Chen Yu-Ju, Lin Chin-Ling, Li Chi-Rong, Huang Shih-Ming, Chan James Yi-Hsin, Fang Wen-Hui, Chen Wei-Liang
School of Nursing, National Defense Medical Center, Taipei, Taiwan.
Department of Internal Medicine, National Cheng Kung University Hospital, Dou_Liou Branch, Tainan, Taiwan.
Psychoneuroendocrinology. 2016 Dec;74:342-349. doi: 10.1016/j.psyneuen.2016.09.027. Epub 2016 Oct 7.
Metabolic syndrome (MetS) has been reported to cause considerable psychoneuroimmunology (PNI) disturbances such as, psychological distress, autonomic nervous imbalance, and impaired immune function. Associations among these psychoneuroimmunology (PNI) factors and their integrated effects with MetS and risk components of MetS necessitate further exploration.
This study investigated associations among psychoneuroimmunological factors, their integrated effects with MetS and risk components of MetS.
This was a cross-sectional study. Participants were recruited from two health management centers at a medical center in Northern Taiwan. Demographics and data on psychological distress (e.g., perceived stress and depression) were collected using self-reported questionnaires. Heart rate variability (HRV) and C-reactive protein values (CRP) were measured to evaluate participants' autonomic nervous function and immune reaction. The risk components of MetS (e.g., elevated blood pressure, impaired fasting glucose, dyslipidemia, and abdominal obesity) were identified according to the Taiwan-specific definition of MetS and were determined based on participants' health examination profiles.
A total of 345 participants with complete data were included for data analysis. Compared with healthy controls, participants with MetS exhibited higher depression scores (11.2±8.5 vs. 8.7±7.0), higher CRP values (2.1±2.5 vs. 0.7±1.0), and lower HRV (total power: 758.7±774.9 vs. 1064.4±1075.0). However, perceived stress in participants with MetS did not significantly differ from that of their healthy counterparts (p>0.05). Univariate analyses indicated that associations among psychoneuroimmunological factors and MetS risk components were statistically heterogeneous: a) perceived stress and depression were significantly associated only with high blood glucose (p<0.05); b) CRP was significantly associated with all MetS risk components (p<0.05); and c) HRV was significantly associated with high triglycerides and high fasting blood glucose (p<0.05). Multivariate analysis indicated that the integrated effects of depression, CRP, and HRV were significantly associated with MetS (p<0.01) after controlling for age and education level.
Higher depression scores, higher CRP values, and lower HRV are independently and additively associated with MetS and risk components of MetS. Accordingly, a multidisciplinary approach to alleviating psychological distress, immune dysfunction, and autonomic nervous imbalance is recommended for promoting well-being in people with subclinical metabolic abnormalities or MetS to minimize downstream health consequences.
据报道，代谢综合征（MetS）会引发相当多的心理神经免疫学（PNI）紊乱，如心理困扰、自主神经失衡和免疫功能受损。这些心理神经免疫学（PNI）因素之间的关联及其与代谢综合征及其风险成分的综合影响需要进一步探索。
本研究调查心理神经免疫学因素之间的关联、它们与代谢综合征及其风险成分的综合影响。
这是一项横断面研究。参与者从台湾北部一家医疗中心的两个健康管理中心招募。使用自我报告问卷收集人口统计学和心理困扰数据（如感知压力和抑郁）。测量心率变异性（HRV）和C反应蛋白值（CRP）以评估参与者的自主神经功能和免疫反应。根据台湾特定的代谢综合征定义确定代谢综合征的风险成分（如血压升高、空腹血糖受损、血脂异常和腹部肥胖），并根据参与者的健康检查资料确定。
共有345名数据完整的参与者纳入数据分析。与健康对照组相比，代谢综合征患者的抑郁评分更高（11.2±8.5对8.7±7.0）、CRP值更高（2.1±2.5对0.7±1.0），且HRV更低（总功率：758.7±774.9对1064.4±1075.0）。然而，代谢综合征患者的感知压力与健康对照组相比无显著差异（p>0.05）。单因素分析表明，心理神经免疫学因素与代谢综合征风险成分之间的关联在统计学上具有异质性：a）感知压力和抑郁仅与高血糖显著相关（p<0.05）；b）CRP与所有代谢综合征风险成分显著相关（p<0.05）；c）HRV与高甘油三酯和高空腹血糖显著相关（p<0.05）。多因素分析表明，在控制年龄和教育水平后，抑郁、CRP和HRV的综合影响与代谢综合征显著相关（p<0.01）。
更高的抑郁评分、更高的CRP值和更低的HRV与代谢综合征及其风险成分独立且累加相关。因此，建议采用多学科方法来缓解心理困扰、免疫功能障碍和自主神经失衡，以促进亚临床代谢异常或代谢综合征患者的健康，尽量减少下游健康后果。
