Fig. 2.

Box plot representation of metabolite differences in controls and posttraumatic stress disorder (PTSD). Red arrows represent the upregulated fluxes, and green arrows represent downregulated metabolic fluxes. Side panels represent differences in metabolic regulatory hormones, tests for glucocorticoid receptor (GR) sensitivity, and markers for inflammation, oxidative stress, and ATP hydrolysis. Red asterisks on the box plots represent the statistically significant difference (P < 0.05) in PTSD vs. controls. Green box, PTSD; red box, controls. It is noted that gluconeogenesis potentially in liver, hypoxic adaptation potentially in muscle, amino acid catabolism, triglyceride synthesis, and ATP hydrolysis are upregulated, whereas urea cycle, lipogenesis, and β-oxidation are downregulated. Measures of GR sensitivity, inflammation, and oxidative stress and the hormones insulin, cortisol, and urinary (Urn.) epinephrine are also elevated in PTSD. GGT, γ-glutamyltransferase; hsCRP, high-sensitivity C-reactive protein.