Association of posttraumatic stress disorder with low-grade elevation of C-reactive protein: Evidence from the general population

Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Klinikum Eilbek (Schön Kliniken), Hamburg, Germany.
Journal of Psychiatric Research (Impact Factor: 3.96). 08/2009; 44(1):15-21. DOI: 10.1016/j.jpsychires.2009.06.002
Source: PubMed


Posttraumatic stress disorder (PTSD) has been associated with several somatic diseases, and low-grade inflammation may be one psychobiological mechanism mediating this relationship. We assessed the association between PTSD and elevated serum levels of C-reactive protein (CRP; >3mg/L) in a large general population sample.
About 3049 adults living in the community were included in the present study. CRP, lipoproteins and triglycerides were determined. Participants were also examined with regard to blood pressure, body mass index (BMI), physical activity, comorbid somatic diseases, medication, daily alcohol intake, and depression.
PTSD was diagnosed in 55 participants (1.8%), and low-grade inflammation (i.e. CRP >3mg/L) was found in 701 subjects (23.0%). PTSD positive participants had significantly higher odds for elevated CRP values than those without PTSD (OR=2.27; 95% CI: 1.32-3.93). Even after adjusting for sex, age, other sociodemographic factors, BMI, blood pressure, lipoproteins and triglycerides, physical activity, comorbid somatic diseases, daily alcohol intake, and trauma exposure, there were almost twofold higher odds for elevated CRP levels in participants with PTSD compared to those without PTSD (OR=1.87; 95% CI: 1.05-3.35).
Our findings suggest a close relationship between PTSD and low-grade inflammation possibly representing one psychobiological pathway from PTSD to poor physical health, particularly with respect to cardiovascular and pulmonary disease as well as diabetes.

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    • "However, another study found that PTSD increased both CRP and intercellular adhesion molecule 1 (ICAM-1) [76]. Similarly, a twofold increase for CRP with PTSD has been observed after adjustment for potential confounders, including BMI and blood pressure [77]. Thus, the link between CRP and PTSD needs to be better defined as past results have shown conflicting increases or decreases. "
    Metabolism 08/2014; 63(12). DOI:10.1016/j.metabol.2014.08.009 · 3.89 Impact Factor
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    • "In contrast to mood disorders, studies on the association between anxiety disorders or substance use disorders (SUD) and inflammatory markers are still rare. Recent studies revealed elevated levels of inflammatory markers in subjects with PTSD (Von Kanel et al., 2007; Gill et al., 2009; Spitzer et al., 2010) and in male but not female subjects with current anxiety disorders (Vogelzangs et al., 2013), whereas decreased CRP and IL-6 levels were observed in women with current social phobia (Vogelzangs et al., 2013). A longitudinal study found generalized anxiety disorder (GAD) to be associated with an increased CRP level, but this association was attributable to health-related factors such as BMI and medication use (Copeland et al., 2012). "
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    ABSTRACT: Inflammation is one possible mechanism underlying the associations between mental disorders and cardiovascular diseases (CVD). However, studies on mental disorders and inflammation have yielded inconsistent results and the majority did not adjust for potential confounding factors. We examined the associations of several pro-inflammatory cytokines (IL-1β, IL-6 and TNF-α) and high sensitive C-reactive protein (hsCRP) with lifetime and current mood, anxiety and substance use disorders (SUD), while adjusting for multiple covariates. The sample included 3’719 subjects, randomly selected from the general population, who underwent thorough somatic and psychiatric evaluations. Psychiatric diagnoses were made with a semi-structured interview. Major depressive disorder was subtyped into “atypical”, “melancholic”, “combined atypical-melancholic” and “unspecified”. Associations between inflammatory markers and psychiatric diagnoses were assessed using multiple linear and logistic regression models. Lifetime bipolar disorders and atypical depression were associated with increased levels of hsCRP, but not after multivariate adjustment. After multivariate adjustment, SUD remained associated with increased hsCRP levels in men (β= 0.13 (95% CI: 0.03,0.23)) but not in women. After multivariate adjustment, lifetime combined and unspecified depression were associated with decreased levels of IL-6 (β= -0.27 (-0.51,-0.02); β= -0.19 (-0.34,-0.05), respectively) and TNF-α (β= -0.16 (-0.30,-0.01); β= -0.10 (-0.19,-0.02), respectively), whereas current combined and unspecified depression were associated with decreased levels of hsCRP (β= -0.20 (-0.39,-0.02); β= -0.12 (-0.24,-0.01), respectively). Our data suggest that the significant associations between increased hsCRP levels and mood disorders are mainly attributable to the effects of comorbid disorders, medication as well as behavioral and physical CVRFs.
    Journal of Psychiatric Research 07/2014; DOI:10.1016/j.jpsychires.2014.07.012 · 3.96 Impact Factor
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    • "date, involving more than 3000 community-living adults in Germany, found no clear differences in TG or HDL-C levels between subjects with and without PTSD [12]. Together, these studies indicate some association of lipids in PTSD. "
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    ABSTRACT: Several cross-sectional studies, but no prospective studies, have reported an association between an abnormal lipid profile and posttraumatic stress disorder (PTSD). We hypothesized that an abnormal lipid profile might predict risk for developing PTSD. In this prospective study, we analyzed data from 237 antidepressant-naïve severely injured patients who participated in the Tachikawa Cohort of Motor Vehicle Accident Study. High-density lipoprotein cholesterol (HDL-C) levels at baseline were significantly lower in patients with PTSD than those without PTSD at 6 months after motor vehicle accident (MVA) and were inversely associated with risk for PTSD. In contrast, triglycerides (TG) at baseline were significantly higher in patients with PTSD than in those without PTSD at 6 months post-MVA and were positively associated with risk for PTSD. There was no clear association between low-density lipoprotein cholesterol or total cholesterol and risk for PTSD. In conclusion, low HDL-C and high TG may be risk factors for PTSD. Determining lipid profiles might help identify those at risk for PTSD after experiencing trauma.
    European Psychiatry 06/2014; DOI:10.1016/j.eurpsy.2014.05.002 · 3.44 Impact Factor
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