In this seminal paper combining the insights of evolution and endocrinology, Bjorntorp pointed out that modernization has a significant impact on the development of metabolic syndrome, with the former being characterized by aging and psychosocial stress. Based on this premise, he hypothesized that age-related decline in growth hormones and sex steroids as well as stress-induced activation of counterregulatory hormones—notably the sympathetic nervous system and hypothalamic pituitary axis—may cause intra-abdominal fat accumulation and attendant metabolic abnormalities and cardiovascular risk.
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