title: Longitudinal associations between post-traumatic stress disorder and metabolic syndrome severity.
abstract: Post-traumatic stress disorder (PTSD) is associated with elevated risk for metabolic syndrome (MetS). However, the direction of this association is not yet established, as most prior studies employed cross-sectional designs. The primary goal of this study was to evaluate bidirectional associations between PTSD and MetS using a longitudinal design.
  
  
  
  A total of 1355 male and female veterans of the conflicts in Iraq and Afghanistan underwent PTSD diagnostic assessments and their biometric profiles pertaining to MetS were extracted from the electronic medical record at two time points (spanning ~2.5 years, n = 971 at time 2).
  
  
  
  The prevalence of MetS among veterans with PTSD was just under 40% at both time points and was significantly greater than that for veterans without PTSD; the prevalence of MetS among those with PTSD was also elevated relative to age-matched population estimates. Cross-lagged panel models revealed that PTSD severity predicted subsequent increases in MetS severity (β = 0.08, p = 0.002), after controlling for initial MetS severity, but MetS did not predict later PTSD symptoms. Logistic regression results suggested that for every 10 PTSD symptoms endorsed at time 1, the odds of a subsequent MetS diagnosis increased by 56%.
  
  
  
  Results highlight the substantial cardiometabolic concerns of young veterans with PTSD and raise the possibility that PTSD may predispose individuals to accelerated aging, in part, manifested clinically as MetS. This demonstrates the need to identify those with PTSD at greatest risk for MetS and to develop interventions that improve both conditions.
authors.affiliation: National Center for PTSD at VA Boston Healthcare System,Boston, MA,USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Wolf
authors.affiliation: National Center for PTSD at VA Boston Healthcare System,Boston, MA,USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Bovin
authors.affiliation: Department of Psychiatry,Boston University School of Medicine,Boston, MA,USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Green
authors.affiliation: National Center for PTSD at VA Boston Healthcare System,Boston, MA,USA.
authors.forename: K S
authors.initials: KS
authors.lastname: Mitchell
authors.affiliation: Boston VA Research Institute,Boston, MA,USA.
authors.forename: T B
authors.initials: TB
authors.lastname: Stoop
authors.affiliation: VA Boston Healthcare System,Research Service,Boston, MA,USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Barretto
authors.affiliation: Department of Psychiatry,Boston University School of Medicine,Boston, MA,USA.
authors.forename: C E
authors.initials: CE
authors.lastname: Jackson
authors.affiliation: Department of Psychiatry,Boston University School of Medicine,Boston, MA,USA.
authors.forename: L O
authors.initials: LO
authors.lastname: Lee
authors.affiliation: New England Research Institutes,Watertown, MA,USA.
authors.forename: S C
authors.initials: SC
authors.lastname: Fang
authors.affiliation: New England Research Institutes,Watertown, MA,USA.
authors.forename: F
authors.initials: F
authors.lastname: Trachtenberg
authors.affiliation: New England Research Institutes,Watertown, MA,USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Rosen
authors.affiliation: National Center for PTSD at VA Boston Healthcare System,Boston, MA,USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Keane
authors.affiliation: National Center for PTSD at VA Boston Healthcare System,Boston, MA,USA.
authors.forename: B P
authors.initials: BP
authors.lastname: Marx
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014728:Veterans / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Accelerated aging; PTSD; cross-lagged design; longitudinal; metabolic syndrome; veterans