Visceral fat accumulation: the missing link between psychosocial factors and cardiovascular disease?
Article first published online: 4 AUG 2009
1991 Blackwell Publishing Ltd
Journal of Internal Medicine
Volume 230, Issue 3, pages 195–201, September 1991
How to Cite
BJÖRNTORP, P. (1991), Visceral fat accumulation: the missing link between psychosocial factors and cardiovascular disease?. Journal of Internal Medicine, 230: 195–201. doi: 10.1111/j.1365-2796.1991.tb00431.x
- Issue published online: 4 AUG 2009
- Article first published online: 4 AUG 2009
- Received 31 January 1991, accepted 25 April 1991.
- cardiovascular disease;
- hypothalamic arousal;
- neuro-endocrine system;
- risk factors;
Abstract. Neuroendocrine responses to psychosocial pressures have been well characterized. The defence reaction is followed by increased activity of the sympathetic nervous system. Essential hypertension might be induced by such mechanisms. The defeat reaction is characterized by increased activity along the corticotropin releasing factor-adreno-corticotropin hormone-cortisol axis, resulting in the inhibition of gonadotropin secretion. Such endocrine disturbances are followed by metabolic aberrations, and probably also by the accumulation of visceral fat. Subjects with abdominal fat accumulation (high waist/hip circumference ratio, WHR) have recently been found to exhibit a number of psychosocial handicaps, together with endocrine aberrations characteristic of the defence and, in particular, the defeat reaction, as well as the associated circulatory and metabolic aberrations. Such abnormalities, including the WHR itself, are established risk factors for cardiovascular disease and diabetes. It is postulated that increased WHR is a symptom of chronic hypothalamic arousal as a result of a defeat reaction to psychosocial pressures. This might lead to the development of disease via circulatory and metabolic derangements.