{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:45:00Z","timestamp":1789523100789,"version":"build-2803163510"},"reference-count":101,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"vor","delay-in-days":156,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["491466077"],"award-info":[{"award-number":["491466077"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Depression and Anxiety"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Allostatic load (AL) is the cumulative wear and tear on the body due to the chronic adverse physical or psychosocial situations. The acute stress response activates the primary mediators of AL, which include cortisol, epinephrine (EPI), norepinephrine (NE), and dehydroepiandrosterone sulfate (DHEA\u2010S). Secondary outcomes, such as metabolic syndrome (MetS), cardiovascular, and immune system changes, can result from long\u2010term stress responses. Given these complex reactions to an acute stressor, a multidimensional stress assessment is required when investigating individual stress reactivity in an experimental setting. This study is aimed at examining the association between the primary mediators of AL and MetS in major depressive disorder (MDD) patients. MDD patients (<jats:italic>n<\/jats:italic> = 164, age = 18\u201365 years old) with MetS+ (<jats:italic>n<\/jats:italic> = 46, weight = 93.10 \u00b1 16.43\u2009kg) and without MetS\u2010 (<jats:italic>n<\/jats:italic> = 118, weight = 73.08 \u00b1 15.22\u2009kg) were analyzed cross\u2010sectionally. Stepwise binary regression and Welch\u2019s <jats:italic>t<\/jats:italic>\u2010test were used to find the associations and differences between the two groups. The regression analysis was fully adjusted for age, sex, and the Beck Depression Inventory\u2010II score. In unadjusted model, cortisol (<jats:italic>b<\/jats:italic> = \u22120.003, <jats:italic>p<\/jats:italic> = 0.034) was inversely associated with MetS. In fully adjusted model, EPI (<jats:italic>b<\/jats:italic> = \u22120.006, <jats:italic>p<\/jats:italic> = 0.007) was inversely associated with MetS. However, significant differences (<jats:italic>p<\/jats:italic> = 0.005) were observed for cortisol between MDD patients without MetS\u2010 (410.13 \u00b1 144.63\u2009nmol\/l) and MDD patients with MetS+ (340.90 \u00b1 132.98\u2009nmol\/l) with a small effect size (Cohen\u2019s <jats:italic>d<\/jats:italic> of 0.489). Significant differences (<jats:italic>p<\/jats:italic> = 0.001) were observed for EPI between MDD patients without MetS\u2010 (185.67 \u00b1 124.44\u2009pg\/ml) and MDD patients with MetS+ (124.95 \u00b1 84.38\u2009pg\/ml) with a moderate effect size (Cohen\u2019s <jats:italic>d<\/jats:italic> of 0.530). These observations are of clinical importance for the management of MDD patients.<\/jats:p>","DOI":"10.1155\/2024\/1355340","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T15:13:38Z","timestamp":1717686818000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Allostatic Load and Metabolic Syndrome in Depressed Patients: A Cross\u2010Sectional 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