Talbot Lisa S, Rao Madhu N, Cohen Beth E, Richards Anne, Inslicht Sabra S, OʼDonovan Aoife, Maguen Shira, Metzler Thomas J, Neylan Thomas C
From the San Francisco VA Medical Center (Talbot, Rao, Cohen, Richards, Inslicht, O'Donovan, Maguen, Metzler, Neylan), San Francisco, California; and Departments of Medicine (Rao, Cohen) and Psychiatry (Talbot, Richards, Inslicht, O'Donovan, Maguen, Neylan), University of California, San Francisco, California.
Psychosom Med. 2015 May;77(4):383-91. doi: 10.1097/PSY.0000000000000176.
Posttraumatic stress disorder (PTSD) is associated with indicators of poor physical health and sleep disturbance. This study investigated the relationship between PTSD and metabolic risk factors and examined the role of sleep duration in medically healthy and medication-free adults.
Participants with PTSD (n = 44, mean age = 30.6 years) and control participants free of lifetime psychiatric history (n = 50, mean age = 30.3 years) recorded sleep using sleep diary for 10 nights and actigraphy for 7 nights. We assessed metabolic risk factors including fasting triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein cholesterol, as well as abdominal fat using dual-energy x-ray absorptiometry.
PTSD was associated with shorter sleep duration (based on self-report, not actigraphy) and higher metabolic risks (controlling for body fat percentage), including increased triglycerides (p = .03), total cholesterol (p < .001), LDL cholesterol (p = .006), very low density lipoprotein cholesterol (p = .002), and cholesterol/high-density lipoprotein ratio (p = .024). In addition, sleep duration was associated with metabolic risks in PTSD (significant correlations ranged from r = -0.20 to r = -0.40) but did not fully account for the association between PTSD and metabolic measures.
Metabolic risk factors are associated with PTSD even in early adulthood, which highlights the need for early intervention. Future longitudinal research should assess whether sleep disturbance in PTSD is a mechanism that contributes to heightened metabolic risk to elucidate the pathway from PTSD to higher rates of medical disorders such as obesity, diabetes, and heart disease.
创伤后应激障碍（PTSD）与身体健康不佳和睡眠障碍指标相关。本研究调查了PTSD与代谢风险因素之间的关系，并检验了睡眠时间在身体健康且未服用药物的成年人中的作用。
患有PTSD的参与者（n = 44，平均年龄 = 30.6岁）和无终生精神病史的对照参与者（n = 50，平均年龄 = 30.3岁）使用睡眠日记记录10晚的睡眠情况，并使用活动记录仪记录7晚的睡眠情况。我们评估了代谢风险因素，包括空腹甘油三酯、总胆固醇、低密度脂蛋白（LDL）胆固醇和高密度脂蛋白胆固醇，以及使用双能X线吸收法测量腹部脂肪。
PTSD与较短的睡眠时间（基于自我报告，而非活动记录仪记录）和较高的代谢风险（控制身体脂肪百分比）相关，包括甘油三酯升高（p = .03）、总胆固醇升高（p < .001）、LDL胆固醇升高（p = .006）、极低密度脂蛋白胆固醇升高（p = .002）以及胆固醇/高密度脂蛋白比值升高（p = .024）。此外，睡眠时间与PTSD中的代谢风险相关（显著相关性范围为r = -0.20至r = -0.40），但并未完全解释PTSD与代谢指标之间的关联。
即使在成年早期，代谢风险因素也与PTSD相关，这凸显了早期干预的必要性。未来的纵向研究应评估PTSD中的睡眠障碍是否是导致代谢风险升高的一种机制，以阐明从PTSD到肥胖、糖尿病和心脏病等更高发病率的医学疾病的途径。
