PTSD and suPAR: A multicohort investigation of chronic inflammation

Posttraumatic stress disorder (PTSD) is associated with poor health. Prior research has shown stressful events are associated with inflammatory biomarkers, such as soluble urokinase plasminogen activator receptor (suPAR), suggesting systemic chronic inflammation could be a mechanism linking adversity to poor health. In this study, we examined associations of PTSD and suPAR in two research cohorts-the E-Risk Study (United Kingdom; n = 1,389) and the Dunedin Multidisciplinary Health and Development Study (New Zealand; n = 927)-and a clinical cohort of medical patients (Denmark; n = 29,285). We also present results from two commonly assessed inflammatory biomarkers: C-reactive protein (CRP) and interleukin-6 (IL-6). People with a lifetime history of PTSD had higher suPAR at age 18 in E-Risk (β = 0.21, p = 0.046) and age 38 in the Dunedin Study (β = 0.23, p = 0.025), but not age 45 in the Dunedin Study (β = 0.18, p = 0.050). Individuals who developed PTSD in the year prior to age 45 in Dunedin had significant increases in suPAR from age 38 to 45 (β = 0.45, p = 0.034). Danish patients with a recent diagnosis of PTSD or a stress-related psychiatric disorder had higher levels of suPAR compared to propensity score-matched patients without such diagnoses (0.10 < βs < 0.24, ps < 0.05). CRP and IL-6 did not show consistent associations with PTSD. These results suggest that PTSD is associated with suPAR and that systemic chronic inflammation could help explain how trauma and PTSD might result in poor health.