Psychosocial factors and inflammation in the multi-ethnic study of atherosclerosis
Psychosocial factors and inflammation in the multi-ethnic study of atherosclerosis
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DOI：
10.1001/archinte.167.2.174
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发表时间：
2007-01-22
影响因子：
--
通讯作者：
Ni, Hanyu
中科院分区：
文献类型：
--
作者：
Ranjit, Nalini;Diez-Roux, Ana V.;Ni, Hanyu
背景资料：心理社会因素与心血管疾病的发生、发展有关，但其病理机制尚不清楚。我们研究了健康成人中心血管疾病的心理社会危险因素与炎症标志物浓度的关系，并评估了这些关系受行为、体重指数（BMI）和糖尿病介导的程度。方法：这项横断面研究使用了多种族动脉粥样硬化研究的基线检查数据，对6814名年龄在45岁至84岁之间的男性和女性进行的多地点研究。回归分析被用来估计协会愤世嫉俗的不信任，慢性压力，抑郁症与血清水平的C-反应蛋白，IL-6，和纤维蛋白原之前和调整后的社会经济地位，行为，BMI，和diabetes.Results：更高水平的愤世嫉俗的不信任与更高水平的炎症标志物。比较量表第80和第20次评分的百分比差异（95%置信区间[CI]）为：IL-6 7%（3%-11%）; C反应蛋白9%（2%-16%）;纤维蛋白原1.3%（0.1%-2.4%）。较高水平的慢性应激与较高浓度的IL-6和C反应蛋白相关。比较2和0持续压力环境的百分比差异（95%CI）为IL-6为4%（1%-8%），C-反应蛋白为5%（1%-11%）。抑郁症与IL-6水平呈正相关（流行病学研究中心-抑郁量表评分>= 21与< 21的百分比差异[95%CI]为7% [1%-14%]）。在调整行为因素后，心理社会因素与炎症标志物的关联减少了20%至55%，在调整BMI和糖尿病后减少了45%至100%，主要是由于BMI的影响。没有协会仍然控制后的社会经济地位，行为，BMI，和diabetes.Conclusions：心理社会因素与较高水平的炎症标志物，最一贯的愤世嫉俗的不信任。结果与BMI、行为和糖尿病的中介作用一致。
Background: Psychosocial factors are associated with the development and progress of cardiovascular disease, but the pathological mechanisms remain unclear. We examined the associations of psychosocial risk factors for cardiovascular disease with concentrations of inflammatory markers among healthy adults and assessed the extent to which these associations are mediated by behaviors, body mass index (BMI), and diabetes mellitus.Methods: This cross-sectional study used data from the baseline examination of the Multi-Ethnic Study of Atherosclerosis, a multisite study of 6814 men and women aged 45 to 84 years. Regression analyses were used to estimate associations of cynical distrust, chronic stress, and depression with serum levels of C-reactive protein, IL-6, and fibrinogen before and after adjustment for socioeconomic position, behaviors, BMI, and diabetes.Results: Higher levels of cynical distrust were associated with higher levels of inflammatory markers. The percentage differences (95% confidence intervals [CIs]) comparing the 80th and 20th percentiles of the scale were 7% (3%-11%) for IL-6; 9% (2%-16%) for C-reactive protein; and 1.3% (0.1%-2.4%) for fibrinogen. Higher levels of chronic stress were associated with higher concentrations of IL-6 and C-reactive protein. The percentage differences (95% CIs) comparing 2 and 0 ongoing stressful circumstances were 4% (1%-8%) for IL-6 and 5% (1%-11%) for C-reactive protein. Depression was positively associated with the level of IL-6 (percentage difference [95% CI] comparing the Center for Epidemiologic Studies -Depression Scale scores of >= 21 vs < 21 was 7% [1%-14%]). Associations of psychosocial factors with inflammatory markers were reduced by 20% to 55% after adjustment for behavioral factors and by 45% to 100% after adjustment for BMI and diabetes, mostly owing to the effect of BMI. No associations remained after controlling for socioeconomic position, behaviors, BMI, and diabetes.Conclusions: Psychosocial factors are associated with higher levels of inflammatory markers, most consistently for cynical distrust. Results are compatible with a mediating role of BMI, behaviors, and diabetes.