Association of primary allostatic load mediators and metabolic syndrome (MetS): A systematic review

Abstract

Allostatic load (AL) exposure may cause detrimental effects on the neuroendocrine system, leading to metabolic syndrome (MetS). The primary mediators of AL involve serum dehydroepiandrosterone sulfate (DHEAS; a functional HPA axis antagonist); further, cortisol, urinary norepinephrine (NE), and epinephrine (EPI) excretion levels (assessed within 12-h urine as a golden standard for the evaluation of the HPA axis activity and sympathetic nervous system activity). However, the evidence of an association between the primary mediators of AL and MetS is limited. This systematic review aimed to critically examine the association between the primary mediators of AL and MetS. PubMed and Web of Science were searched for articles from January 2010 to December 2021, published in English. The search strategy focused on cross-sectional and case–control studies comprising adult participants with MetS, obesity, overweight, and without chronic diseases. The STROBE checklist was used to assess study quality control. Of 770 studies, twenty-one studies with a total sample size (n = 10,666) met the eligibility criteria. Eighteen studies were cross-sectional, and three were case–control studies. The included studies had a completeness of reporting score of COR % = 87.0 ± 6.4%. It is to be noted, that cortisol as a primary mediator of AL showed an association with MetS in 50% (urinary cortisol), 40% (serum cortisol), 60% (salivary cortisol), and 100% (hair cortisol) of the studies. For DHEAS, it is to conclude that 60% of the studies showed an association with MetS. In contrast, urinary EPI and urinary NE had 100% no association with MetS. In summary, there is a tendency for the association between higher serum cortisol, salivary cortisol, urinary cortisol, hair cortisol, and lower levels of DHEAS with MetS. Future studies focusing on longitudinal data are warranted for clarification and understanding of the association between the primary mediators of AL and MetS.

Prevalence of Potentially Inappropriate Prescriptions According to the New STOPP/START Criteria in Nursing Homes: A Systematic Review

“…The Completeness of Reporting (COR) score for each manuscript was calculated from the formula: COR (%) = (yes ÷ (yes + no) × 100). Quality was measured according to previous studies [47,48], that is, "low" (COR: 0-49%), "moderate" (COR: 50-74%) and "high" if ≥75% of items were met. In the case of any study obtaining a COR of less than 49%, it would be extracted from the review.…”

Long‐term glucocorticoids in relation to the metabolic syndrome and cardiovascular disease: A systematic review and meta‐analysis

“…Here, we provide an overview of current knowledge regarding the relationship of long‐term HairGC with MetS and CVD. In contrast to previous overviews [13, 14], we do not only describe the role of hair cortisol (HairF), but also hair cortisone (HairE) in relation to cardiometabolic health. In addition, we investigate the impact of age and sex in the relationship among HairGC, MetS, and CVD.…”