Department of Mental Health of Older People, Faculty of Brain Sciences, University College London, London, UK.
Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Nat Rev Endocrinol. 2023 Jan;19(1):10-27. doi: 10.1038/s41574-022-00746-8. Epub 2022 Oct 12.
The activation of stress-related neuroendocrine systems helps to maintain homeostasis, but excessive stress can damage body functions. We review current evidence from basic sciences and epidemiology linking stress to the development and progression of metabolic disorders throughout life. Findings from rodents demonstrate that stress can affect features of metabolic dysfunction, such as insulin resistance, glucose and lipid homeostasis, as well as ageing processes such as cellular senescence and telomere length shortening. In human studies, stressors in the home, workplace and neighbourhood are associated with accelerated ageing and metabolic and immune alterations, both directly and indirectly via behavioural risks. The likelihood of developing clinical conditions, such as diabetes mellitus and hepatic steatosis is increased in individuals with adverse childhood experiences or long-term (years) or severe stress at work or in private life. The increased risk of metabolic disorders is often associated with other stress-related conditions, such as mental health disorders, cardiovascular disease and increased susceptibility to infections. Equally, stress can worsen prognosis in metabolic diseases. As favourable modifications in stressors are associated with reductions in incidence of metabolic disorders, further investigation of the therapeutic value of targeting stress in personalized medicine is warranted.
应激相关神经内分泌系统的激活有助于维持内环境稳态,但过度的应激会损害身体功能。我们综述了基础科学和流行病学的现有证据,这些证据将应激与代谢紊乱的发生和进展联系起来。啮齿动物的研究结果表明,应激可以影响代谢功能障碍的特征,如胰岛素抵抗、葡萄糖和脂质稳态,以及细胞衰老和端粒缩短等衰老过程。在人类研究中,家庭、工作场所和社区中的压力源与加速衰老以及代谢和免疫改变有关,这些改变既可以直接发生,也可以通过行为风险间接发生。有不良童年经历或长期(数年)工作或私人生活中严重应激的个体,发生糖尿病和肝脂肪变性等临床疾病的可能性增加。代谢紊乱的风险增加通常与其他与应激相关的疾病有关,如心理健康障碍、心血管疾病和增加感染易感性。同样,应激会使代谢疾病的预后恶化。由于应激源的有利改变与代谢紊乱发生率的降低有关,因此有必要进一步研究针对个性化医学中应激的治疗价值。
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