The Impact of Blast Exposure—With or Without Traumatic Brain Injury—on Metabolic Abnormalities in Post-9/11 Veterans

• Published in: The journal of head trauma rehabilitation Vol. 38; no. 5; pp. 380 - 390
• Main Authors: Lendvai, Dora, Whittemore, Robin, Womack, Julie A., Fortier, Catherine B., Milberg, William P., Fonda, Jennifer R.
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health, Inc 01-09-2023
• Subjects: Adult; Blast Injuries - complications; Brain Injuries, Traumatic - complications; Brain Injuries, Traumatic - epidemiology; Cross-Sectional Studies; Humans; Male; Obesity; Overweight; Stress Disorders, Post-Traumatic - psychology; Veterans - psychology
• ISSN: 0885-9701; 1550-509X
• DOI: 10.1097/HTR.0000000000000874

The primary aim included explorations of: (1) the associations between the history of blast exposure (BE), close blast exposure (CBE), and blast-related traumatic brain injury (bTBI) and metabolic abnormality; and (2) the potential mediating effect of comorbid psychological and somatic conditions on these associations. The secondary aim explored the association of dose-response impact of BE, CBE, and bTBI and metabolic abnormality.
Data were collected by the Translational Research Center for TBI and Stress Disorders (TRACTS).
Post-9/11 veterans from the TRACTS baseline sample who had conflict-zone deployment experience ( N = 734).
Cross-sectional secondary data analysis. We computed relative risks (RRs) and 95% CI using modified Poisson regression. We quantified the impact of co-occurring psychological and somatic conditions on this association using mediation analyses.
Exposures included BE (<100 m), CBE (<10 m), and bTBI. Metabolic abnormality outcomes included (1) overweight/obesity (defined by abnormal waist-hip ratio [WHR] and abnormal waist circumference [WC]); (2) glucose dysregulation; and (3) meeting criteria for cardiometabolic syndrome (defined by guidelines).
The sample was majority male (91%) and White (68%), with a mean age of 34.6 years (SD = 8.99). Most participants had 1 or more BE (83%); 48% experienced 1 or more CBE. Overweight/obesity was highly prevalent in the sample (51% had abnormal WHR and 60% abnormal WC). There was no significant direct or indirect association between BE, CBE, and bTBI and metabolic abnormalities (RRs: 0.70-1.51; P 's > .05).
Future research is needed to investigate the association of BE with metabolic abnormalities with larger, more targeted sample selection, and longer follow-up. Effective and sustainable weight management and metabolic health prevention interventions for this veteran cohort are needed.