Institute of Epidemiology II, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany.
Cytokine. 2013 Aug;63(2):201-8. doi: 10.1016/j.cyto.2013.04.033. Epub 2013 May 22.
Several studies have shown associations of posttraumatic stress disorder (PTSD) with the development of cardiometabolic diseases. The underlying psychopathological mechanisms, including potential links to inflammatory processes, have been discussed but remain elusive. Therefore, the aim of the present study was to evaluate the association of PTSD symptoms with the inflammatory biomarkers C-reactive protein (CRP) and interleukin-18 (IL-18). The study population consisted of 3012 participants aged 32-81years drawn from the population-based KORA F4 study conducted in 2006-08 in the Augsburg region (Southern Germany). PTSD symptoms were measured by the Impact of Event Scale, the Posttraumatic Diagnostic Scale and interview data and classified as no, partial or full PTSD. The associations of PTSD with CRP and IL-18 concentrations were estimated by multiple regression analyses with adjustments for age, sex and cardiometabolic risk factors. Linear regression analyses showed no significant association between PTSD and CRP or IL-18 concentration: adjusted for age and sex, the geometric mean concentrations in participants with full PTSD was for CRP 9% lower and for IL-18 1% higher than in participants with no PTSD (p values 0.53 and 0.89). However, further analyses indicated that individuals with partial PTSD had an increased chance of belonging to the highest quartile of the IL-18 concentration. No significant association was observed for any of the three subscales intrusion, avoidance or hyperarousal with CRP or IL-18 concentration. This large, population-based study could not find an association of full PTSD with CRP and IL-18 concentrations. Further research is needed to analyse these relationships.
几项研究表明,创伤后应激障碍(PTSD)与心血管代谢疾病的发展有关。潜在的精神病理学机制,包括与炎症过程的潜在联系,已经被讨论过,但仍然难以捉摸。因此,本研究旨在评估 PTSD 症状与炎症生物标志物 C 反应蛋白(CRP)和白细胞介素-18(IL-18)之间的关系。该研究人群由 3012 名年龄在 32-81 岁的参与者组成,他们来自于 2006-08 年在德国南部奥格斯堡地区进行的基于人群的 KORA F4 研究。PTSD 症状通过事件影响量表、创伤后诊断量表和访谈数据进行测量,并分为无、部分或完全 PTSD。通过多元回归分析,调整年龄、性别和心血管代谢危险因素,估计 PTSD 与 CRP 和 IL-18 浓度之间的关联。线性回归分析显示,PTSD 与 CRP 或 IL-18 浓度之间没有显著关联:在调整了年龄和性别后,完全 PTSD 患者的 CRP 几何平均浓度比无 PTSD 患者低 9%,IL-18 浓度高 1%(p 值分别为 0.53 和 0.89)。然而,进一步的分析表明,部分 PTSD 患者更有可能属于 IL-18 浓度最高的四分位数。任何一个侵入、回避或过度警觉的亚量表与 CRP 或 IL-18 浓度都没有显著关联。这项大型的基于人群的研究未能发现完全 PTSD 与 CRP 和 IL-18 浓度之间存在关联。需要进一步的研究来分析这些关系。