Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center, Beaverton, Oreg., USA.
Neuroendocrinology. 2013;98(4):254-66. doi: 10.1159/000355632. Epub 2013 Sep 21.
The increased prevalence and high comorbidity of metabolic syndrome (MetS) and mental health disorders (MHDs) have prompted investigation into the potential contributing mechanisms. There is a bidirectional association between MetS and MHDs including schizophrenia, bipolar disorder, depression, anxiety, attention-deficit/hyperactivity disorder, and autism spectrum disorders. Medication side effects and social repercussions are contributing environmental factors, but there are a number of shared underlying neurological and physiological mechanisms that explain the high comorbidity between these two disorders. Inflammation is a state shared by both disorders, and it contributes to disruptions of neuroregulatory systems (including the serotonergic, dopaminergic, and neuropeptide Y systems) as well as dysregulation of the hypothalamic-pituitary-adrenal axis. MetS in pregnant women also exposes the developing fetal brain to inflammatory factors that predispose the offspring to MetS and psychopathologies. Due to the shared nature of these conditions, treatment should address aspects of both mental health and metabolic disorders. Additionally, interventions that can interrupt the transfer of increased risk of the disorders to the next generation need to be developed. © 2013 S. Karger AG, Basel.
代谢综合征（MetS）和精神健康障碍（MHDs）的患病率增加和高共病性促使人们研究潜在的致病机制。MetS 和 MHDs 之间存在双向关联，包括精神分裂症、双相情感障碍、抑郁症、焦虑症、注意力缺陷/多动障碍和自闭症谱系障碍。药物副作用和社会影响是促成的环境因素，但有许多共同的潜在神经和生理机制可以解释这两种疾病的高共病性。炎症是这两种疾病共有的一种状态，它导致神经调节系统（包括 5-羟色胺能、多巴胺能和神经肽 Y 系统）的紊乱，并导致下丘脑-垂体-肾上腺轴的失调。孕妇的 MetS 也使发育中的胎儿大脑暴露于炎症因子之下，使后代易患 MetS 和精神病理。由于这些情况的共同性质，治疗应该同时解决心理健康和代谢紊乱两方面的问题。此外，需要开发可以中断将这些疾病的风险传递给下一代的干预措施。© 2013 S. Karger AG, Basel.
