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Associations of trauma exposure and post-traumatic stress disorder with the activity of the renin–angiotensin–aldosterone-system in the general population

Published online by Cambridge University Press:  18 June 2018

Jan Terock Open the ORCID record for Jan Terock [Opens in a new window] ,
Anke Hannemann ,
Deborah Janowitz Open the ORCID record for Deborah Janowitz [Opens in a new window] ,
Harald J. Freyberger ,
Stephan B. Felix Open the ORCID record for Stephan B. Felix [Opens in a new window] ,
Marcus Dörr ,
Matthias Nauck Open the ORCID record for Matthias Nauck [Opens in a new window] ,
Henry Völzke Open the ORCID record for Henry Völzke [Opens in a new window]  and
Hans J. Grabe Open the ORCID record for Hans J. Grabe [Opens in a new window]
Jan Terock*
Affiliation:
Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany Department of Psychiatry and Psychotherapy, HELIOS Hanseklinikum Stralsund, Stralsund, Germany
Anke Hannemann
Affiliation:
Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
Deborah Janowitz
Affiliation:
Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
Harald J. Freyberger
Affiliation:
Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany Department of Psychiatry and Psychotherapy, HELIOS Hanseklinikum Stralsund, Stralsund, Germany
Stephan B. Felix
Affiliation:
Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
Marcus Dörr
Affiliation:
Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
Matthias Nauck
Affiliation:
Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
Henry Völzke
Affiliation:
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
Hans J. Grabe
Affiliation:
Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany German Center for Neurodegenerative Diseases DZNE, Site Rostock/Greifswald, Germany
*
Author for correspondence: Jan Terock, E-mail: jan.terock@helios-gesundheit.de
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Abstract

Background

Previous studies suggested that exposure to traumatic events during childhood and adulthood and post-traumatic stress disorder (PTSD) are associated with a dysregulation of different neuroendocrine systems. However, the activity of the renin–angiotensin–aldosterone-system (RAAS) in relation to trauma/PTSD has been largely neglected.

Methods

Traumatization, PTSD, and plasma concentrations of renin and aldosterone were measured in 3092 individuals from the general population. Subgroups according to the status of traumatization (‘without trauma’; ‘trauma, without PTSD’, ‘PTSD’) were formed and compared regarding renin and aldosterone concentrations. Additionally, we calculated the associations between the number of traumata, renin, and aldosterone concentrations. Finally, associations of PTSD with renin/aldosterone levels were controlled for the number of traumata (‘trauma load’).

Results

Levels of renin, but not aldosterone, were increased in traumatized persons without PTSD (p = 0.02) and, even stronger, with PTSD (p < 0.01). Moreover, we found a dose–response relation between the number of traumata and renin levels (β = 0.065; p < 0.001). Regression analyses showed PTSD as a significant predictor of renin (β = 0.38; p < 0.01). This effect was only slightly attenuated when controlled for trauma load (β = 0.32; p < 0.01).

Conclusions

Our results suggest that traumatization has lasting and cumulative effects on RAAS activity. Finding elevated renin levels in PTSD independent from trauma load supports the concept of PTSD as a disorder with specific neuroendocrine characteristics. Alternatively, elevated renin levels in traumatized persons may increase the risk for developing PTSD. Our findings contribute to explain the relationship between traumatic stress/PTSD and physical disorders.

Keywords

Aldosteronechronic stressgeneral populationPTSDrenintrauma
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 5 , April 2019 , pp. 843 - 851
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

*

Contributed equally.

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