Research Center, Montreal Heart Institute, Montreal, Canada Psychology Department, Université de Montréal, Canada.
Department of Psychology, McGill University, Montreal, Canada.
Ann Behav Med. 2019 May 3;53(6):515-526. doi: 10.1093/abm/kay063.
Little is known about the role of physiological stress responses in metabolic syndrome (MetS).
To examine whether patterns of autonomic response to psychological stress are associated with MetS and whether this association is moderated by sex.
1121 men and women (Mage = 65.3 ± 6.77 years) with and without coronary artery disease (CAD) underwent an anger recall stressor task. Heart rate and heart-rate variability (HRV; HF, LF/HF) were assessed. Clusters of participants showing similar patterns of response across baseline, stress, and recovery periods were created using ACECLUS and FASTCLUS in SAS. Logistic regressions included clusters and interaction between clusters and sex as independent variables, controlling for relevant covariates. ANCOVAs were conducted in secondary analyses utilizing a continuous composite representation of MetS.
Men and women showing greater tonic and phasic HR elevations were more likely to meet MetS criteria (OR = 1.45, [95% CI = 1.02-2.07], p = .037). HF-HRV cluster interacted significantly with sex (p < .001) to predict MetS. In women, those with significant parasympathetic withdrawal to stress and poor recovery were more likely to have MetS than women with a more moderate response (OR = 2.56, [95% CI = 1.23-5.41], p = .013). Women who displayed stress-related parasympathetic activation were also at greater risk of MetS (OR = 2.30, [95% CI = 1.30-4.07], p = .004). Results using a continuous measure of MetS were generally consistent with these findings.
Among older participants with CAD or other noncardiovascular disease, hyperreactivity to stress was associated with greater prevalence of MetS, particularly in women. Consistent with emerging literature, women who showed blunting or activation of parasympathetic responses to stress were similarly at greater risk.
对于生理应激反应在代谢综合征（MetS）中的作用知之甚少。
研究心理应激时自主神经反应模式是否与 MetS 相关，以及这种关联是否受性别影响。
1121 名患有和不患有冠状动脉疾病（CAD）的男性和女性（Mage=65.3±6.77 岁）接受了愤怒回忆应激源任务。评估心率和心率变异性（HF、LF/HF）。使用 SAS 中的 ACECLUS 和 FASTCLUS 在基线、应激和恢复期间创建具有相似反应模式的参与者集群。逻辑回归包括集群以及集群与性别之间的相互作用作为自变量，同时控制相关协变量。在二次分析中使用 MetS 的连续综合表现进行了方差分析。
显示更大的紧张和相位心率升高的男性和女性更有可能符合 MetS 标准（OR=1.45，[95%CI=1.02-2.07]，p=0.037）。HF-HRV 集群与性别显著相互作用（p<0.001）以预测 MetS。在女性中，与应激时副交感神经撤退和恢复不良的女性相比，应激时副交感神经激活的女性更有可能患有 MetS（OR=2.56，[95%CI=1.23-5.41]，p=0.013）。显示应激相关副交感神经激活的女性也有更大的 MetS 风险（OR=2.30，[95%CI=1.30-4.07]，p=0.004）。使用 MetS 的连续测量结果通常与这些发现一致。
在患有 CAD 或其他非心血管疾病的老年参与者中，对压力的过度反应与 MetS 的患病率增加有关，尤其是在女性中。与新兴文献一致，对压力的副交感神经反应迟钝或激活的女性同样面临更大的风险。
