Räikkönen K, Lassila R, Keltikangas-Järvinen L, Hautanen A
Department of Psychology, University of Helsinki, Finland.
Arterioscler Thromb Vasc Biol. 1996 Mar;16(3):363-7. doi: 10.1161/01.atv.16.3.363.
The effect of chronic stress on tissue-type plasminogen activator (TPA) and plasminogen activator inhibitor-1 (PAI-1) antigens was studied in 69 healthy middle-aged men. Chronic stress, defined as feelings of fatigue, lack of energy, increased irritability, and demoralization, was positively associated with plasma concentrations of PAI-1 antigen but was unrelated to TPA. The association remained unaltered after controlling for age, smoking, alcohol consumption, and physical activity but became nonsignificant after further controlling for abdominal obesity, BMI, and serum insulin and triglyceride levels. This attenuated association implies that the relationship between vital exhaustion and PAI-1 may be secondary to the effects of the metabolic variables. Thus, the present study shows that long-term stress affects the fibrinolytic system and suggests that obesity and insulin and triglyceride concentrations, which are closely correlated with the fibrinolytic parameters, may mediate the association. These findings are consistent with the hypothesis that chronic stress causes increased synthesis of PAI-1, thus promoting the risk for atherothrombotic disease by decreasing the likelihood of spontaneous fibrinolysis and increasing the likelihood of fibrin deposition.
在69名健康中年男性中研究了慢性应激对组织型纤溶酶原激活物（TPA）和纤溶酶原激活物抑制剂-1（PAI-1）抗原的影响。慢性应激定义为疲劳感、精力不足、易怒增加和士气低落，与PAI-1抗原的血浆浓度呈正相关，但与TPA无关。在控制年龄、吸烟、饮酒和身体活动后，这种关联仍然不变，但在进一步控制腹部肥胖、BMI以及血清胰岛素和甘油三酯水平后，这种关联变得不显著。这种减弱的关联意味着活力耗竭与PAI-1之间的关系可能继发于代谢变量的影响。因此，本研究表明长期应激会影响纤溶系统，并提示与纤溶参数密切相关的肥胖、胰岛素和甘油三酯浓度可能介导这种关联。这些发现与慢性应激导致PAI-1合成增加的假说一致，从而通过降低自发纤溶的可能性和增加纤维蛋白沉积的可能性来促进动脉粥样硬化血栓形成疾病的风险。
