac risk; Obesity; PTSD