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Thursday, January 08, 2009

Study: PTSD Increases Obesity, High Blood Pressure and Insulin Resistance Risk

From EurekAlert:

Veterans with post-traumatic stress disorder (PTSD) are more likely to have metabolic syndrome than veterans without PTSD. New research [pdf] published in the open access journal BMC Medicine has shown that after controlling for other factors such as depression or substance abuse, there is a significant association between metabolic syndrome and PTSD.

Metabolic syndrome is composed of a cluster of clinical signs including obesity, high blood pressure and insulin resistance. It has been associated with diabetes, cardiovascular morbidity and mortality.

Any traumatic event or series of events can cause PTSD. According to the UK National Institute for Clinical Excellence (NICE), up to 30% of people who have experienced a traumatic event may go on to develop PTSD and it may affect about 8% of people at some point in their lives.

Pia Heppner, of the Veterans Affairs of San Diego, VA Center of Excellence for Stress and Mental Health (CESAMH) and the University of California San Diego, with a team of researchers from the VA, analyzed clinical data from 253 male and female veterans. They found that those with a higher severity of PTSD were more likely to meet the diagnostic criteria for metabolic syndrome.

Dr. Heppner said, "This line of research suggests that stress and post-stress responses are related to long-term health outcomes. Studies show that veterans, prisoners of war and individuals exposed to severe trauma have higher rates of physical morbidity and mortality and increased health care utilization. Our findings suggest that metabolic syndrome provides a useful framework for assessing and describing the physical burden of PTSD and can be used prospectively to evaluate health risks that may be associated with combat exposure and PTSD."


In educational interest, article(s) quoted from extensively.

From Wikipedia:

Metabolic syndrome is a combination of medical disorders that increase the risk of developing cardiovascular disease and diabetes. It affects one in five people, and prevalence increases with age. Some studies estimate the prevalence in the USA to be up to 25% of the population.

Metabolic syndrome is also known as metabolic syndrome X, syndrome X, insulin resistance syndrome, Reaven's syndrome, and CHAOS (Australia). A similar condition in overweight horses is referred to as equine metabolic syndrome; it is unknown if they have the same etiology.


From the American Heart Association:

What is the metabolic syndrome?

The metabolic syndrome is characterized by a group of metabolic risk factors in one person. They include:

* Abdominal obesity (excessive fat tissue in and around the abdomen)
* Atherogenic dyslipidemia (blood fat disorders — high triglycerides, low HDL cholesterol and high LDL cholesterol — that foster plaque buildups in artery walls)
* Elevated blood pressure
* Insulin resistance or glucose intolerance (the body can’t properly use insulin or blood sugar)
* Prothrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor–1 in the blood)
* Proinflammatory state (e.g., elevated C-reactive protein in the blood)

People with the metabolic syndrome are at increased risk of coronary heart disease and other diseases related to plaque buildups in artery walls (e.g., stroke and peripheral vascular disease) and type 2 diabetes. The metabolic syndrome has become increasingly common in the United States. It’s estimated that over 50 million Americans have it.

The dominant underlying risk factors for this syndrome appear to be abdominal obesity and insulin resistance. Insulin resistance is a generalized metabolic disorder, in which the body can’t use insulin efficiently. This is why the metabolic syndrome is also called the insulin resistance syndrome. ...

How is the metabolic syndrome diagnosed?

There are no well-accepted criteria for diagnosing the metabolic syndrome. The criteria proposed by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), with minor modifications, are currently recommended and widely used.

The American Heart Association and the National Heart, Lung, and Blood Institute recommend that the metabolic syndrome be identified as the presence of three or more of these components:

* Elevated waist circumference:
Men — Equal to or greater than 40 inches (102 cm)
Women — Equal to or greater than 35 inches (88 cm)
* Elevated triglycerides:
Equal to or greater than 150 mg/dL
* Reduced HDL (“good”) cholesterol:
Men — Less than 40 mg/dL
Women — Less than 50 mg/dL
* Elevated blood pressure:
Equal to or greater than 130/85 mm Hg
* Elevated fasting glucose:
Equal to or greater than 100 mg/dL

AHA Recommendation for Managing the Metabolic Syndrome:

The primary goal of clinical management of the metabolic syndrome is to reduce the risk for cardiovascular disease and type 2 diabetes. Then, the first-line therapy is to reduce the major risk factors for cardiovascular disease: stop smoking and reduce LDL cholesterol, blood pressure and glucose levels to the recommended levels.

For managing both long- and short-term risk, lifestyle therapies are the first-line interventions to reduce the metabolic risk factors. These lifestyle interventions include:

* Weight loss to achieve a desirable weight (BMI less than 25 kg/m2)
* Increased physical activity, with a goal of at least 30 minutes of moderate-intensity activity on most days of the week
* Healthy eating habits that include reduced intake of saturated fat, trans fat and cholesterol


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