Rosenbaum, Simon, Stubbs, Brendon, Ward, Philip B., Steel, Zachary, Lederman, Oscar and Vancampfort, Davy (2015) The prevalence and risk of metabolic syndrome and its components among people with posttraumatic stress disorder: A systematic review and meta-analysis. Metabolism, 64 (8). pp. 926-933. ISSN 0026-0495 (doi:https://doi.org/10.1016/j.metabol.2015.04.009)

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Abstract

Objective: People with posttraumatic stress disorder (PTSD) have a higher mortality than the general population, mainly due to cardiovascular diseases (CVD). Metabolic syndrome (MetS) and its components are highly predictive of CVD. The aim of this meta-analysis was to describe pooled frequencies of MetS and its components in people with PTSD and to compare MetS prevalences in PTSD versus the general population.

Method: Medline, PsycARTICLES, Embase and CINAHL were searched until 02/2015 for cross-sectional and baseline data of longitudinal studies in adults with PTSD. Two independent reviewers conducted the searches and extracted data. Random effects meta-analysis with a relative risk, subgroups and meta-regression analyses were employed.

Results: Overall, 9 studies met the inclusion criteria including 9,254 individuals in midlife with PTSD and 6,852 general population controls. The pooled MetS prevalence was 38.7% (95%CI = 32.1%-45.6%; Q = 52.1, p < 0.001; N = 9; n = 9,673; age range = 44-61years). Abdominal obesity was observed in 49.3% (95%CI = 29.7%-69.0%), hyperglycaemia in 36.1% (95%CI = 18.8%-55.6%), hypertriglyceridemia in 45.9% (95%CI = 12.2%-81.9%), low high density-lipoprotein-cholesterol in 46.4% (95%CI = 26.4%-67.0%) and hypertension in 76.9% (95%CI = 67.9%-84.8). The MetS prevalence was consistently high across geographical regions, settings or populations (war veterans or not). Compared with matched general population controls, people with PTSD had an almost double increased risk for MetS (RR = 1.82; 95%CI = 1.72-1.92; p < 0.001). Most analyses were not statistically heterogeneous.

Conclusions: MetS is highly prevalent in people with PTSD. Routine screening and multidisciplinary management of medical and behavioral conditions is needed. Future research should focus on how cardio-metabolic outcomes are moderated by clinical and treatment characteristics and genetic factors.

Item Type:	Article
Additional Information:	This is the Author's Accepted Manuscript version, uploaded in accordance with the publisher's self-archiving policy. Note to users: Accepted manuscripts are Articles in Press that have been peer reviewed and accepted for publication by the Editorial Board of this publication. They have not yet been copy edited and/or formatted in the publication house style, and may not yet have the full ScienceDirect functionality, e.g., supplementary files may still need to be added, links to references may not resolve yet etc. The text could still change before final publication.
Uncontrolled Keywords:	PTSD, metabolic syndrome, glucose, MetS, cardiovascular disease, lipids
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > R Medicine (General)
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences
Last Modified:	14 Oct 2016 09:33
URI:	http://gala.gre.ac.uk/id/eprint/13608

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