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

J Head Trauma Rehabil. 2023 Sep-Oct;38(5):380-390. doi: 10.1097/HTR.0000000000000874. Epub 2023 Mar 23.

Abstract

Objective: 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.

Setting: Data were collected by the Translational Research Center for TBI and Stress Disorders (TRACTS).

Participants: Post-9/11 veterans from the TRACTS baseline sample who had conflict-zone deployment experience ( N = 734).

Design: 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.

Main measures: 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).

Results: 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).

Conclusion: 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.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, N.I.H., Extramural

MeSH terms

  • 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