Tsai Szu-Ying, Hsu Jui-Yun, Lin Ching-Huang, Kuo Yen-Chun, Chen Chi-Han, Chen Hsing-Yuan, Liu Shu-Jung, Chien Kuo-Liong
Department of Family Medicine, Hsinchu MacKay Memorial Hospital, No. 690, Section 2, Guangfu Road, East District, Hsinchu City, Taiwan.
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan. Room 517, No.17, Xu-Zhou Rd., Taipei, 10055, Taiwan.
Int J Cardiol Cardiovasc Risk Prev. 2024 Jul 10;23:200305. doi: 10.1016/j.ijcrp.2024.200305. eCollection 2024 Dec.
The roles of endogenous stress hormones (norepinephrine, epinephrine, and cortisol) in cardiovascular diseases have been discussed. However, the higher versus lower level of stress hormones in relation to cardiovascular risks remained uncertain.
We searched databases from their inception to 31, March 2023. We conducted a meta-analysis to estimate the effect of higher to lower level of stress hormones with random effect model. Subgroup and meta-regression analysis were done to clarify the heterogeneity.
In total, 33 studies involving 43641 participants were included. With regard to cardiovascular disease risks, a higher risk for individuals with higher level of all stress hormones (risk ratio (RR), 1.63; 95 % Confidence intervals (CIs): 1.36, 1.97) was noted compared with lower level of all stress hormones. The meta-regression showed that as the follow-up year increased per year, the impact of higher level of all stress hormones on the risk of cardiovascular disease declined significantly (RR, -0.09; 95 % CIs: 0.15, -0.03, p = 0.006). A significantly higher risk of cardiovascular diseases for individuals with higher level of norepinephrine (RR, 1.68; 95 % CIs: 1.37, 2.06), with higher level of epinephrine (RR, 1.58; 95 % CIs: 1.10, 2.26), and with higher level of cortisol (RR, 1.60; 95 % CIs: 1.04, 2.26) were noted compared with a lower level of each stress hormone.
Higher levels of stress hormones were significantly associated with higher risks of cardiovascular diseases compared with lower levels of stress hormones.
内源性应激激素（去甲肾上腺素、肾上腺素和皮质醇）在心血管疾病中的作用已被讨论。然而，应激激素水平较高与较低时心血管风险的比较仍不明确。
我们检索了自建库至2023年3月31日的数据库。我们进行了一项荟萃分析，以随机效应模型估计应激激素水平较高与较低时的影响。进行亚组分析和荟萃回归分析以阐明异质性。
总共纳入了33项研究，涉及43641名参与者。关于心血管疾病风险，与所有应激激素水平较低的个体相比，所有应激激素水平较高的个体风险更高（风险比（RR）为1.63；95%置信区间（CI）：1.36，1.97）。荟萃回归显示，随着随访年份每年增加，所有应激激素水平较高对心血管疾病风险的影响显著下降（RR为-0.09；95%CI：0.15，-0.03，p = 0.006）。与每种应激激素水平较低的个体相比，去甲肾上腺素水平较高（RR为1.68；95%CI：1.37，2.06）、肾上腺素水平较高（RR为1.58；95%CI：1.10，2.26）和皮质醇水平较高（RR为1.60；95%CI：1.04，2.26）的个体患心血管疾病的风险显著更高。
与应激激素水平较低相比，应激激素水平较高与心血管疾病风险较高显著相关。
