Epel E S, McEwen B, Seeman T, Matthews K, Castellazzo G, Brownell K D, Bell J, Ickovics J R
Health Psychology Program, University of California, San Francisco 94143-0848, USA.
Psychosom Med. 2000 Sep-Oct;62(5):623-32. doi: 10.1097/00006842-200009000-00005.
Excessive central fat puts one at greater risk of disease. In animal studies, stress-induced cortisol secretion has been shown to increase central fat. The objective of this study was to assess whether women with central fat distribution (as indicated by a high waist-to-hip ratio [WHR]), across a range of body mass indexes, display consistently heightened cortisol reactivity to repeated laboratory stressors.
Fifty-nine healthy premenopausal women, 30 with a high WHR and 29 with a low WHR, were exposed to consecutive laboratory sessions over 4 days (three stress sessions and one rest session). During these sessions, cortisol and psychological responses were assessed.
Women with a high WHR evaluated the laboratory challenges as more threatening, performed more poorly on them, and reported more chronic stress. These women secreted significantly more cortisol during the first stress session than women with a low WHR. Furthermore, lean women with a high WHR lacked habituation to stress in that they continued to secrete significantly more cortisol in response to now familiar challenges (days 2 and 3) than lean women with a low WHR.
Central fat distribution is related to greater psychological vulnerability to stress and cortisol reactivity. This may be especially true among lean women, who did not habituate to repeated stress. The current cross-sectional findings support the hypothesis that stress-induced cortisol secretion may contribute to central fat and demonstrate a link between psychological stress and risk for disease.
腹部脂肪过多会使人患疾病的风险更高。在动物研究中，应激诱导的皮质醇分泌已被证明会增加腹部脂肪。本研究的目的是评估在一系列体重指数范围内，具有腹部脂肪分布特征（以高腰臀比[WHR]表示）的女性是否对重复的实验室应激源始终表现出更高的皮质醇反应性。
59名健康的绝经前女性，30名高腰臀比女性和29名低腰臀比女性，在4天内连续接受实验室测试（三次应激测试和一次休息测试）。在这些测试期间，评估皮质醇和心理反应。
高腰臀比女性认为实验室挑战更具威胁性，在挑战中的表现更差，并且报告有更多的慢性应激。这些女性在第一次应激测试期间分泌的皮质醇明显多于低腰臀比女性。此外，高腰臀比的瘦女性对压力缺乏适应性，因为与低腰臀比的瘦女性相比，她们在面对熟悉的挑战（第2天和第3天）时继续分泌明显更多的皮质醇。
腹部脂肪分布与更大的心理应激易感性和皮质醇反应性有关。在对重复应激不产生适应性的瘦女性中可能尤其如此。目前的横断面研究结果支持应激诱导的皮质醇分泌可能导致腹部脂肪增加这一假说，并证明了心理应激与疾病风险之间的联系。
