Neurocognitive difficulties in trauma-exposed adults with metabolic syndrome: no influence of PTSD status or PTSD and metabolic syndrome comorbidity.

Sharain Suliman, Leigh van den Heuvel, Erine Bröcker, Soraya Seedat
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Abstract

Background: Metabolic syndrome (MetS) and posttraumatic stress disorder (PTSD) often co-occur and both may compromise cognition, owing in part to common underlying mechanisms. Few studies have investigated the additive effects of these disorders on cognitive performance. Our aims were to compare cognitive performance between patients with PTSD and trauma-exposed controls (TEC) and investigate the additive effects of MetS factors on cognition.

Methods: In this case-control study, we included 474 adult participants, 236 with PTSD and 238 TEC. Demographic, neuropsychiatric, metabolic-related, and neurocognitive assessments were undertaken and MANCOVAs performed controlling for age. Cognitive domains (immediate and delayed memory, attention, language, visuospatial performance, working memory and global cognition) were the dependent variables in the analysis. Patient status and presence/absence of MetS or MetS components were independent variables, in each model.

Results: Patients with PTSD did not demonstrate worse cognitive performance than TEC on the neurocognitive domains assessed, and the presence of MetS in patients with PTSD did not alter this finding. Individuals with MetS also did not demonstrate worse cognition when compared to those without MetS. When we looked at individual MetS features, higher BMI was associated with poorer visuospatial performance, CONCLUSIONS: These findings contrast with many previous studies showing worse neurocognitive performance related to both PTSD and MetS. Further investigation is required to establish the contribution of MetS to cognitive deficits in those with PTSD. Generalisability and inferences regarding the directionality of associations are limited.

背景:代谢综合征(MetS)和创伤后应激障碍(PTSD)经常并发,两者都可能损害认知能力,部分原因是两者具有共同的潜在机制。很少有研究调查这些疾病对认知能力的叠加效应。我们的目的是比较创伤后应激障碍患者和创伤暴露对照组(TEC)的认知能力,并研究 MetS 因素对认知能力的叠加效应:在这项病例对照研究中,我们纳入了 474 名成年参与者,其中 236 人患有创伤后应激障碍,238 人患有创伤暴露对照。研究人员进行了人口统计学、神经精神病学、代谢相关和神经认知评估,并在控制年龄的情况下进行了 MANCOVA。认知领域(即时和延迟记忆、注意力、语言、视觉空间表现、工作记忆和整体认知)是分析的因变量。在每个模型中,患者状态和是否存在 MetS 或 MetS 成分是自变量:结果:在所评估的神经认知领域中,创伤后应激障碍患者的认知表现并不比 TEC 差,创伤后应激障碍患者是否患有 MetS 也不会改变这一结果。与没有 MetS 的人相比,有 MetS 的人也没有表现出更差的认知能力。当我们观察个体 MetS 特征时,较高的体重指数与较差的视觉空间表现相关:这些研究结果与之前的许多研究结果形成了鲜明对比,这些研究结果表明创伤后应激障碍和 MetS 都会导致神经认知能力下降。要确定创伤后应激障碍患者的认知缺陷是由 MetS 造成的,还需要进一步的调查。有关关联方向性的普遍性和推断是有限的。
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