Altered response to neuroendocrine challenge linked to indices of the metabolic syndrome in healthy adults.
Altered response to neuroendocrine challenge linked to indices of the metabolic syndrome in healthy adults.
复制标题
健康成年人对神经内分泌挑战的反应改变与代谢综合征指数有关。
DOI：
10.1055/s-0032-1306342
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Carpenter,LL
中科院分区：
文献类型：
--
作者：
Tyrka,AR;Walters,OC;Price,LH;Anderson,GM;Carpenter,LL
代谢综合征（MetS）以向心性肥胖、高血压、胰岛素抵抗和高胆固醇血症为特征。下丘脑-垂体-肾上腺（HPA）轴活动在代谢综合征中经常异常，过量的皮质醇暴露可能与代谢紊乱有关。我们调查的假设，皮质醇和促肾上腺皮质激素（ACTH）的反应，一个标准化的神经内分泌挑战试验将与MetS指数在社区样本的健康成年人。健康的成年人，125名男性和170名女性，没有重大的医疗问题或慢性药物从社区招募。参与者完成了地塞米松/促肾上腺皮质激素释放激素（Dex/CRH）测试，并测量了人体测量，血压，糖化血红蛋白（HbA 1c）和胆固醇。参与者报告了他们早期生活压力和近期压力的历史，以及情绪和焦虑症状。皮质醇和ACTH对Dex/CRH试验的反应与中心性肥胖（p<0.001）和血压（p<0.01）呈负相关，与HDL胆固醇呈正相关（p<0.01）。在控制体重指数（BMI）后，这些发现仍然显着。压力和焦虑和抑郁症状的措施呈负相关，皮质醇和促肾上腺皮质激素反应在Dex/CRH测试，但不相关的MetS指数。HPA轴功能的改变与MetS组分有关，即使在健康的社区样本中也表明这些过程可能参与MetS的发病机制。确定发病前的风险过程可能允许在疾病发展之前进行检测和干预。
Metabolic syndrome (MetS) is characterized by central obesity, hypertension, insulin resistance, and hypercholesterolemia. Hypothalamic-pituitary-adrenal (HPA) axis activity is frequently abnormal in MetS, and excessive cortisol exposure may be implicated in metabolic derangements. We investigated the hypothesis that cortisol and adrenocorticotropic hormone (ACTH) responses to a standardized neuroendocrine challenge test would be associated with indices of MetS in a community sample of healthy adults. Healthy adults, 125 men and 170 women, without significant medical problems or chronic medications were recruited from the community. Participants completed the dexamethasone/corticotropin-releasing hormone (Dex/CRH) test, and anthropometric measurements, blood pressure, glycosylated hemoglobin (HbA1c), and cholesterol were measured. Participants reported on their history of early life stress and recent stress, as well as mood and anxiety symptoms. Cortisol and ACTH responses to the Dex/CRH test were negatively associated with measures of central adiposity (p<0.001) and blood pressure (p<0.01), and positively associated with HDL cholesterol (p<0.01). These findings remained significant after controlling for body mass index (BMI). Measures of stress and anxiety and depressive symptoms were negatively correlated with cortisol and ACTH responses in the Dex/CRH test but were not related to MetS indices. That altered HPA axis function is linked to MetS components even in a healthy community sample suggests that these processes may be involved in the pathogenesis of MetS. Identification of premorbid risk processes might allow for detection and intervention prior to the development of disease.