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The prevalence and risk of metabolic syndrome and its components among people with posttraumatic stress disorder: a systematic review and meta-analysis
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 prevalence 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 9,673 individuals in midlife with PTSD and 6852 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 = 44-61 years). Abdominal obesity was observed in 49.3% (95% CI = 29.7%-69.0%), hyperglycemia 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.
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“chronic conditions such as coronary artery disease, fibromyalgia, rheumatoid arthritis, and mood disorders such as Major Depressive Disorder (MDD) and Post Traumatic Stress Disorder (PTSD) have also been associated with abnormally high CORT levels and metabolic disruptions ( 5-13 ).”
From Dynamic modulation of glucose utilisation by glucocorticoid rhythms in health and disease (2020) · cites this paper as [7]
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“many of these conditions are accompanied by a disruption of normal glucose metabolism while preserving some degree of CORT rhythmicity.”
From Dynamic modulation of glucose utilisation by glucocorticoid rhythms in health and disease (2020) · cites this paper as [7]
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“in hypercortisolism, it is not only that CORT levels are higher than normal, but in some cases, they also display abnormal rhythmicity. This varies depending on whether the underlying condition is associated with Cushing's syndrome, depression, PTSD, acute inflammation following major surgery, or chronic inflammatory diseases (e.g., rheumatoid arthritis) ( 2, 5-13, 57-60 ).”
From Dynamic modulation of glucose utilisation by glucocorticoid rhythms in health and disease (2020) · cites this paper as [7]
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“Social determinants including poverty, poor education, unemployment, homelessness and childhood abuse increase the risk for both mental and physical disorders.89,292”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [89]
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Metadata
- Authors
- Rosenbaum, S., Stubbs, B., Ward, P. B., Steel, Z., Lederman, O., & Vancampfort, D.
- Affiliations
- UNSW Sydney (AU)
- University of Greenwich (GB)
- KU Leuven (BE)
- Corresponding author
- Vancampfort, Davy
- Venue
- Metabolism
- Publisher
- Elsevier BV
- Published
- 2015-08
- Volume
- 64
- Issue
- 8
- Pages
- 926-933
- ISSN
- 0026-0495 (ISSN-L)
- OpenAlex
- W2154972467
- Cited by
- 246
- References
- 59
- Citations by year
- 2026: 12 · 2025: 33 · 2024: 33 · 2023: 28 · 2022: 18 · 2021: 20 · 2020: 19 · 2019: 26 · 2018: 16 · 2017: 17 · 2016: 18 · 2015: 6
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Greenwich Academic Literature Archive (University of Greenwich) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion)
- Lirias (KU Leuven) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
- Keywords
- post-traumatic stress disorder, metabolic syndrome, prevalence, abdominal obesity, hypertriglyceridemia, low HDL cholesterol, hypertension, hyperglycemia, cardiovascular risk, war veterans, middle-aged adults, comorbidities, multidisciplinary management, trauma-informed care
- MeSH terms
- Humans, Risk, Stress Disorders, Post-Traumatic, Prevalence, Metabolic Syndrome
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