Terock Jan, Hannemann Anke, Janowitz Deborah, Völzke Henry, Nauck Matthias, Freyberger Harald-Jürgen, Wallaschofski Henri, Grabe Hans Jörgen
Department of Psychiatry and Psychotherapy, University Medicine Greifswald, HELIOS Hanseklinikum Stralsund, Stralsund, Germany.
Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
J Psychosom Res. 2017 May;96:42-48. doi: 10.1016/j.jpsychores.2017.03.007. Epub 2017 Mar 16.
Living alone is considered as a chronic stress factor predicting different health conditions and particularly cardiovascular disease (CVD). Alexithymia is associated with increased psychological distress, less social skills and fewer close relationships, making alexithymic subjects particularly susceptible to chronic stress imposed by "living alone". Only few studies investigated the renin-angiotensin-aldosterone-system (RAAS) activity in response to chronic stress. We aimed at evaluating the effects of "living alone" as a paradigm for chronic stress on RAAS activity and putatively differential effects depending on alexithymic personality features.
Alexithymia and serum concentrations of renin and aldosterone were measured in 944 subjects from the population-based SHIP-1 study. Subgroups were formed using the median of the Toronto Alexithymia Scale-20 (TAS-20) and a cohabitation status of "living alone" or "living together". Analyses were adjusted for various psychosocial, behavioral and metabolic risk factors.
"Living alone" was associated with elevated plasma renin (p<0.01, β=0.138) but not aldosterone concentrations in the total sample. On subgroup level, we found associations of "living alone" and elevated renin concentrations only in subjects low in TAS-20 scores (p<0.01, β=0.219). Interactional effects of alexithymia×cohabitation status were found for the aldosterone-to-renin ratio (p=0.02, β=-0.234).
The association of chronic stress imposed by "living alone" with increased RAAS activity contributes to explain the relationship of this psychosocial stress condition and increased risk for CVD. In contrast, alexithymic subjects may be less affected by the deleterious effects of "living alone".
独居被视为一种慢性应激因素，可预测不同的健康状况，尤其是心血管疾病（CVD）。述情障碍与心理困扰增加、社交技能较少以及亲密关系较少有关，这使得述情障碍患者特别容易受到“独居”所带来的慢性应激的影响。只有少数研究调查了肾素 - 血管紧张素 - 醛固酮系统（RAAS）对慢性应激的反应活性。我们旨在评估“独居”作为慢性应激范例对RAAS活性的影响，以及根据述情障碍人格特征可能存在的差异影响。
在基于人群的SHIP - 1研究的944名受试者中测量述情障碍以及肾素和醛固酮的血清浓度。使用多伦多述情障碍量表 - 20（TAS - 20）的中位数以及“独居”或“同住”的同居状态形成亚组。分析针对各种心理社会、行为和代谢风险因素进行了调整。
在总样本中，“独居”与血浆肾素升高相关（p<0.01，β = 0.138），但与醛固酮浓度无关。在亚组水平上，我们发现仅在TAS - 20得分低的受试者中，“独居”与肾素浓度升高相关（p<0.01，β = 0.219）。发现述情障碍×同居状态对醛固酮与肾素比值有交互作用（p = 0.02，β = -0.234）。
“独居”所带来的慢性应激与RAAS活性增加之间的关联有助于解释这种心理社会应激状况与CVD风险增加之间的关系。相比之下，述情障碍患者可能较少受到“独居”有害影响的影响。
