Gou Yifan, Cheng Shiqiang, Kang Meijuan, Zhou Ruixue, Liu Chen, Hui Jingni, Liu Ye, Wang Bingyi, Shi Panxing, Zhang Feng
Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Sciences Center, Xi'an Jiaotong University, Xi'an, China.
Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Sciences Center, Xi'an Jiaotong University, Xi'an, China; Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China.
Biol Psychiatry. 2025 Apr 15;97(8):786-793. doi: 10.1016/j.biopsych.2024.09.026. Epub 2024 Oct 10.
Allostatic load (AL) is an objective measure of the biological components of chronic stress in clinical practice, which potentially influence depression, anxiety, and suicide. In this study, we investigated the association between AL and these mental disorders.
In this cohort study of 333,017 adults, participants without previous diagnoses of depression, anxiety, or suicide were observed from March 13, 2006, to October 31, 2022. AL was estimated using 10 biomarkers that reflect metabolic, cardiovascular, and inflammatory dysregulation. Diagnoses were based on ICD-10. We performed Cox proportional hazard models to assess the relationship between AL and these mental disorders. We also conducted subgroup analyses for sex, age, and Townsend Deprivation Index, as well as sensitivity analyses.
The median follow-up period was 13 years. Over the follow-up period, 13,441 (4.04%) participants developed depression, 13,903 (4.17%) developed anxiety, and 796 (0.24%) committed suicide. In the fully adjusted model, individuals with high AL had an increased risk of depression (hazard ratio = 1.389, p = 8.38 × 10), anxiety (hazard ratio = 1.304, p = 5.82 ×10), and suicide (hazard ratio = 1.433, p = 4.46 ×10). Women and younger individuals with high AL were vulnerable to depression and anxiety, while moderate AL levels were significantly associated with suicide in men and younger participants. Moreover, individuals with middle and high AL had an elevated risk of comorbid depression and anxiety.
High AL is positively associated with increased risks of depression, anxiety, and suicide, highlighting its potential as a predictive tool in mental health.
在临床实践中，应激负荷（AL）是慢性应激生物学成分的一种客观衡量指标，它可能影响抑郁、焦虑和自杀。在本研究中，我们调查了AL与这些精神障碍之间的关联。
在这项对333,017名成年人的队列研究中，于2006年3月13日至2022年10月31日观察了既往未被诊断为抑郁、焦虑或有自杀行为的参与者。使用反映代谢、心血管和炎症失调的10种生物标志物来估计AL。诊断基于国际疾病分类第十版（ICD - 10）。我们进行了Cox比例风险模型分析，以评估AL与这些精神障碍之间的关系。我们还按性别、年龄和汤森德剥夺指数进行了亚组分析以及敏感性分析。
中位随访期为13年。在随访期间，13,441名（4.04%）参与者患了抑郁症，13,903名（4.17%）患了焦虑症，796名（0.24%）自杀。在完全调整模型中，高AL个体患抑郁症（风险比 = 1.389，p = 8.38×10）、焦虑症（风险比 = 1.304，p = 5.82×10）和自杀（风险比 = 1.433，p = 4.46×10）的风险增加。高AL的女性和年轻人易患抑郁症和焦虑症，而中等AL水平与男性及年轻参与者的自杀显著相关。此外，中高AL个体患抑郁症和焦虑症共病的风险升高。
高AL与抑郁症、焦虑症和自杀风险增加呈正相关，突出了其作为心理健康预测工具的潜力。
