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Open Access Highly Accessed Research article

The association of posttraumatic stress disorder and metabolic syndrome: a study of increased health risk in veterans

Pia S Heppner12*, Eric F Crawford3, Uzair A Haji1, Niloofar Afari12, Richard L Hauger12, Boris A Dashevsky4, Paul S Horn45, Sarah E Nunnink1 and Dewleen G Baker12

Author Affiliations

1 Veterans Affairs San Diego Health Care System, Research Service, MC 151, La Jolla Village Drive, San Diego, CA 92161, USA

2 Department of Psychiatry, University of California at San Diego, Gilman Drive, MC:0603, La Jolla, CA 92093-0603, USA

3 Durham Veterans Affairs Medical Center, Felton Street, Durham, NC 27705, USA

4 Psychiatry Service, Cincinnati Veterans Affairs Medical Center, Vine Street, Cincinnati, OH 45220, USA

5 Department of Mathematical Sciences, University of Cincinnati, Old Chemistry Building, Cincinnati, OH 45221-0025, USA

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BMC Medicine 2009, 7:1  doi:10.1186/1741-7015-7-1

Published: 9 January 2009



There is accumulating evidence for a link between trauma exposure, posttraumatic stress disorder (PTSD) and diminished health status. To assess PTSD-related biological burden, we measured biological factors that comprise metabolic syndrome, an important established predictor of morbidity and mortality, as a correlate of long-term health risk in PTSD.


We analyzed clinical data from 253 male and female veterans, corresponding to five factors linked to metabolic syndrome (systolic and diastolic blood pressure, waist-to-hip ratio and fasting measures of high-density lipoprotein (HDL) cholesterol, serum triglycerides and plasma glucose concentration). Clinical cut-offs were defined for each biological parameter based on recommendations from the World Health Organization and the National Cholesterol Education Program. Controlling for relevant variables including sociodemographic variables, alcohol/substance/nicotine use and depression, we examined the impact of PTSD on metabolic syndrome using a logistic regression model.


Two-fifths (40%) of the sample met criteria for metabolic syndrome. Of those with PTSD (n = 139), 43% met criteria for metabolic syndrome. The model predicted metabolic syndrome well (-2 log likelihood = 316.650, chi-squared = 23.731, p = 0.005). Veterans with higher severity of PTSD were more likely to meet diagnostic criteria for metabolic syndrome (Wald = 4.76, p = 0.03).


These findings provide preliminary evidence linking higher severity of PTSD with risk factors for diminished health and increased morbidity, as represented by metabolic syndrome.