"Association of Severity of Posttraumatic Stress Disorder With Inflammation: Using Total White Blood Cell Count as a Marker".
"Association of Severity of Posttraumatic Stress Disorder With Inflammation: Using Total White Blood Cell Count as a Marker".
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DOI：
10.1177/2470547019877651
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发表时间：
2019-01-01
期刊：
影响因子：
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通讯作者：
Scherrer, Jeffrey F
中科院分区：
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作者：
Koraishy, Farrukh M;Salas, Joanne;Scherrer, Jeffrey F
背景：炎症与创伤后应激障碍(PTSD)有关。目前尚不清楚总白细胞(WBC)计数，一种常规检查的炎症标志物，是否与使用病历数据的PTSD症状轨迹有关。方法：我们使用潜在类别增长分析，使用PTSD检查表(PCL)评分来识别三年的PTSD症状轨迹。每个患者的结果是从PTSD指数诊断到最后一次PCL的最大WBC计数。采用线性回归分析方法，在控制年龄、性别、种族、肥胖、吸烟、糖尿病、高血压、心血管疾病、抑郁症和其他并存炎症条件前后，计算并比较每个轨迹的平均WBC计数。结果：患者年龄40.2(SD±13.5)岁，男性83.7%，白人67.9%。我们根据一段时间内症状的严重程度确定了三个PCL轨迹组：“中度-大量减少”、“中度严重-轻微减少”和“严重-持续”。在调整后的分析中，“重度持续性”与“中度重度下降”相比，WBC计数显著增加(B=0.64；95%CI=0.18，1.09；p=0.006)。虽然无统计学意义，但“中度重度-轻微下降”与“中度-重度下降”相比，WBC计数也较高(B=0.42；95%CI：-0.02，0.86；p=0.061)。结论：持续重度PTSD与WBC计数高于改善PTSD相关。在涉及大型管理病历数据库的回溯性队列研究中，白细胞似乎可用于测量精神障碍和炎症之间的联系。
BACKGROUND: Inflammation is known to be associated with posttraumatic stress disorder (PTSD). It is not known if total white blood cell (WBC) count, a routinely checked inflammatory marker, is associated with PTSD symptom trajectories using medical record data.METHODS: We used latent class growth analysis to identify three-year PTSD symptom trajectories using PTSD Checklist (PCL) scores. The outcome for each patient was maximum WBC count from index PTSD diagnosis to last PCL. Using linear regression analysis, we then calculated and compared the average WBC count for each trajectory before and after controlling for age, gender, race, obesity, smoking, diabetes, hypertension, cardiovascular disease, depression and other co-morbid inflammatory conditions.RESULTS: Patients were 40.2 (SD±13.5) years of age, 83.7% male and 67.9% white. We identified three PCL trajectory groups based on symptom severity over time: 'moderate-large decrease', 'moderate severe-slight decrease', and 'severe-persistent'. In adjusted analyses, 'severe-persistent' vs. 'moderate-large decrease' had significantly higher WBC count (B=0.64; 95%CI=0.18, 1.09; p=.006). Although non-significant, 'moderate severe-slight decrease' vs. 'moderate-large decrease' also had a higher WBC count (B=0.42; 95% CI: -0.02, 0.86; p=.061).CONCLUSION: Persistently severe PTSD is associated with a higher WBC count than improving PTSD. WBC appears to have utility for measuring the association between psychiatric disorders and inflammation in retrospective cohort studies involving large administrative medical record data bases.