PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among US veterans
PTSD is associated with poor health behavior and greater Body Mass Index through depression, increasing cardiovascular disease and diabetes risk among US veterans
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DOI：
10.1016/j.pmedr.2019.100930
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发表时间：
2019-09-01
影响因子：
2.8
通讯作者：
Nelson, Karin M.
中科院分区：
文献类型：
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作者：
Hoerster, Katherine D.;Campbell, Sarah;Nelson, Karin M.
创伤后应激障碍（PTSD）是心血管疾病（CVD）和糖尿病的危险因素。Dedert及其同事假设了一种模型，即PTSD导致不良健康行为、抑郁和临床前疾病标志物，并且这些因素导致CVD和糖尿病（Ann Behav Med，2010，61-78）。本研究对该模型进行了初步检验。使用2012-2013年进行的邮寄横断面调查的数据，在N = 657例具有完整人口统计学数据的患者中进行路径分析。我们首先分析了假设模型，然后是四个替代方案，以确定最佳拟合模型。另一个模型指定了从抑郁到健康行为的途径，具有最佳拟合。与假设相反，较高的PTSD症状与较好的体力活动和饮食质量相关。在从PTSD到身体质量指数（BMI）的特定间接途径中，只有通过抑郁症的途径是重要的。较高的抑郁症状与较少的体力活动，较差的饮食和更大的吸烟可能性显着相关。此外，抑郁症通过体力活动对BMI的特定间接影响是显着的。目前吸烟和较高的BMI与糖尿病的可能性较大相关，高血压与CVD的可能性较大相关。PTSD症状可能会通过抑郁症对健康行为和BMI的负面影响增加CVD和糖尿病的风险。无论有没有创伤后应激障碍，抑郁症可能是针对退伍军人心血管和代谢疾病的干预措施的重要目标。
Posttraumatic stress disorder (PTSD) is a risk factor for cardiovascular disease (CVD) and diabetes. Dedert and colleagues hypothesized a model whereby PTSD leads to poor health behaviors, depression, and pre-clinical disease markers, and that these factors lead to CVD and diabetes (Ann Behav Med, 2010, 61-78). This study provides a preliminary test of that model. Using data from a mailed cross-sectional survey conducted 2012-2013, path analysis was conducted among N = 657 with complete demographic data. We first analyzed the hypothesized model, followed by four alternatives, to identify the best-fitting model. The alternate model that specified pathways from depression to health behaviors had the best fit. Contrary to hypotheses, higher PTSD symptoms were associated with better physical activity and diet quality. Of the specific indirect pathways from PTSD to Body Mass Index (BMI), only the path through depression was significant. Higher depression symptoms were significantly associated with less physical activity, poorer diet, and greater likelihood of smoking. In addition, the specific indirect effect from depression to BMI through physical activity was significant. Current smoking and higher BMI were associated with greater likelihood of diabetes, and hypertension was associated with greater likelihood of CVD. PTSD symptoms may increase risk for CVD and diabetes through the negative impact of depression on health behaviors and BMI. With or without PTSD, depression may be an important target in interventions targeting cardiovascular and metabolic diseases among veterans.