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Bharti V, Bhardwaj A, Elias DA, Metcalfe AWS, Kim JS. A Systematic Review and Meta-Analysis of Lipid Signatures in Post-traumatic Stress Disorder. Front Psychiatry 2022; 13:847310. [PMID: 35599759 PMCID: PMC9120430 DOI: 10.3389/fpsyt.2022.847310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 04/12/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Research assessing lipid levels in individuals diagnosed with post-traumatic stress disorder (PTSD) has yielded mixed results. This study aimed to employ meta-analytic techniques to characterize the relationship between the levels of lipid profiles and PTSD. METHODS We performed meta-analyses of studies comparing profiles and levels of lipids between PTSD patients and healthy individuals by searching Embase, Ovid Medline, Scopus, PsycINFO, and Cochrane databases for the studies until March 2021. Meta-analyses were performed using random-effects models with the restricted maximum-likelihood estimator to synthesize the effect size assessed by standardized mean difference (SMD) across studies. FINDINGS A total of 8,657 abstracts were identified, and 17 studies were included. Levels of total cholesterol (TC) (SMD = 0.57 95% CI, 0.27-0.87, p = 0.003), low-density lipoprotein (LDL) (SMD = 0.48, 95% CI, 0.19-0.76, p = 0.004), and triglyceride (TG) (SMD = 0.46, 95% CI, 0.22-0.70, p = 0.001) were found to be higher, while levels of high-density lipoprotein (HDL) (SMD = -0.47, -0.88 to -0.07, p = 0.026) were found to be lower in PTSD patients compared to healthy controls. Subgroup analysis showed that TG levels were higher in PTSD patients who were on or off of psychotropic medications, both < 40 and ≥ 40 years of age, and having body mass index of < 30 and ≥ 30 compared to healthy controls. INTERPRETATION This work suggested dysregulation of lipids in PTSD that may serve as biomarker to predict the risk. The study will be useful for physicians considering lipid profiles in PTSD patients to reduce cardiovascular morbidity and mortality.
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Affiliation(s)
- Veni Bharti
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.,Health and Environments Research Centre (HERC) Laboratory, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Aseem Bhardwaj
- Health and Environments Research Centre (HERC) Laboratory, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - David A Elias
- Canadian Health Solutions Inc., Saint John, NB, Canada.,Dalhousie Medicine New Brunswick, Dalhousie University, Halifax, NS, Canada
| | - Arron W S Metcalfe
- Canadian Health Solutions Inc., Saint John, NB, Canada.,Canadian Imaging Research Centre, Saint John, NB, Canada
| | - Jong Sung Kim
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.,Health and Environments Research Centre (HERC) Laboratory, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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Chen X, Lin J, Kong LN, Shen YL, Chen YL, Guo QW, Zhang JC, Yang M, Fang DZ. Effects of earthquake and related environmental factors on relationship of posttraumatic stress disorder with LDLR rs5925. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 714:136811. [PMID: 32018970 DOI: 10.1016/j.scitotenv.2020.136811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/17/2020] [Accepted: 01/17/2020] [Indexed: 06/10/2023]
Abstract
To test the relationship not yet explored before among earthquake and related environmental factors, low-density lipoprotein receptor (LDLR) and posttraumatic stress disorder (PTSD), the genetic variation of LDLR rs5925 was selected and PTSD was examined by PTSD Checklist-Civilian Version (PCLC) in adolescents with different genotypes of LDLR rs5925 longitudinally at 6, 12 and 18 months after the 2008 Wenchuan earthquake. The C allele carriers were observed to have higher PTSD prevalence than the TT homozygotes in the male subjects, and higher PTSD prevalence and PCL-C scores in the female subjects only at 6 months. When compared to that at 12 months, decreased PTSD prevalence was observed at 18 months only in the female C allele carriers, but not in the female TT homozygotes or the male subjects. The potential risk factors of PTSD and predictors of PCL-C scores were different during the follow-up. LDLR rs5925 was one of the predictors for PCL-C scores at 6 and 12 months, and one of the potential factors for PTSD prevalence at 6 months. These results suggest that interactions may occur between earthquakes and other related environmental factors, which could affect the relationship of LDLR rs5925 with PTSD and be considered for individualized treatment.
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Affiliation(s)
- Xu Chen
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, PR China
| | - Jia Lin
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, PR China
| | - Ling Nan Kong
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, PR China
| | - Yi Lin Shen
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, PR China
| | - Yong Li Chen
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, PR China
| | - Qi Wei Guo
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, PR China
| | - Ji Cheng Zhang
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, PR China
| | - Mei Yang
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, PR China
| | - Ding Zhi Fang
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, PR China.
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Feng Y, Lin J, Su M, Zhang X, Fang DZ. Interplays of estrogen receptor alpha gene rs2234693 with post-traumatic stress disorder influence serum glucose and lipids profiles in Chinese adolescents. J Clin Neurosci 2018; 61:36-43. [PMID: 30470649 DOI: 10.1016/j.jocn.2018.11.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 11/05/2018] [Indexed: 12/17/2022]
Abstract
Both post-traumatic stress disorder (PTSD) and estrogen receptor alpha (ESR1) gene rs2234693 were reported to influence serum glucose and lipids profiles. However, their interactions on serum glucose and lipids profiles have not been reported. A total of 708 Chinese Han high school students were recruited at 6th months after the 2008 Wenchuan Earthquake. Serum concentrations of fasting blood glucose (FBG), fasting blood insulin (FBI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were detected. Body mass index (BMI) and homeostatic model assessment of insulin resistance (HOMA-IR) were calculated. PTSD was assessed by the PTSD Checklist Civilian Version (PCL-C). Variants of ESR1 rs2234693 was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analyses and verified by DNA sequencing. The male subjects with PTSD had a trend of higher FBG (p = 0.077) and significantly higher FBI and HOMA-IR than male controls. The PTSD subjects had significantly higher levels of FBG, FBI, HOMA-IR and HDL-C than the controls only in the male C allele carriers irrespective of adjustment for age and BMI. In the male controls group, the C allele carriers had significantly lower HDL-C than the TT homozygotes regardless of adjustment for age and BMI. In female PTSD group, the C allele carriers had significantly higher TC/HDL-C and LDL-C/HDL-C than the TT homozygotes after adjustment for age and BMI. These results suggest the interplays of ESR1 rs2234693 with PTSD influence serum glucose and lipids profiles with a gender dependent manner.
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Affiliation(s)
- Yue Feng
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, PR China; Department of Clinical Laboratory, Mianyang Central Hospital, Mianyang, PR China
| | - Jia Lin
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, PR China
| | - Mi Su
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, PR China
| | - Xin Zhang
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, PR China
| | - Ding Zhi Fang
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, PR China.
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Tae H, Huh HJ, Hwang J, Chae JH. Relationship between serum lipid concentrations and posttraumatic stress symptoms in the bereaved after the Sewol ferry disaster: A prospective cohort study. Psychiatry Res 2018; 266:132-137. [PMID: 29864612 DOI: 10.1016/j.psychres.2018.04.058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 03/13/2018] [Accepted: 04/22/2018] [Indexed: 12/01/2022]
Abstract
The objective of this study was to investigate the relationship between serum lipid concentrations and PTSD symptoms in the bereaved after a traumatic familial loss. Eighteen months after the Sewol ferry disaster, 107 subjects who experienced traumatic losses as a result of the accident completed a mental and medical survey as well as laboratory tests for lipid profiles. At 30 months after the trauma, a total of 64 individuals completed a follow-up psychometric survey and biochemical measurements. We performed multiple linear regression analyses, examining the association between PTSD symptoms and lipid profiles. Other potential influences on lipid profiles such as metabolic risk factors, demographic risk factors, and underlying medical history were accounted for. Participants reporting clinically significant PTSD symptoms exhibited lower serum HDL-C levels than those without PTSD symptoms. In addition, we found that the severity of PTSD symptoms and sex could explain the changes in lipid profiles independently of other possible risk factors of changes. The results of this study suggest that PTSD symptoms may contribute to an increased risk for developing metabolic syndrome via detrimental changes in lipid concentrations. Routine screening and multidisciplinary management to prevent metabolic syndrome in individuals who experience traumatic losses would therefore be valuable.
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Affiliation(s)
- Hyejin Tae
- Department of Psychiatry, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea
| | - Hyu Jung Huh
- Stress Clinic, Health Promotion Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jihyun Hwang
- Catholic Biomedical Industrial Institute, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jeong-Ho Chae
- Department of Psychiatry, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea.
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Tudor L, Konjevod M, Nikolac Perkovic M, Svob Strac D, Nedic Erjavec G, Uzun S, Kozumplik O, Sagud M, Kovacic Petrovic Z, Pivac N. Genetic Variants of the Brain-Derived Neurotrophic Factor and Metabolic Indices in Veterans With Posttraumatic Stress Disorder. Front Psychiatry 2018; 9:637. [PMID: 30542302 PMCID: PMC6277864 DOI: 10.3389/fpsyt.2018.00637] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 11/08/2018] [Indexed: 12/12/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is a trauma and stressor related disorder that may develop after exposure to an event that involved the actual or possible threat of death, violence or serious injury. Its molecular underpinning is still not clear. Brain-derived neurotrophic factor (BDNF) modulates neuronal processes such as the response to stress, but also weight control, energy and glucose homeostasis. Plasma BDNF levels and a functional BDNF Val66Met (rs6265) polymorphism were reported to be associated with PTSD, as well as with increased body mass index (BMI) and dyslipidaemia in healthy subjects and patients with cardio-metabolic diseases, but these results are controversial. The other frequently studied BDNF polymorphism, C270T (rs56164415), has been associated with the development of different neuropsychiatric symptoms/disorders. As far as we are aware, there are no data on the association of BDNF Val66Met and C270T polymorphisms with metabolic indices in PTSD. Due to high rates of obesity and dyslipidaemia in PTSD, the aim of this study was to elucidate the association of BDNF Val66Met and C270T polymorphisms with BMI and lipid levels in veterans with PTSD. We hypothesized that BDNF variants contribute to susceptibility to metabolic disturbances in PTSD. The study included 333 Caucasian males with combat related PTSD, diagnosed according to DSM-5 criteria. Genotyping of the BDNF Val66Met and C270T polymorphisms was performed using the real-time PCR method. Results were analyzed using hierarchical multiple linear regression and the Mann-Whitney test, with p-value corrected to 0.005. The results showed that BDNF Val66Met and BDNF C270T polymorphisms were not significantly associated with BMI, total cholesterol, LDL-cholesterol, HDL-cholesterol or triglycerides. Although the BDNF C270T polymorphism was nominally associated only with HDL-cholesterol in veterans with PTSD, this significance disappeared after controlling for the effect of age. Namely, slightly higher plasma HDL values in T allele carriers, compared to CC homozygotes, were associated with differences in age. Our results, controlled for the critical covariates, revealed that BDNF Val66Met and C270T were not significantly associated with metabolic indices in veterans with PTSD and that these genetic variants do not contribute to susceptibility to metabolic disturbances in PTSD.
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Affiliation(s)
- Lucija Tudor
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Marcela Konjevod
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Matea Nikolac Perkovic
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Dubravka Svob Strac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Gordana Nedic Erjavec
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Suzana Uzun
- Department of Biological Psychiatry and Psychogeriatry, University Psychiatric Hospital Vrapce, Zagreb, Croatia.,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Oliver Kozumplik
- Department of Biological Psychiatry and Psychogeriatry, University Psychiatric Hospital Vrapce, Zagreb, Croatia.,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Marina Sagud
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Psychiatry, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Zrnka Kovacic Petrovic
- Department of Biological Psychiatry and Psychogeriatry, University Psychiatric Hospital Vrapce, Zagreb, Croatia.,Department of Psychopharmacology, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Nela Pivac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
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Lin W, Gong L, Xia M, Dai W. Prevalence of posttraumatic stress disorder among road traffic accident survivors: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2018; 97:e9693. [PMID: 29505023 PMCID: PMC5779792 DOI: 10.1097/md.0000000000009693] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Involvement in road traffic accidents (RTAs) may put individuals at increased risk for a wide range of psychiatric disorders, among which posttraumatic stress disorder (PTSD) presents a public health issue. However, a great disparity was observed among studies exploring the prevalence of PTSD among RTA survivors. This meta-analysis aimed to explore the pooled prevalence of PTSD among RTA survivors. METHODS Electronic databases of PubMed, Embase, Web of Science, PsycARTICLES, PsycINFO, and CINAHL were searched to identify relevant studies. Study selection and data extraction were conducted independently by 2 investigators, and a meta-analysis was performed to synthesize the data. Heterogeneity among studies was evaluated using the Cochran Q test and quantified using the I statistic. Subgroup analyses were performed to identify the source of the heterogeneity. The possibility of publication bias was assessed using Egger linear test. RESULTS Fifteen eligible studies containing 6804 RTA survivors were identified in this meta-analysis, of which 1489 were identified with PTSD. The pooled prevalence of PTSD among RTA survivors was 22.25% (95% confidence interval: 16.71%-28.33%). A high degree of heterogeneity was observed across studies (I = 97.1%, P < .001), with reported PTSD prevalence ranging from 6.3% to 58.3%. Subgroup analyses found that the prevalence of PTSD among RTA survivors varied significantly across studies in relation to the instrument used to assess PTSD, country, race, gender, and education level (P < .05). CONCLUSION The high pooled prevalence of PTSD among RTA survivors found in this study significantly underscores the need for providing timely and effective intervention strategies for RTA survivors.
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Affiliation(s)
| | | | | | - Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
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