壓力激素與心血管疾病風險的相關性－ 一個具代表性的台灣中老年族群世代研究

Abstract

背景：心血管疾病是一個全球主要健康問題；然而，壓力激素與心血管疾病之間的關係仍然不確定。本研究的目的在於探討它們之間的關係。 研究材料與方法：本研究為前瞻性世代研究，我們使用的研究資料依據西元2000年時進行的老人健康之社會因素與生物指標計畫，其調查族群為台灣中老年族群。參與者接受了夜間尿液壓力荷爾蒙評估（腎上腺素、正腎上腺素、皮質醇），將尿液壓力激素濃度分成四等分位後，進行多變量羅吉斯回歸分析，以評估壓力激素濃度與心血管疾病事件和腦血管疾病事件之間的調整後勝算比。 結果與討論：經過6年的追蹤後，共有724名參與者納入分析。尿中腎上腺素在最高的四分位數濃度的受試者，相較於尿中腎上腺素在第一至第三個四分位數的受試者，有顯著較高的腦血管疾病風險(調整後勝算比，2.88，95信賴區間，1.23-6.73，p=0.01)。此外，尿中皮質醇濃度在第三個四分位數的受試者，相較第一個四分位數受試者，有顯著較低的腦血管疾病風險(調整後勝算比，0.19，95%信賴區間，0.15-0.73)。 結論：尿液腎上腺素濃度升高與腦血管疾病風險增加相關，相對較高的尿中皮質醇濃度與較低腦血管疾病風險相關。未來仍需要進一步研究以更深入探討此議題。

Introduction: Cardiovascular diseases (CVDs) remain a major global health concern; however, the relationship between stress hormones and CVDs remains uncertain. This study aimed to explore this relationship. Methods: This is a prospective cohort study using data from the Social Environment and Biomarkers of Aging Study (SEBAS) conducted in 2000, which included middle-aged and elderly Taiwanese individuals. Participants were assessed for overnight urinary stress hormones (epinephrine, norepinephrine, and cortisol). Upon stratifying urinary stress hormone levels into quartiles, multivariable logistic regression analysis was conducted to assess the adjusted odds ratios (ORs) between stress hormone levels and cardiovascular and cerebrovascular events. Results: After 6-years of follow-up, 724 participants were included for analysis. Participants with the highest quartile concentration of urinary epinephrine had a significantly higher risk of cerebrovascular diseases compared with individuals in the first through third quartiles of urinary epinephrine (OR, 2.88, 95% Confidence interval (CI), 1.23-6.73, p=0.01). Additionally, participants in the third quartile of urinary cortisol had a significantly lower risk of cerebrovascular disease compared with those in the first quartile (OR, 0.19, 95% CI, 0.15-0.73). Conclusions: Elevated urine epinephrine level was linked to an increased risk of cerebrovascular disease. Relatively higher urinary cortisol concentration was associated with a lower risk of cerebrovascular disease. Further investigation is needed to explore this issue more thoroughly.