 |
|
Psychosocial Factors and Inflammation in the Multi-Ethnic Study of Atherosclerosis
Nalini Ranjit, PhD;
Ana V. Diez-Roux, MD, PhD;
Steven Shea, MD;
Mary Cushman, MD, MSc;
Teresa Seeman, PhD;
Sharon A. Jackson, PhD;
Hanyu Ni, PhD, MPH
Arch Intern Med. 2007;167(2):174-181.
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.
Author Affiliations: Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor (Drs Ranjit and Diez-Roux); Division of General Medicine, College of Physicians and Surgeons, and Division of Epidemiology, School of Public Health, Columbia University New York, NY (Dr Shea); Department of Medicine, University of Vermont, Burlington (Dr Cushman); Division of Geriatrics, School of Medicine, University of California–Los Angeles (Dr Seeman); and Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (Dr Ni). Dr Jackson is a contractor from Northrop Grumman Corporation, Atlanta, Ga, to the Division for Heart Disease and Stroke Prevention, Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta.
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Demographic Differences in Systemic Inflammatory Response Syndrome Score After Trauma
NeSmith et al.
Am J Crit Care 2012;21:35-41.
ABSTRACT
| FULL TEXT
Optimism in Relation to Inflammation and Endothelial Dysfunction in Older Men: The VA Normative Aging Study
Ikeda et al.
Psychosom. Med. 2011;73:664-671.
ABSTRACT
| FULL TEXT
Hostility and acute coronary syndrome in a transitional post-communist Muslim country: a population-based study in Tirana, Albania
Burazeri and Kark
Eur J Public Health 2011;21:469-476.
ABSTRACT
| FULL TEXT
Association Between Depression and Inflammation--Differences by Race and Sex: The META-Health Study
AMYRE Morris et al.
Psychosom. Med. 2011;73:462-468.
ABSTRACT
| FULL TEXT
Emotional Functioning at Age 7 Years is Associated With C-Reactive Protein in Middle Adulthood
Appleton et al.
Psychosom. Med. 2011;73:295-303.
ABSTRACT
| FULL TEXT
Autonomic Nervous System Dysfunction and Inflammation Contribute to the Increased Cardiovascular Mortality Risk Associated With Depression
Kop et al.
Psychosom. Med. 2010;72:626-635.
ABSTRACT
| FULL TEXT
Increased Mortality Risk for Workers With a Compensated, Permanent Occupational Disability of the Upper or Lower Extremities: A 21-Year Follow-up Study
Lin et al.
Am J Epidemiol 2010;171:917-923.
ABSTRACT
| FULL TEXT
Psychosocial Risk Factors and Retinal Microvascular Signs: The Multi-Ethnic Study of Atherosclerosis
Jensen et al.
Am J Epidemiol 2010;171:522-531.
ABSTRACT
| FULL TEXT
Association of Optimism and Pessimism With Inflammation and Hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA)
Roy et al.
Psychosom. Med. 2010;72:134-140.
ABSTRACT
| FULL TEXT
Association of Salivary Cortisol Circadian Pattern With Cynical Hostility: Multi-Ethnic Study of Atherosclerosis
Ranjit et al.
Psychosom. Med. 2009;71:748-755.
ABSTRACT
| FULL TEXT
Divergent Effects of Laughter and Mental Stress on Arterial Stiffness and Central Hemodynamics
Vlachopoulos et al.
Psychosom. Med. 2009;71:446-453.
ABSTRACT
| FULL TEXT
Association between depression and coronary artery calcification in women with systemic lupus erythematosus
Greco et al.
Rheumatology (Oxford) 2009;48:576-581.
ABSTRACT
| FULL TEXT
A Preliminary Study of Daily Interpersonal Stress and C-Reactive Protein Levels Among Adolescents From Latin American and European Backgrounds
Fuligni et al.
Psychosom. Med. 2009;71:329-333.
ABSTRACT
| FULL TEXT
Associations of Depression With C-Reactive Protein, IL-1, and IL-6: A Meta-Analysis
Howren et al.
Psychosom. Med. 2009;71:171-186.
ABSTRACT
| FULL TEXT
Psychological Distress and Cardiovascular Risk: What Are the Links?
von Kanel
J Am Coll Cardiol 2008;52:2163-2165.
FULL TEXT
Traditional and Novel Cardiovascular Risk Factors for Retinal Vein Occlusion: The Multiethnic Study of Atherosclerosis
Cheung et al.
IOVS 2008;49:4297-4302.
ABSTRACT
| FULL TEXT
Do Psychological Factors Affect Inflammation and Incident Coronary Heart Disease: The Whitehall II Study
Nabi et al.
Arterioscler. Thromb. Vasc. Bio. 2008;28:1398-1406.
ABSTRACT
| FULL TEXT
Why traumatic leg amputees are at increased risk for cardiovascular diseases
Naschitz and Lenger
QJM 2008;101:251-259.
ABSTRACT
| FULL TEXT
Depressive Symptoms Moderate the Influence of Hostility on Serum Interleukin-6 and C-Reactive Protein
Stewart et al.
Psychosom. Med. 2008;70:197-204.
ABSTRACT
| FULL TEXT
Psychosocial Aspects of Chronic Disease: ESRD as a Paradigmatic Illness
Cukor et al.
J. Am. Soc. Nephrol. 2007;18:3042-3055.
ABSTRACT
| FULL TEXT
Socioeconomic Position, Race/Ethnicity, and Inflammation in the Multi-Ethnic Study of Atherosclerosis
Ranjit et al.
Circulation 2007;116:2383-2390.
ABSTRACT
| FULL TEXT
Cardiovascular Health Disparities: A Systematic Review of Health Care Interventions
Davis et al.
Med Care Res Rev 2007;64:29S-100S.
ABSTRACT
|
