The Association between Post-traumatic Stress Disorder and Insulin Resistance Open Access

Xiang, Lingwei (2015)

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Introduction: Previous studies has linked posttraumatic stress disorder (PTSD) with insulin resistance (IR), however, most of these studies are cross-sectional and did not capturing familial and early environmental factors.

Methods: We examined whether PTSD associates with future IR before and after controlling for shared genetics and childhood environment in a prospective study of middle-aged male twins from the Vietnam Era Twin Registry. PTSD was diagnosed at enrollment in 1992 with Diagnostic Interview Schedule (DIS) for psychiatric disorders according to the Diagnostic and Statistical Manual of Mental Disorders-Third Edition-Revised (DSM-III-R). IR was measured by insulin and glucose levels as determined by the homeostatic model assessment (HOMA). A total of 475 twins were included in the analysis of PTSD and IR. Of these, 59 were new cases of diabetes diagnosed during follow-up. Mixed-effects regression models were used to examine individual, between-pair and within-pair associations.

Results: Approximately, 23% of participants met the criteria for lifetime PTSD at enrollment. When evaluating twins brothers as a family unit, PTSD was associate with 1.32 mmol/L higher HOMA-IR (95% Confidence Interval: 1.01, 1.73) adjusted for social demographic factors. However, the association became insignificant after controlling for obesity. We found no significant association when evaluating PTSD within discordant twin pairs, however.

Conclusion: Among Vietnam War-era veterans, familial PTSD is positively associated with future insulin resistance, but the effect is mostly mediated by obesity.

Table of Contents

Background. 1

Methods. 2

Study Population. 2

Measurement of Insulin Resistance. 3

Assessment of PTSD. 3

Assessment of potential confounders and mediators. 3

Statistical Analysis. 4

Results. 5

PTSD and Diabetes. 6


Discussion. 7

Reference. 10

Tables and Figures. 13

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