Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, 85764 Neuherberg, Germany.
Psychoneuroendocrinology. 2012 Feb;37(2):230-7. doi: 10.1016/j.psyneuen.2011.06.007. Epub 2011 Jul 13.
The renin-angiotensin-aldosterone-system (RAAS) is one of the most important systems involved in the pathogenesis of cardiovascular diseases. Its role in stress response has been generally neglected, although the progression of cardiovascular disease is considerably increased in the presence of stress and especially in the presence of depression risk. With the present analysis we aimed to evaluate whether the activity of the RAAS correlates with depressive symptomatology and with chronic stress. Moreover, we aimed to analyse whether stress response is altered in the presence of depressed symptomatology. We chose "living alone" to be our paradigm of chronic stress.
Aldosterone and renin levels were assessed in 1743 (829 men, 914 women) from the population-based KORA study (Cooperative Health Research in the Region of Augsburg). The relationship between aldosterone, renin levels and the different combinations of living alone and depressive symptomatology was examined in three different multiple linear regression models adjusted for age, sex, creatinine levels, potassium levels, body mass index (BMI) and bio-behavioural factors. Neither "living alone" nor depressive symptomatology alone were associated with an activation of the RAAS, but the combination of living alone and depressive symptomatology yielded a highly significant increase in the aldosterone (p<0.01) and renin level (p=0.03).
Our findings show that depressive symptomatology is associated with a hyper-responsiveness to chronic stress. Under the condition of chronic stress depressed individuals have an activated RAAS. Activation of the RAAS might explain the known increased risk of negative cardiovascular disease outcomes in this group.
肾素-血管紧张素-醛固酮系统（RAAS）是参与心血管疾病发病机制的最重要系统之一。尽管心血管疾病的进展在应激存在下，尤其是在存在抑郁风险的情况下显著增加，但它在应激反应中的作用通常被忽视。通过本分析，我们旨在评估 RAAS 的活性是否与抑郁症状和慢性应激相关。此外，我们旨在分析在存在抑郁症状的情况下，应激反应是否发生改变。我们选择“独居”作为我们慢性应激的范例。
在基于人群的 KORA 研究（奥格斯堡合作健康研究）中，评估了 1743 名（829 名男性，914 名女性）参与者的醛固酮和肾素水平。在三个不同的多元线性回归模型中，根据年龄、性别、肌酐水平、钾水平、体重指数（BMI）和生物行为因素调整后，检查了醛固酮、肾素水平与独居和抑郁症状的不同组合之间的关系。独居或抑郁症状本身都与 RAAS 的激活无关，但独居和抑郁症状的组合导致醛固酮（p<0.01）和肾素水平（p=0.03）显著增加。
我们的研究结果表明，抑郁症状与对慢性应激的过度反应有关。在慢性应激的情况下，抑郁个体的 RAAS 被激活。RAAS 的激活可能解释了该人群中已知的心血管疾病不良结局风险增加的原因。
