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Chronic Stress And Metabolic Syndrome Linked
A DGReview of :"Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study."
Circulation
11/27/2002
By Anne MacLennan
The first evidence that chronic stress may be a cause of metabolic syndrome (MS) has emerged from a study from the University College London, London, England.
Causes of this disorder, which may be a precursor of coronary disease, are uncertain.
Prompted by the possibility disturbances in neuroendocrine and cardiac autonomic activity (CAA) contribute to MS development, Dr E J Brunner and colleagues examined the reversibility and power of psychosocial and behavioural factors to explain the neuroendocrine adaptations that accompany MS.
The double blind, case control study compared 30 working men, aged 45 years to 63 years, and all with MS (all drawn from the Whitehall II cohort), with 153 healthy controls.
Cortisol secretion, sensitivity and 24-hour cortisol metabolite and catecholamine output were measured over two days, and CAA was obtained from power spectral analysis of heart rate variability (HRV) recordings.
While the 24-hour cortisol metabolite and normetanephrine (three-methoxynorepinephrine) outputs were higher among cases than controls, HRV and total power were lower among cases.
Also higher among cases were serum interleukin-six, plasma C-reactive protein and viscosity, whereas lower HRV was linked with higher normetanephrine output.
Among former cases (23 men with MS five years previously) cortisol output, heart rate and interleukin-six were at the same levels as those of controls.
The researchers found psychosocial factors accounted for 37 percent of the link between MS and normetanephrine output and seven percent to 19 percent for CAA.
Health-related behaviours accounted for between five percent and 18 percent of neuroendocrine differences.
Thus, neuroendocrine stress axes are activated in MS, and there is relative cardiac sympathetic predominance. However, the neuroendocrine changes may be reversible.
Although this study provides the first evidence chronic stress may be a cause of MS, confirmatory prospective studies are required, conclude these authors.
Circulation 2002;Nov 19;106(21):2659-65.
"Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study."
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