Department of Psychiatry and Psychotherapy,University Medicine Greifswald,Greifswald,Germany.
Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald,Greifswald,Germany.
Psychol Med. 2019 Apr;49(5):843-851. doi: 10.1017/S0033291718001496. Epub 2018 Jun 18.
Previous studies suggested that exposure to traumatic events during childhood and adulthood and post-traumatic stress disorder (PTSD) are associated with a dysregulation of different neuroendocrine systems. However, the activity of the renin-angiotensin-aldosterone-system (RAAS) in relation to trauma/PTSD has been largely neglected.
Traumatization, PTSD, and plasma concentrations of renin and aldosterone were measured in 3092 individuals from the general population. Subgroups according to the status of traumatization ('without trauma'; 'trauma, without PTSD', 'PTSD') were formed and compared regarding renin and aldosterone concentrations. Additionally, we calculated the associations between the number of traumata, renin, and aldosterone concentrations. Finally, associations of PTSD with renin/aldosterone levels were controlled for the number of traumata ('trauma load').
Levels of renin, but not aldosterone, were increased in traumatized persons without PTSD (p = 0.02) and, even stronger, with PTSD (p < 0.01). Moreover, we found a dose-response relation between the number of traumata and renin levels (β = 0.065; p < 0.001). Regression analyses showed PTSD as a significant predictor of renin (β = 0.38; p < 0.01). This effect was only slightly attenuated when controlled for trauma load (β = 0.32; p < 0.01).
Our results suggest that traumatization has lasting and cumulative effects on RAAS activity. Finding elevated renin levels in PTSD independent from trauma load supports the concept of PTSD as a disorder with specific neuroendocrine characteristics. Alternatively, elevated renin levels in traumatized persons may increase the risk for developing PTSD. Our findings contribute to explain the relationship between traumatic stress/PTSD and physical disorders.
先前的研究表明，儿童期和成年期暴露于创伤事件以及创伤后应激障碍（PTSD）与不同神经内分泌系统的失调有关。然而，肾素-血管紧张素-醛固酮系统（RAAS）的活性与创伤/创伤后应激障碍的关系在很大程度上被忽视了。
在来自普通人群的 3092 个人中测量了创伤、PTSD 以及肾素和醛固酮的血浆浓度。根据创伤状态（“无创伤”；“创伤，无 PTSD”，“PTSD”）形成亚组，并比较肾素和醛固酮浓度。此外，我们计算了创伤数量与肾素和醛固酮浓度之间的关联。最后，控制创伤数量（“创伤负荷”）后，将 PTSD 与肾素/醛固酮水平的关联进行了控制。
无 PTSD 的创伤患者（p = 0.02）和 PTSD 患者（p < 0.01）的肾素水平升高，但无 PTSD 的创伤患者的肾素水平升高（p = 0.02），甚至更强。此外，我们发现创伤数量与肾素水平之间存在剂量反应关系（β = 0.065；p < 0.001）。回归分析表明，PTSD 是肾素的重要预测指标（β = 0.38；p < 0.01）。当控制创伤负荷时，这种影响仅略有减弱（β = 0.32；p < 0.01）。
我们的研究结果表明，创伤对 RAAS 活性具有持久和累积的影响。在 PTSD 中独立于创伤负荷发现肾素水平升高支持 PTSD 作为一种具有特定神经内分泌特征的疾病的概念。或者，创伤患者的肾素水平升高可能会增加发生 PTSD 的风险。我们的研究结果有助于解释创伤后应激障碍/创伤后应激障碍与身体疾病之间的关系。
