University of Zurich, Institute of Psychology, Clinical Psychology and Psychotherapy, Switzerland; University of Zurich, University Research Priority Program (URPP) Dynamics of Healthy Aging, Switzerland.
University of Zurich, Institute of Psychology, Clinical Psychology and Psychotherapy, Switzerland.
J Psychosom Res. 2018 Feb;105:14-20. doi: 10.1016/j.jpsychores.2017.11.019. Epub 2017 Dec 2.
Despite the increased risk for cardiovascular morbidity associated with vital exhaustion (VE), the underlying pathophysiological mechanisms remain unclear. Allostatic load may constitute the missing link between VE and cardiovascular diseases. The aim of the present study was to investigate whether men with different degrees of VE would differ in terms of allostatic load, chronic stress, and social support.
The Men Stress 40+ study sample consisted of N=121 apparently healthy men aged 40 to 75years. The following allostatic load markers were aggregated to create a cumulative index of biological stress: salivary cortisol, salivary dehydroepiandrosterone sulfate (DHEA-S), waist-to-hip-ratio, systolic and diastolic blood pressure. Long-term cortisol and DHEA were additionally measured in hair. Chronic stress and social support were assessed via validated questionnaires. Groups of mildly, substantially, and severely exhausted men were compared using one-way ANOVAs with appropriate post-hoc tests.
Men who reported mild or severe levels of vital exhaustion had the highest scores on the cumulative index of biological stress. Hair cortisol was unrelated to vital exhaustion; hair DHEA was highest in men with substantial levels of exhaustion. Men with mild exhaustion reported the lowest levels of chronic stress, while men with severe exhaustion reported the lowest levels of social support.
Signs of allostatic load are detectable in vitally exhausted men at a stage where no major cardiovascular consequences have yet ensued.
尽管与活力耗竭（VE）相关的心血管发病风险增加，但潜在的病理生理机制仍不清楚。适应负荷可能是 VE 与心血管疾病之间缺失的联系。本研究的目的是调查不同程度 VE 的男性在适应负荷、慢性应激和社会支持方面是否存在差异。
Men Stress 40+ 研究样本包括 121 名年龄在 40 至 75 岁之间的健康男性。将唾液皮质醇、唾液脱氢表雄酮硫酸盐（DHEA-S）、腰臀比、收缩压和舒张压等适应负荷标志物聚合为生物应激的累积指数。头发中还额外测量了长期皮质醇和 DHEA。通过验证过的问卷评估慢性应激和社会支持。使用单向方差分析（ANOVA）和适当的事后检验比较轻度、中度和重度疲劳组。
报告轻度或重度活力耗竭的男性在生物应激累积指数上的得分最高。头发皮质醇与活力耗竭无关；头发 DHEA 在中度疲劳的男性中最高。轻度疲劳的男性报告的慢性应激水平最低，而重度疲劳的男性报告的社会支持水平最低。
在尚未出现重大心血管后果的阶段，活力耗竭的男性中可以检测到适应负荷的迹象。
