National Center for PTSD, Boston, MA.
Translational Research Center for Traumatic Brain Injury and Stress Disorders, and Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Boston Healthcare System, 150 S. Huntington Ave, Boston, MA.
Mil Med. 2020 Jun 8;185(5-6):e592-e596. doi: 10.1093/milmed/usaa005.
Post-traumatic stress disorder (PTSD) is associated with an increased risk of cardiovascular and metabolic diseases and physical inactivity. Cardiorespiratory fitness (CRF), which is modifiable by physical activity, is a strong independent predictor of cardiometabolic health. However, the relationship between CRF and cardiometabolic health in veterans with PTSD is unknown. Thus, this study aimed to explore the cross-sectional relationships among CRF, indices of cardiometabolic health (ie, HbA1c, blood lipids, blood pressure, waist-hip ratio, and body mass index), and PTSD severity in veterans with PTSD.
This study was approved by the local Institutional Review Board. All participants were informed of the study risks and provided consent prior to participation. Participants (n = 13) completed a cardiopulmonary exercise test, a fasting blood draw, and the Clinician Administered PTSD Scale. Correlations between CRF and cardiometabolic health were examined with Spearman's rank correlations, and differences in PTSD symptom severity were explored as a function of CRF (ie, low-to-moderate vs. high CRF), using multiple linear regression.
Peak oxygen uptake ($\dot{\mathrm{V}}$O2peak) was correlated with high-density lipoproteins rho = 0.60, P = 0.04 and diastolic blood pressure rho = -0.56, P = 0.05. Ventilatory threshold was correlated with HbA1c rho = -0.61, P = 0.03 and diastolic blood pressure rho = -0.56, P = 0.05. Higher CRF was associated with lower total PTSD severity standardized β = -0.84, P = 0.01, adjusted R2 = 0.47, total Cluster C symptoms (avoidance/numbing) β = -0.71, P = 0.02, adjusted R2 = 0.49, and total Cluster D symptoms (hyperarousal) β = -0.89, P = 0.01, adjusted R2 = 0.41, while adjusting for age and smoking status.
These preliminary findings suggest that CRF and by proxy physical activity may be important factors in understanding the increased risk of cardiovascular and metabolic disease associated with PTSD.
创伤后应激障碍（PTSD）与心血管和代谢疾病以及身体活动减少的风险增加有关。心肺功能（CRF）可通过身体活动改变，是心血管代谢健康的强有力独立预测因子。然而，PTSD 退伍军人的 CRF 与心血管代谢健康之间的关系尚不清楚。因此，本研究旨在探讨 PTSD 退伍军人中 CRF 与心血管代谢健康指标（即 HbA1c、血脂、血压、腰臀比和体重指数）之间的横断面关系。
本研究获得了当地机构审查委员会的批准。所有参与者在参与之前均被告知了研究风险并同意参加。参与者（n=13）完成了心肺运动测试、空腹抽血和临床医生管理的 PTSD 量表。使用 Spearman 等级相关检验检查了 CRF 与心血管代谢健康之间的相关性，并使用多元线性回归探讨了 PTSD 症状严重程度随 CRF 的差异（即低至中度 CRF 与高 CRF）。
峰值摄氧量（$\dot{\mathrm{V}}$O2peak）与高密度脂蛋白呈正相关 rho=0.60，P=0.04，与舒张压呈负相关 rho=-0.56，P=0.05。通气阈与 HbA1c 呈负相关 rho=-0.61，P=0.03，与舒张压呈负相关 rho=-0.56，P=0.05。较高的 CRF 与 PTSD 严重程度标准化得分较低相关β=-0.84，P=0.01，调整后的 R2=0.47，总 Cluster C 症状（回避/麻木）β=-0.71，P=0.02，调整后的 R2=0.49，总 Cluster D 症状（过度警觉）β=-0.89，P=0.01，调整后的 R2=0.41，同时调整年龄和吸烟状况。
这些初步发现表明，CRF 及其代理身体活动可能是理解 PTSD 相关心血管和代谢疾病风险增加的重要因素。
