engleski

Cytokines and metabolic syndrome in Croatian war veterans with post-traumatic stress disorder (PTSD)

The post-traumatic stress disorder (PTSD) develops as a reaction to stress in an individual who has been exposed to a traumatic event that threatens life, leads to serious and permanent injury or if a person has been exposed to sexual violence. Due to disturbances in glucocorticoid signalling, stress affects communication through hypothalamus-hypophysis-adrenal (HHA) axis and the immune system, resulting in disturbances of immune reactions. Changes in immune responses are associated with increased morbidity and mortality of patients with PTSD. How cytokines affect the emotional and psychological state is still not fully understood, but research shows that increased levels of pro-inflammatory cytokines are associated with symptoms of anxiety and depression. Furthermore, in people with PTSD higher prevalence of metabolic syndrome (MS) and consequential disorders was observed. The aim of this study was to determine possible changes in the concentration of pro-inflammatory cytokines in patients with PTSD and to identify possible relationship with increased risk for MS development. The study included 81 male veterans who served in Croatian Homeland war. In 50 patients the diagnosis of PTSD was confirmed by the certified psychiatrists from the University Psychiatric Hospital Vrapče, Zagreb, according to ICD- 10 and DSM-IV-TR diagnostic criteria. Control group included 31 participants who were exposed to similar trauma of combat activities, but fortunately did not develop symptoms of the disease. In blood of the participants the concentrations of interleukins IL-1, IL-6 and tumour necrosis factor α (TNF-α) were determined by ELISA tests, and the risk of MS was assessed according to National Cholesterol Education Program (NCEP) and International Diabetes Federation (IDF) criteria. The values of IL-1, IL-6 and TNF-α were within the reference range in both, PTSD and control group. There was no statistically significant difference between the two groups. According to IDF criteria, in PTSD group the increased risk for the development of MS was identified. No relationship between cytokine levels and MS risk factors was established. Normal levels of interleukins are probably the result of an adaptation of the organism during the time elapsed from the moment of stress. The increased risk of developing MS indicates the need for intensive supervision and patient education in order to prevent further health deterioration.

cytokines ; metabolic syndrome ; PTSD

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