Center for Population and Health, Georgetown University, Washington, DC, USA.
Stress. 2013 Jul;16(4):411-20. doi: 10.3109/10253890.2013.789015. Epub 2013 May 3.
Allostatic load theory implies a relationship between exposure to psychological stress and multi-system physiological dysregulation. We used data from population-based samples of men and women in Russia (Moscow; n = 1800; age, mean 68.6 years), Taiwan (n = 1036; 65.6 years) and the United States (US; n = 1054; 58.0 years) -- which are likely to vary widely with respect to levels of stress exposure and biological markers -- to determine the magnitude of the association between perceived stress and physiological dysregulation. The measure of overall dysregulation was based on 15 markers including standard cardiovascular/metabolic risk factors as well as markers of inflammation and neuroendocrine activity. Subjective psychological stress was measured by the perceived stress scale. Only the Moscow sample demonstrated a positive association with overall dysregulation in both sexes. In the US, we found an association among women but not men. Among the Taiwanese, who report the lowest perceived stress, there was no association in women but an unexpected inverse relationship in men. The effects also varied across system-level subscores: the association with perceived stress was most consistent for standard cardiovascular/metabolic factors. Perceived stress was associated with inflammation and neuroendocrine activity in some samples. Although the evidence that perceived stress is the primary source of physiological dysregulation is generally modest, it was stronger in Russia where the level of perceived stress was particularly high. For Russia only, we had information about heart function based on a 24 h ambulatory electrocardiogram; perceived stress was consistently associated with heart rate dysregulation in Russian men and women.
应激适应理论意味着心理压力暴露与多系统生理失调之间存在关系。我们使用了来自俄罗斯（莫斯科；n=1800；年龄，平均 68.6 岁）、中国台湾（n=1036；65.6 岁）和美国（n=1054；58.0 岁）人群样本的数据，这些样本在压力暴露和生物学标志物方面可能存在很大差异，以确定感知压力与生理失调之间的关联程度。整体失调的衡量标准基于 15 个标志物，包括标准心血管/代谢危险因素以及炎症和神经内分泌活动的标志物。主观心理压力通过感知压力量表来衡量。只有莫斯科样本在两性中都表现出与整体失调的正相关。在美国，我们发现女性存在关联，但男性没有。在台湾，报告感知压力最低的女性没有关联，但男性却出现了意想不到的负相关。这些影响在系统水平子分数上也有所不同：感知压力与标准心血管/代谢因素的关联最为一致。在一些样本中，感知压力与炎症和神经内分泌活动有关。尽管有证据表明感知压力是生理失调的主要来源，但在感知压力水平特别高的俄罗斯，这一证据更为明显。仅在俄罗斯，我们就有基于 24 小时动态心电图的心脏功能信息；感知压力与俄罗斯男性和女性的心率失调始终存在关联。
