title: Metabolic risk factors and posttraumatic stress disorder: the role of sleep in young, healthy adults.
abstract: OBJECTIVE
  Posttraumatic stress disorder (PTSD) is associated with indicators of poor physical health and sleep disturbance. This study investigated the relationship between PTSD and metabolic risk factors and examined the role of sleep duration in medically healthy and medication-free adults.
  
  
  METHODS
  Participants with PTSD (n = 44, mean age = 30.6 years) and control participants free of lifetime psychiatric history (n = 50, mean age = 30.3 years) recorded sleep using sleep diary for 10 nights and actigraphy for 7 nights. We assessed metabolic risk factors including fasting triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein cholesterol, as well as abdominal fat using dual-energy x-ray absorptiometry.
  
  
  RESULTS
  PTSD was associated with shorter sleep duration (based on self-report, not actigraphy) and higher metabolic risks (controlling for body fat percentage), including increased triglycerides (p = .03), total cholesterol (p < .001), LDL cholesterol (p = .006), very low density lipoprotein cholesterol (p = .002), and cholesterol/high-density lipoprotein ratio (p = .024). In addition, sleep duration was associated with metabolic risks in PTSD (significant correlations ranged from r = -0.20 to r = -0.40) but did not fully account for the association between PTSD and metabolic measures.
  
  
  CONCLUSIONS
  Metabolic risk factors are associated with PTSD even in early adulthood, which highlights the need for early intervention. Future longitudinal research should assess whether sleep disturbance in PTSD is a mechanism that contributes to heightened metabolic risk to elucidate the pathway from PTSD to higher rates of medical disorders such as obesity, diabetes, and heart disease.
authors.affiliation: From the San Francisco VA Medical Center (Talbot, Rao, Cohen, Richards, Inslicht, O'Donovan, Maguen, Metzler, Neylan), San Francisco, California; and Departments of Medicine (Rao, Cohen) and Psychiatry (Talbot, Richards, Inslicht, O'Donovan, Maguen, Neylan), University of California, San Francisco, California.
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Talbot
authors.forename: Madhu N
authors.initials: MN
authors.lastname: Rao
authors.forename: Beth E
authors.initials: BE
authors.lastname: Cohen
authors.forename: Anne
authors.initials: A
authors.lastname: Richards
authors.forename: Sabra S
authors.initials: SS
authors.lastname: Inslicht
authors.forename: Aoife
authors.initials: A
authors.lastname: OʼDonovan
authors.forename: Shira
authors.initials: S
authors.lastname: Maguen
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Metzler
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Neylan
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D055815:Young Adult