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心血管和皮质醇对急性心理应激和肥胖的反应:荷兰饥荒出生队列研究的横断面和前瞻性关联。

Cardiovascular and cortisol reactions to acute psychological stress and adiposity: cross-sectional and prospective associations in the Dutch Famine Birth Cohort Study.

机构信息

School of Sport and Exercise Sciences, University of Birmingham, Birmingham, United Kingdom.

出版信息

Psychosom Med. 2012 Sep;74(7):699-710. doi: 10.1097/PSY.0b013e31825e3b91. Epub 2012 Jul 20.

Abstract

OBJECTIVE

In recent analyses of data from a large community sample, negative cross-sectional and prospective associations between cardiac stress reactivity and obesity were observed. The present study reexamined the association between cardiovascular reactivity and adiposity in the Dutch Famine Birth Cohort, with the additional aim of examining the association between cortisol reactivity and adiposity.

METHODS

Blood pressure, heart rate, and salivary cortisol were measured at rest and in response to standard laboratory stress tasks in 725 adults. Height, weight, waist-and-hip circumference, and skinfold thickness were measured. Between 4 to 7 years later, 460 participants reported current height and weight. Obesity was defined as a body mass index of 30 kg/m(2) or higher.

RESULTS

Those with a greater body mass index (β = -0.39 beats per minute (bpm)), waist-to-hip ratio (β = -0.15 bpm), and triceps and subscapular skinfold thicknesses (β = -1.0 and -1.8 bpm) or who were categorized as obese (-3.9 bpm) displayed smaller cardiac reactions to acute stress (all p < .001). With the exception of waist-to-hip ratio, the same negative associations emerged for cortisol reactivity (all p ≤ .01). In prospective analyses, low cardiac reactivity was associated with an increased likelihood of becoming or remaining obese in the subsequent 4 to 7 years (odds ratio = 1.03, p = .01). All associations withstood adjustment for a range of possible confounders.

CONCLUSIONS

The present analyses provide additional support for the hypothesis that it is low not high cardiac and cortisol stress reactivity that is related to adiposity.

摘要

目的

在最近对来自大型社区样本数据的分析中,观察到心脏应激反应与肥胖之间存在负向的横断面和前瞻性关联。本研究在荷兰饥荒出生队列中重新检验了心血管反应性与肥胖之间的关系,并额外旨在检验皮质醇反应性与肥胖之间的关系。

方法

在 725 名成年人中,在休息时和对标准实验室应激任务作出反应时,测量血压、心率和唾液皮质醇。测量身高、体重、腰围和臀围以及皮褶厚度。4 至 7 年后,460 名参与者报告了当前的身高和体重。肥胖定义为体重指数为 30kg/m(2)或更高。

结果

那些体重指数较高的人(β = -0.39 次/分钟(bpm))、腰围与臀围比例较高的人(β = -0.15 bpm)、三头肌和肩胛下皮褶厚度较高的人(β = -1.0 和 -1.8 bpm)或被归类为肥胖的人(β = -3.9 bpm),其心脏对急性应激的反应较小(均 p <.001)。除了腰围与臀围比例,皮质醇反应性也出现了同样的负向关联(均 p ≤.01)。在前瞻性分析中,低心脏反应性与随后 4 至 7 年内肥胖或持续肥胖的可能性增加相关(比值比=1.03,p =.01)。所有关联均在调整了一系列可能的混杂因素后成立。

结论

本分析为低而非高的心脏和皮质醇应激反应与肥胖相关的假说提供了额外的支持。

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