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心理压力与代谢综合征的关联:系统评价和荟萃分析。

The association between psychological stress and metabolic syndrome: A systematic review and meta-analysis.

机构信息

School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Infectious Diseases and Vaccinology, Taiwan National Institute of Health, Taipei, Taiwan.

出版信息

Obes Rev. 2019 Nov;20(11):1651-1664. doi: 10.1111/obr.12915. Epub 2019 Jul 26.

Abstract

Literature suggests that occupational stress is associated with a higher risk of metabolic syndrome; yet less is known whether other sources of stress have similar effects. This review aims to examine whether the relationship between psychological stress and metabolic syndrome differs by sources of stress. Three databases (PubMed, Web of Science, and CINAHL) were searched for eligible articles; meta-analyses were conducted using the random effects model. After controlling for covariates, adults in the high-stress groups had 45% higher chance of having metabolic syndrome than adults in the low-stress groups (odds ratio [OR] = 1.450; 95% confidence interval [CI], 1.211-1.735; P < .001). The subsequent meta-analysis based on cross-sectional studies suggested that occupational stress showed the strongest effect (OR = 1.692; 95% CI, 1.182-2.424; P = .004), while perceived general stress showed the weakest effect (OR = 1.217; 95% CI, 1.017-1.457; P = .032). Unfortunately, there is a lack of longitudinal studies for subsequent meta-analysis based on sources of stress. There is a need for continued research to examine the long-term relationship between different sources of stress and the risk of metabolic syndrome. Traditional recommendations for preventing metabolic syndrome (eg, low-fat diet and exercise) may not achieve the best outcome if clinicians overlook patients' psychosocial stress.

摘要

文献表明,职业压力与代谢综合征的风险增加有关;但人们对于其他压力源是否也有类似的影响知之甚少。本综述旨在研究心理压力与代谢综合征之间的关系是否因压力源的不同而有所不同。我们在三个数据库(PubMed、Web of Science 和 CINAHL)中搜索了符合条件的文章;使用随机效应模型进行了荟萃分析。在控制了协变量后,高压力组的成年人患代谢综合征的几率比低压力组的成年人高 45%(优势比 [OR] = 1.450;95%置信区间 [CI],1.211-1.735;P <.001)。随后基于横断面研究的荟萃分析表明,职业压力的影响最大(OR = 1.692;95% CI,1.182-2.424;P =.004),而感知一般压力的影响最弱(OR = 1.217;95% CI,1.017-1.457;P =.032)。遗憾的是,缺乏基于压力源的后续荟萃分析的纵向研究。需要进一步研究以检验不同压力源与代谢综合征风险之间的长期关系。如果临床医生忽视了患者的心理社会压力,那么预防代谢综合征的传统建议(例如低脂饮食和运动)可能无法达到最佳效果。

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