Stapel Britta, Jelinic Maria, Drummond Grant R, Hartung Dagmar, Kahl Kai G
Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany.
Department of Physiology, Anatomy and Microbiology, Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora, VIC, Australia.
Front Psychiatry. 2022 Apr 4;13:831358. doi: 10.3389/fpsyt.2022.831358. eCollection 2022.
The neurobiological and behavioral underpinnings linking mental disorders, in particular, major depressive disorder (MDD), with cardiovascular disorders are a matter of debate. Recent research focuses on visceral (intra-abdominal and epicardial) adipose tissue and inflammation and their impact on the development of cardiometabolic disorders. Intra-abdominal adipose tissue is defined as an endocrine active fat compartment surrounding inner organs and is associated with type 2 diabetes mellitus, a risk factor for the later development of cardiovascular disorders. Epicardial (pericardial) adipose tissue is a fat compartment surrounding the heart with close proximity to the arteries supporting the heart. Visceral adipose tissue (VAT) is an important source of inflammatory mediators that, in concert with other risk factors, plays a leading role in cardiovascular diseases. In conjunction with the behavioral (physical inactivity, sedentary lifestyle), psychological (adherence problems), and hormonal (dysfunction of the hypothalamus-pituitary-adrenal axis with subsequent hypercortisolism) alterations frequently accompanying MDD, an enhanced risk for cardiovascular disorders results.
将精神障碍,尤其是重度抑郁症(MDD)与心血管疾病联系起来的神经生物学和行为学基础存在争议。最近的研究集中在内脏(腹内和心外膜)脂肪组织和炎症及其对心脏代谢紊乱发展的影响。腹内脂肪组织被定义为围绕内部器官的具有内分泌活性的脂肪隔室,并且与2型糖尿病相关,2型糖尿病是心血管疾病后期发展的一个危险因素。心外膜(心包)脂肪组织是围绕心脏的脂肪隔室,与为心脏供血的动脉紧密相邻。内脏脂肪组织(VAT)是炎症介质的重要来源,它与其他危险因素共同作用,在心血管疾病中起主导作用。与MDD经常伴随的行为(身体不活动、久坐的生活方式)、心理(依从性问题)和激素(下丘脑 - 垂体 - 肾上腺轴功能障碍及随后的高皮质醇血症)改变相结合,导致心血管疾病风险增加。