Assessment of plasma C-reactive protein as a biomarker of posttraumatic stress disorder risk.
Assessment of plasma C-reactive protein as a biomarker of posttraumatic stress disorder risk.
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DOI：
10.1001/jamapsychiatry.2013.4374
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发表时间：
2014-04
期刊：
影响因子：
25.8
通讯作者：
Baker, Dewleen G.
中科院分区：
文献类型：
--
作者：
Eraly, Satish A.;Nievergelt, Caroline M.;Maihofer, Adam X.;Barkauskas, Donald A.;Biswas, Nilima;Agorastos, Agorastos;O'Connor, Daniel T.;Baker, Dewleen G.
创伤后应激障碍(PTSD)在横断面研究中与外周炎症有关。目前尚不清楚这种观察到的关联是由于易患炎症的创伤后应激障碍(如有时假设的那样)，还是由于易患创伤后应激障碍的炎症。以确定炎症标志物C反应蛋白(CRP)的血浆浓度是否有助于预测未来的PTSD症状。海军陆战队复原力研究(MRS)是一项对部署在战区的约2,600名海军陆战队士兵进行的前瞻性研究，在此期间，创伤后应激障碍症状和各种生理和心理参数在部署前以及在部署7个月后大约3个月和6个月确定。受试者是从四个即将部署到战区的全男性步兵营招募的。2978名受试者被要求参与，其中2610人(87.6%)同意，2555人(85.8%)被纳入当前分析。部署后关于战斗暴露的数据来自2215名受试者(2555名受试者中的86.7%)，创伤后应激障碍症状的数据分别来自部署后3个月和6个月的1861名(72.8%)和1609名受试者(63.0%)。部署后三个月，采用临床医生创伤后应激障碍评定量表(CAPS)进行评估。我们使用零膨胀负二项回归(ZINBR)来确定基线血浆CRP浓度对部署后CAP的影响，ZINBR是为分布设计的程序，例如本研究中的CAPS，除了正偏外，还有多余的零。调整基线上限、创伤暴露和其他相关协变量后，我们发现基线血浆C反应蛋白浓度是部署后上限评分的一个非常显著的总体预测因子(p=0.002)：C反应蛋白浓度每增加10倍，非零结局(有无任何创伤后应激障碍症状)的比数比为1.51时(95%可信区间为1.151.97；p=0.003)，当非零时(出现症状时的程度)为1.062(95%可信区间为0.991.14；p=0.086)。外周炎症的标志物，血浆CRP，可能与创伤后应激障碍症状的出现有关，提示炎症可能是创伤后应激障碍的易感性。
Post-traumatic stress disorder (PTSD) has been associated in cross-sectional studies with peripheral inflammation. It is not known whether this observed association is due to PTSD predisposing to inflammation (as sometimes postulated) or to inflammation predisposing to PTSD. To determine whether plasma concentration of the inflammatory marker, C-reactive protein (CRP), helps predict future PTSD symptoms. The Marine Resiliency Study (MRS), a prospective study of ~2,600 war zone-deployed Marines, during which PTSD symptomatology and various physiological and psychological parameters were determined pre-deployment and at approximately three and six months following a seven month deployment. Subjects were recruited from four all-male infantry battalions imminently deploying to a war zone. Participation was requested of 2,978 subjects, of whom 2,610 (87.6%) consented and 2,555 (85.8%) were included in the current analysis. Post-deployment data on combat exposure were included from 2,215 subjects (86.7% of the 2,555 included subjects), and on PTSD symptomatology from 1,861 (72.8%) and 1,609 subjects (63.0%) at three and six months following deployment, respectively. PTSD symptoms three months after deployment, assessed by the Clinician Administered PTSD Scale (CAPS). We determined the effects of baseline plasma CRP concentration on post-deployment CAPS using Zero-inflated negative binomial regression (ZINBR), a procedure designed for distributions, such as CAPS in this study, which have an excess of zeros in addition to being positively skewed. Adjusting for baseline CAPS, trauma exposure, and other relevant covariates, we found baseline plasma CRP concentration to be a highly significant overall predictor of post-deployment CAPS scores (p=0.002): each 10-fold increment in CRP concentration was associated with an odds ratio of non-zero outcome (presence vs. absence of any PTSD symptoms) of 1.51 (95% CI, 1.15–1.97; p = 0.003) and a fold increase in outcome when non-zero (extent of symptoms when present) of 1.062 (95% CI, 0.99–1.14; p = 0.086). A marker of peripheral inflammation, plasma CRP, may be prospectively associated with PTSD symptom emergence, suggesting that inflammation may predispose to PTSD.
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影响因子：
16.2
作者：
Cavalier, Margherita;Ropele, Stefan;Schmidt, Reinhold
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Gilbertson, MW;Shenton, ME;Pitman, RK
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Pitman, RK