Osei Francis, Wippert Pia-Maria, Block Andrea
Professorship for Medical Sociology and Psychobiology, Department of Health and Physical Activity, University of Potsdam, Potsdam 14469, Germany.
Faculty of Health Sciences, joint Faculty of the University of Potsdam, The Brandenburg Medical School Theodor Fontane, and the Brandenburg University of Technology Cottbus - Senftenberg, Am Mühlenberg 9 14476, Potsdam, Germany.
Depress Anxiety. 2024 Jun 6;2024:1355340. doi: 10.1155/2024/1355340. eCollection 2024.
Allostatic load (AL) is the cumulative wear and tear on the body due to the chronic adverse physical or psychosocial situations. The acute stress response activates the primary mediators of AL, which include cortisol, epinephrine (EPI), norepinephrine (NE), and dehydroepiandrosterone sulfate (DHEA-S). Secondary outcomes, such as metabolic syndrome (MetS), cardiovascular, and immune system changes, can result from long-term stress responses. Given these complex reactions to an acute stressor, a multidimensional stress assessment is required when investigating individual stress reactivity in an experimental setting. This study is aimed at examining the association between the primary mediators of AL and MetS in major depressive disorder (MDD) patients. MDD patients ( = 164, age = 18-65 years old) with MetS+ ( = 46, weight = 93.10 ± 16.43 kg) and without MetS- ( = 118, weight = 73.08 ± 15.22 kg) were analyzed cross-sectionally. Stepwise binary regression and Welch's -test were used to find the associations and differences between the two groups. The regression analysis was fully adjusted for age, sex, and the Beck Depression Inventory-II score. In unadjusted model, cortisol ( = -0.003, = 0.034) was inversely associated with MetS. In fully adjusted model, EPI ( = -0.006, = 0.007) was inversely associated with MetS. However, significant differences ( = 0.005) were observed for cortisol between MDD patients without MetS- (410.13 ± 144.63 nmol/l) and MDD patients with MetS+ (340.90 ± 132.98 nmol/l) with a small effect size (Cohen's of 0.489). Significant differences ( = 0.001) were observed for EPI between MDD patients without MetS- (185.67 ± 124.44 pg/ml) and MDD patients with MetS+ (124.95 ± 84.38 pg/ml) with a moderate effect size (Cohen's of 0.530). These observations are of clinical importance for the management of MDD patients.
应激负荷（AL）是由于慢性不良身体或心理社会状况导致的身体累积性磨损。急性应激反应会激活AL的主要调节因子，其中包括皮质醇、肾上腺素（EPI）、去甲肾上腺素（NE）和硫酸脱氢表雄酮（DHEA-S）。长期应激反应可能导致诸如代谢综合征（MetS）、心血管和免疫系统变化等次要结果。鉴于对急性应激源的这些复杂反应，在实验环境中研究个体应激反应性时需要进行多维应激评估。本研究旨在探讨AL的主要调节因子与重度抑郁症（MDD）患者MetS之间的关联。对患有MetS+（n = 46，体重 = 93.10 ± 16.43 kg）和未患有MetS-（n = 118，体重 = 73.08 ± 15.22 kg）的MDD患者（n = 164，年龄 = 18 - 65岁）进行横断面分析。采用逐步二元回归和韦尔奇t检验来发现两组之间的关联和差异。回归分析对年龄、性别和贝克抑郁量表-II得分进行了全面调整。在未调整模型中，皮质醇（β = -0.003，p = 0.034）与MetS呈负相关。在完全调整模型中，EPI（β = -0.006，p = 0.007）与MetS呈负相关。然而，未患有MetS-的MDD患者（410.13 ± 144.63 nmol/l）与患有MetS+的MDD患者（340.90 ± 132.98 nmol/l）之间观察到皮质醇存在显著差异（p = 0.005），效应量较小（科恩d值为0.489）。未患有MetS-的MDD患者（185.67 ± 124.44 pg/ml）与患有MetS+的MDD患者（124.95 ± 84.38 pg/ml）之间观察到EPI存在显著差异（p = 0.001），效应量中等（科恩d值为0.530）。这些观察结果对于MDD患者的管理具有临床重要性。
