孤独与社交隔离：被忽视的肥胖和2型糖尿病危险因素

Core Viewpoint - Loneliness and social isolation are increasingly recognized as significant public health challenges that can exacerbate the risk of type 2 diabetes (T2DM) through complex physiological mechanisms [5][7][15]. Summary by Sections Impact of Loneliness and Social Isolation - A significant portion of the global population experiences social isolation, with over 25% affected, and more than 20% suffering from chronic loneliness, which poses risks beyond psychological health [5][7]. - Research indicates that individuals lacking social connections have a 30% higher risk of developing T2DM compared to those with adequate social support [5][9]. Research Findings - A meta-analysis involving over 1.11 million participants revealed that individuals experiencing loneliness have a 32% increased risk of T2DM, while those who are socially isolated face a 20% higher risk [9]. - The study adjusted for confounding factors such as gender, age, and socioeconomic status, confirming the stability of these associations [9]. Biological Mechanisms - Loneliness can disrupt the hypothalamic-pituitary-adrenal (HPA) axis, leading to increased cortisol levels, which in turn raises blood sugar levels and contributes to insulin resistance [10]. - Social isolation can cause excessive sympathetic nervous system activation and inflammatory responses, further impairing metabolic health and increasing T2DM risk [11]. Implications for Public Health - The findings suggest a need for integrating social health assessments into chronic disease management strategies, emphasizing the importance of social connections in diabetes prevention [8][13]. - Recommendations include encouraging community engagement and support networks, as well as implementing psychological interventions to address loneliness [13][15]. Future Directions - A comprehensive management approach that includes social support and psychological adjustment is essential for effective T2DM prevention and treatment [14][15]. - The integration of social prescriptions and community resources into healthcare systems could significantly improve outcomes for high-risk populations, such as the elderly and socially isolated individuals [13][15].