Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany.
Psychoneuroendocrinology. 2011 Feb;36(2):200-9. doi: 10.1016/j.psyneuen.2010.07.009. Epub 2010 Aug 6.
Leptin, involved in energy homeostasis and a predictor of cardiovascular disease, has recently been recognized as mediator in stress reactions. We aimed to explore the association between leptin levels and two stress-related conditions, social isolation and depressed mood, both associated with increased cardiovascular mortality.
We analysed leptin levels in 1229 subjects (643 men, 586 women), derived from the population-based MONIKA/KORA study. Standardized questionnaires were used to assess depressive mood and social isolation. In a multiple linear regression adjusted for body weight, age and survey, the association between leptin, social isolation and depressed mood and its interaction was explored in men and women separately. Leptin was then dichotomized and four analyses, adjusted for age, BMI, lifestyle factors, psychosomatic complaints and metabolic variables were performed to compare the risk of elevated leptin levels in the risk groups.
Increased leptin levels were associated with social isolation (p=0.04) and the interaction between social isolation and depressed mood (p=0.02) in men but not in women. In socially isolated and depressed men, leptin levels (mean: 6.07 ng/ml) were significantly increased compared to neither depressed nor isolated men (mean: 4.51 ng/ml, p=0.04). In the multivariate adjusted logistic regression model, the combination of depressed state and social isolation was associated with a 4-fold increased risk (p<0.001) for elevated leptin levels.
The finding of elevated leptin levels in socially isolated and depressed men raises the possibility that increased cardiovascular mortality in socially isolated men is partially mediated by hyperleptinemia.
瘦素参与能量稳态,是心血管疾病的预测因子,最近被认为是应激反应的中介。我们旨在探讨瘦素水平与两种与应激相关的情况(社会隔离和抑郁情绪)之间的关联,这两种情况都与心血管死亡率增加有关。
我们分析了来自基于人群的 MONIKA/KORA 研究的 1229 名受试者(643 名男性,586 名女性)的瘦素水平。使用标准化问卷评估抑郁情绪和社会隔离。在调整体重、年龄和调查的多元线性回归中,分别在男性和女性中探讨瘦素、社会隔离和抑郁情绪之间的关联及其相互作用。然后将瘦素分为二项,并进行四项分析,调整年龄、BMI、生活方式因素、身心症状和代谢变量,以比较风险组中升高的瘦素水平的风险。
在男性中,较高的瘦素水平与社会隔离(p=0.04)和社会隔离与抑郁情绪之间的相互作用(p=0.02)相关,但在女性中不相关。在社会隔离和抑郁的男性中,瘦素水平(平均值:6.07ng/ml)明显高于既不抑郁也不孤立的男性(平均值:4.51ng/ml,p=0.04)。在多变量调整的逻辑回归模型中,抑郁状态和社会隔离的组合与升高的瘦素水平的 4 倍风险相关(p<0.001)。
在社会隔离和抑郁的男性中升高的瘦素水平提示,社会隔离的男性中增加的心血管死亡率部分是由高瘦素血症介导的。