Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; Department of Biomedical Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa.
Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa.
J Psychiatr Res. 2023 Sep;165:105-114. doi: 10.1016/j.jpsychires.2023.07.018. Epub 2023 Jul 19.
Chronic systemic inflammation has been implicated in trauma exposure, independent of a psychiatric diagnosis, and in posttraumatic stress disorder (PTSD) and its highly comorbid conditions, such as metabolic syndrome (MetS). The present study used network analysis to examine the interacting associations between pro-inflammatory cytokines, posttraumatic stress (PTS) symptoms and symptom clusters, and individual components of MetS, in a cohort of 312 participants (n = 139 PTSD cases, n = 173 trauma-exposed controls). Pro-inflammatory cytokines were measured in serum samples using immunoturbidimetric and multiplex assays. Three network models were assessed, and the decision on which model to use was guided by network stability estimates and denseness. Weak negative associations were observed between interleukin one beta (IL-1β) and detachment (D6) and irritability (E1); tumour necrosis factor alpha (TNFα) and hypervigilance (E3); and C-reactive protein (CRP) and emotional cue reactivity (B4), which could be due to high cortisol levels present in a female-majority cohort. Network models also identified positive associations between CRP and waist circumference, blood pressure, and high-density lipoprotein cholesterol (HDL-C). The strongest association was observed between CRP and waist circumference, providing evidence that central obesity is an important inflammatory component of MetS. Some networks displayed high instability, which could be due to the small pool of participants with viable cytokine data. Overall, this study provides evidence for associations between inflammation, PTS symptoms and components of MetS. Future longitudinal studies measuring pro-inflammatory cytokines in the immediate aftermath of trauma are required to gain better insight into the role of inflammation in trauma-exposure and PTSD.
慢性全身炎症与创伤暴露有关，与精神科诊断无关，与创伤后应激障碍（PTSD）及其高度共病，如代谢综合征（MetS）有关。本研究使用网络分析，在 312 名参与者队列中（n=139 例 PTSD 病例，n=173 例创伤暴露对照组），检查促炎细胞因子、创伤后应激（PTS）症状和症状群以及 MetS 个体成分之间的相互关联。使用免疫比浊法和多重检测法测量血清样本中的促炎细胞因子。评估了三种网络模型，网络稳定性估计和密度指导选择使用哪种模型。观察到白细胞介素 1β（IL-1β）与疏离（D6）和易怒（E1）、肿瘤坏死因子-α（TNFα）与过度警惕（E3）以及 C 反应蛋白（CRP）与情绪线索反应性（B4）之间存在微弱的负相关，这可能是由于女性为主的队列中存在高皮质醇水平所致。网络模型还确定了 CRP 与腰围、血压和高密度脂蛋白胆固醇（HDL-C）之间的正相关。CRP 与腰围之间的关联最强，这表明中心性肥胖是 MetS 的一个重要炎症成分。一些网络显示出高度的不稳定性，这可能是由于具有可行细胞因子数据的参与者人数较少所致。总的来说，这项研究提供了炎症与 PTS 症状和 MetS 成分之间关联的证据。需要进行测量创伤后即刻促炎细胞因子的前瞻性纵向研究，以更好地了解炎症在创伤暴露和 PTSD 中的作用。
