The association between blast exposure and transdiagnostic health symptoms on systemic inflammation.
The association between blast exposure and transdiagnostic health symptoms on systemic inflammation.
复制标题
爆炸暴露与全身炎症的跨诊断健康症状之间的关联。
DOI：
10.1038/s41386-021-01138-8
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
McGlinchey,Regina
中科院分区：
文献类型：
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作者：
Hayes,JasmeetP;Pierce,MeghanE;Valerio,KateE;Miller,MarkW;Huber,BertrandRussell;Fortier,CatherineB;Fonda,JenniferR;Milberg,William;McGlinchey,Regina
在包括创伤后应激障碍、抑郁症和创伤性脑损伤在内的一系列疾病中，可以观察到全身炎症的慢性升高。尽管以前的工作已经分别证明了炎症和各种诊断之间的联系，但很少有研究在同一模型中检查跨诊断症状和炎症。这项研究的目的是检查精神和健康变量与全身炎症之间的关系，并确定轻度创伤性脑损伤(MTBI)和/或暴露于爆炸弹药是否缓和了这些关系。验证性因素分析在9/11后退伍军人的大样本(N= 357)中显示出与反映创伤应激、情感、躯体和代谢潜在变量的四因素模型很好地吻合。分层回归模型显示，每个潜在变量都与较高水平的全身炎症有关。然而，即使在对心理健康潜在变量进行调整后，与炎症的关系也出现在既有战区爆炸暴露又有代谢失调的人中。探索性分析表明，冲击波暴露以剂量-反应方式与代谢失调有关，自我报告的较近的冲击波与最大的代谢失调有关。总而言之，这些结果提供了对与炎症关系最密切的症状类型的更多了解，并强调了保持健康生活方式的重要性，以减少肥胖和其他代谢症状对中青年退伍军人未来慢性疾病的影响。
Chronic elevation of systemic inflammation is observed in a wide range of disorders including PTSD, depression, and traumatic brain injury. Although previous work has demonstrated a link between inflammation and various diagnoses separately, few studies have examined transdiagnostic symptoms and inflammation within the same model. The objective of this study was to examine relationships between psychiatric and health variables and systemic inflammation and to determine whether mild traumatic brain injury (mTBI) and/or exposure to blast munitions moderate these relationships. Confirmatory factor analysis in a large sample (N= 357) of post-9/11 Veterans demonstrated a good fit to a four-factor model reflecting traumatic stress, affective, somatic, and metabolic latent variables. Hierarchical regression models revealed that each of the latent variables were associated with higher levels of systemic inflammation. However, the strongest relationship with inflammation emerged among those who had both war-zone blast exposures and metabolic dysregulation, even after adjusting for mental health latent variables. Exploratory analyses showed that blast exposure was associated with metabolic dysregulation in a dose-response manner, with self-reported closer blast proximity associated with the greatest metabolic dysregulation. Together, these results provide a greater understanding of the types of symptoms most strongly associated with inflammation and underscore the importance of maintaining a healthy lifestyle to reduce the impact of obesity and other metabolic symptoms on future chronic disease in younger to middle-aged Veterans.