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Association of posttraumatic stress disorder with low-grade elevation of C-reactive protein: Evidence from the general population
Authors:Carsten Spitzer  Sven Barnow  Henri Wallaschofski  Harald J. Freyberger  Hans Joergen Grabe
Affiliation:a Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Klinikum Eilbek (Schön Kliniken), Hamburg, Martinistr. 52, 20246 Hamburg, Germany
b Institute of Psychology, Ruprecht-Karls University, Heidelberg, Germany
c Institute for Community Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany
d Department of Gastroenterology, Endocrinology and Nutrition, Ernst-Moritz-Arndt-University, Greifswald, Germany
e Institute of Epidemiology and Social Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany
f Department of Psychiatry and Psychotherapy, Ernst-Moritz-Arndt-University, Greifswald, Germany
Abstract:

Background

Posttraumatic stress disorder (PTSD) has been associated with several somatic diseases, and low-grade inflammation may be one psychobiological mechanism mediating this relationship. We assessed the association between PTSD and elevated serum levels of C-reactive protein (CRP; >3 mg/L) in a large general population sample.

Methods

About 3049 adults living in the community were included in the present study. CRP, lipoproteins and triglycerides were determined. Participants were also examined with regard to blood pressure, body mass index (BMI), physical activity, comorbid somatic diseases, medication, daily alcohol intake, and depression.

Results

PTSD was diagnosed in 55 participants (1.8%), and low-grade inflammation (i.e. CRP >3 mg/L) was found in 701 subjects (23.0%). PTSD positive participants had significantly higher odds for elevated CRP values than those without PTSD (OR = 2.27; 95% CI: 1.32-3.93). Even after adjusting for sex, age, other sociodemographic factors, BMI, blood pressure, lipoproteins and triglycerides, physical activity, comorbid somatic diseases, daily alcohol intake, and trauma exposure, there were almost twofold higher odds for elevated CRP levels in participants with PTSD compared to those without PTSD (OR = 1.87; 95% CI: 1.05-3.35).

Conclusions

Our findings suggest a close relationship between PTSD and low-grade inflammation possibly representing one psychobiological pathway from PTSD to poor physical health, particularly with respect to cardiovascular and pulmonary disease as well as diabetes.
Keywords:Posttraumatic stress disorder (PTSD)   Inflammation   C-Reactive protein (CRP)   Cardiovascular disease (CVD)   General population
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