Behavioral Medicine Research Center, University of Miami, Miami, FL, USA; Department of Psychology, University of Miami, Coral Gables, FL, USA.
Behavioral Medicine Research Center, University of Miami, Miami, FL, USA.
J Psychosom Res. 2022 Jun;157:110785. doi: 10.1016/j.jpsychores.2022.110785. Epub 2022 Mar 22.
Vital exhaustion (VE) is more strongly associated with cardiovascular disease (CVD) risk for women than men. This study examined whether sex differences in associations of VE with CVD risk markers are accounted for by unique associations of VE with regional adiposity.
The study enrolled 143 persons (18-55 years) without diagnosed conditions. VE was assessed by the Maastricht questionnaire. CVD indices were measured using the euglycemic-hyperinsulinemia clamp, resting blood pressure, and blood draws. Regional adiposity was measured using computed tomography and 2-D echocardiography. This cross-sectional study employed a path analysis approach, including relevant covariates.
Of the cohort, aged 38.7 ± 8.4 years, 65% were men, and 41% were obese. The final model had excellent fit (χ(36) = 36.5, p = .45; RMSEA = 0.009, CFI = 0.999). For women, but not men, the model indicated paths from VE to: 1) lower insulin sensitivity (B = -0.10, p = .04), and higher total cholesterol to HDL ratio (B = 0.12, p = .09), triglycerides (B = 0.10, p = .08), and C-reactive protein (B = 0.08, p = .09) through visceral adiposity; 2) higher mean arterial pressure (B = 0.14, p = .04), lower insulin sensitivity (B = -0.09, p = .08), and higher C-reactive protein (B = 0.12, p = .07) through subcutaneous adiposity; 3) lower insulin sensitivity (B = -0.07, p = .08) and higher total cholesterol to HDL ratio (B = 0.16, p = .03) through liver adiposity; and 4) higher C-reactive protein (B = 0.08, p = .09) through epicardial adiposity.
Results extend prior evidence by showing that the association of VE with CVD risk in women is linked with specific regional adiposity elevation. Further study of adiposity-related mechanisms in women who experience early decline in vitality may inform clinical targets for CVD prevention.
与男性相比，极度疲惫（VE）与女性的心血管疾病（CVD）风险的相关性更强。本研究旨在探讨 VE 与 CVD 风险标志物的相关性是否因 VE 与区域性肥胖的独特相关性而存在性别差异。
该研究纳入了 143 名（18-55 岁）无诊断疾病的人群。VE 通过马斯特里赫特问卷进行评估。CVD 指数通过葡萄糖-胰岛素正葡萄糖钳夹、静息血压和血液抽取进行测量。区域性肥胖通过计算机断层扫描和二维超声心动图进行测量。这项横断面研究采用路径分析方法，包括相关协变量。
队列中年龄为 38.7±8.4 岁，其中 65%为男性，41%为肥胖者。最终模型拟合度良好（χ(36) = 36.5，p =.45；RMSEA = 0.009，CFI = 0.999）。对于女性，但不是男性，该模型表明 VE 与以下方面存在关联：1）胰岛素敏感性降低（B = -0.10，p =.04），总胆固醇与高密度脂蛋白比值升高（B = 0.12，p =.09），甘油三酯（B = 0.10，p =.08）和 C 反应蛋白（B = 0.08，p =.09）通过内脏脂肪；2）平均动脉压升高（B = 0.14，p =.04），胰岛素敏感性降低（B = -0.09，p =.08），C 反应蛋白升高（B = 0.12，p =.07）通过皮下脂肪；3）胰岛素敏感性降低（B = -0.07，p =.08）和总胆固醇与高密度脂蛋白比值升高（B = 0.16，p =.03）通过肝脂肪；4）C 反应蛋白升高（B = 0.08，p =.09）通过心外膜脂肪。
结果扩展了先前的证据，表明 VE 与女性 CVD 风险的相关性与特定的区域性肥胖升高有关。对经历活力早期下降的女性中与脂肪相关的机制进行进一步研究，可能为 CVD 预防提供临床目标。
