Department of Behavioural Science and Health, University College London, London, UK.
Psychophysiology. 2019 Jun;56(6):e13341. doi: 10.1111/psyp.13341. Epub 2019 Jan 28.
Loneliness is linked with all-cause mortality and coronary heart disease. Altered neuroendocrine and inflammatory responses to stress constitute potential pathways linking loneliness and ill-health. Stress responsivity is modified in people with Type 2 diabetes, but it is unclear whether loneliness influences biological stress responses in this population. We assessed interleukin-6 (IL-6), interleukin-1 receptor antagonist (IL-1RA), monocyte chemoattractant protein-1 (MCP-1), and cortisol responses to acute stress in 135 people with Type 2 diabetes. Loneliness was measured used the Revised UCLA Loneliness Scale. Loneliness was inversely associated with cortisol output poststress (B = -4.429, p = 0.019) independent of age, sex, education, marital status, body mass index, and smoking. Lonelier individuals had raised MCP-1 concentrations 75 min poststress independent of covariates (B = 0.713, p = 0.022). No associations between loneliness and IL-6 or IL-1RA concentrations were detected. These results suggest that loneliness is associated with disturbances in stress responsivity in people with diabetes, and the impact of loneliness on health in people with diabetes may be mediated in part through dysregulation of inflammatory and neuroendocrine systems. Future research is required to understand if such changes increase the risk of poorer outcomes in this population.
孤独与全因死亡率和冠心病有关。压力下神经内分泌和炎症反应的改变构成了将孤独与健康不良联系起来的潜在途径。2 型糖尿病患者的应激反应能力发生了改变，但尚不清楚孤独是否会影响该人群的生物应激反应。我们评估了 135 名 2 型糖尿病患者对急性应激的白细胞介素 6（IL-6）、白细胞介素 1 受体拮抗剂（IL-1RA）、单核细胞趋化蛋白 1（MCP-1）和皮质醇反应。使用修订后的加州大学洛杉矶分校孤独量表测量孤独感。孤独感与应激后皮质醇的产生呈负相关（B=-4.429，p=0.019），与年龄、性别、教育程度、婚姻状况、体重指数和吸烟无关。在考虑了协变量后，孤独感更强的个体在应激后 75 分钟时 MCP-1 浓度升高（B=0.713，p=0.022）。孤独感与 IL-6 或 IL-1RA 浓度之间没有关联。这些结果表明，孤独感与糖尿病患者的应激反应能力障碍有关，而孤独感对糖尿病患者健康的影响可能部分是通过炎症和神经内分泌系统的失调来介导的。需要进一步研究以了解这些变化是否会增加该人群不良结局的风险。
