Self-rated health and vital exhaustion, but not depression, is related to inflammation in women with coronary heart disease
Self-rated health and vital exhaustion, but not depression, is related to inflammation in women with coronary heart disease
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DOI：
10.1016/j.bbi.2005.01.001
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发表时间：
2005-11-01
影响因子：
15.1
通讯作者：
Ahnve, S
中科院分区：
文献类型：
--
作者：
Janszky, I;Lekander, M;Ahnve, S
在以人群为基础的研究中，较差的主观幸福感与冠心病(CHD)发病率和死亡率的增加以及现有CHD的不良后果相关。人们对这种联系的机制知之甚少，但免疫活动似乎是一种潜在的途径。尽管越来越多的证据表明免疫活动与主观感受有关。很少有研究对冠心病患者进行检查，结果相互矛盾。我们连续检查了因急性心肌梗死住院和/或接受了经皮冠状动脉腔内成形术或冠状动脉旁路移植术的女性患者。我们通过问卷调查评估抑郁、生命衰竭和自我评估的健康状况。测定循环超敏C反应蛋白(HsCRP)、白介素6(IL-6)和白介素1受体拮抗剂(IL-1ra)浓度。在控制了潜在的混杂因素后，IL-6水平与生命衰竭和自评健康状况呈显着正相关。超敏C反应蛋白与生命衰竭和自测健康之间的关系非常显著。而心理因素与IL-1ra水平的相关性较弱，炎症标志物与抑郁的相关性也不显著。当将炎症标记物和心理健康指标分类时，两者之间的关系也相似。总而言之，炎症活动..通过IL-6和hsCRP水平评估，与CHD妇女的生命衰竭和自我评估的健康有关。这些发现可能为主观幸福感和冠心病之间可能存在的心理神经免疫联系提供进一步的证据。我们的观察还提出了一种可能性，即在冠心病中，细胞因子诱导的疾病反应可能更好地由生命衰竭和自我评估健康的概念来代表，而不是抑郁。(C)2005 Elsevier Inc.保留所有权利。
Poor subjective well-being has been associated with increased coronary heart disease (CHD) morbidity and mortality in population-based studies and with adverse outcomes in existing CHD. Little is known about the mechanisms responsible for this association, but immune activity appears to be a potential pathway. Despite the growing evidence linking immune activity to subjective feelings. very few studies have examined patients with CHD, and the results are conflicting. We examined consecutive women patients hospitalized for acute myocardial infarction, and/or underwent percutaneous transluminal coronary angioplasty or coronary artery bypass grafting. We assessed depression, vital exhaustion, and self-rated health by questionnaires. Circulating levels of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and interleukin-1 receptor antagonist (IL-1ra) concentrations were determined. After controlling for potential confounding factors there was a significant positive correlation between IL-6 levels and vital exhaustion and poor self-rated health. The association between hsCRP and vital exhaustion and self-rated health was borderline significant. In contrast, the correlations between psychological factors and IL-1ra levels were weak and non-significant, as were the correlations between inflammatory markers and depression. Similar relationships between the inflammatory markers and the measures of psychological well-being were obtained when the latter ones were categorized into tertiles. In conclusion, inflammatory activity.. assessed by IL-6 and hsCRP levels, was associated with vital exhaustion and self-rated health in CHD women. These findings may provide further evidence for a possible psychoneuroimmune link between subjective well-being and CHD. Our observations also raise the possibility that a cytokine-induced sickness response in CHD may be better represented by constructs of vital exhaustion and self-rated health than of depression. (c) 2005 Elsevier Inc. All rights reserved.