Narita Kosuke, Murata Tetsuhito, Hamada Toshihiko, Kosaka Hirotaka, Sudo Satoru, Mizukami Kimiko, Yoshida Haruyoshi, Wada Yuji
Department of Neuropsychiatry, University of Fukui, Eiheiji-cho, Fukui 910-1193, Japan.
Psychoneuroendocrinology. 2008 Apr;33(3):305-12. doi: 10.1016/j.psyneuen.2007.11.013.
Anxiety has been shown to be associated with cardiovascular disease. Atherosclerosis is responsible for the vast majority of cardiovascular events. Recent evidence is accumulating to show that insulin resistance (IR) plays a central role in determining the clinical manifestations of established atherosclerotic lesions. The current preliminary study aimed to investigate the associations between trait anxiety, IR, and atherosclerotic progression in healthy elderly subjects with normal fasting glucose and without metabolic syndrome. Thirty-five healthy elderly subjects (19 males and 16 females, mean age 64.5+/-4.7 years) were enrolled in this study. Trait anxiety was measured using a questionnaire corresponding to the trait anxiety scale taken from the State and Trait Anxiety Inventory. The homeostasis model assessment (HOMA-R) and plasma leptin-to-adiponectin ratio (L/A ratio), which are convenient IR indexes calculated from fasting blood sampling, were examined. As measurements of atherosclerotic progression, we performed two ultrasound methods, namely brachial artery flow-mediated dilation (FMD), an endothelial function assessment quantitatively reflecting the endothelium-dependent vasodilation responses following hyperemia, and measurement of carotid intima-media thickness (IMT). The severity of trait anxiety was positively associated with HOMA-R and L/A ratio, and negatively associated with the percent change of brachial artery FMD (%FMD). HOMA-R and L/A ratio were positively associated with carotid IMT, and L/A ratio was negatively associated with %FMD. These data showed the associations between trait anxiety, IR indexes and endothelial dysfunction or atherosclerotic progression. This pilot study, with a cross-sectional design, supports the promising role of IR for clarifying the pathophysiological mechanism by which anxiety contributes to an increasing risk of atherosclerosis.
焦虑已被证明与心血管疾病有关。动脉粥样硬化是绝大多数心血管事件的病因。最近越来越多的证据表明，胰岛素抵抗（IR）在确定已形成的动脉粥样硬化病变的临床表现中起着核心作用。当前的这项初步研究旨在调查空腹血糖正常且无代谢综合征的健康老年受试者的特质焦虑、IR与动脉粥样硬化进展之间的关联。本研究纳入了35名健康老年受试者（19名男性和16名女性，平均年龄64.5±4.7岁）。使用对应于取自状态 - 特质焦虑量表的特质焦虑量表的问卷来测量特质焦虑。检测了稳态模型评估（HOMA - R）和血浆瘦素与脂联素比值（L/A比值），这是通过空腹采血计算得出的便捷的IR指标。作为动脉粥样硬化进展的测量方法，我们采用了两种超声方法，即肱动脉血流介导的扩张（FMD），一种定量反映充血后内皮依赖性血管舒张反应的内皮功能评估方法，以及颈动脉内膜中层厚度（IMT）的测量。特质焦虑的严重程度与HOMA - R和L/A比值呈正相关，与肱动脉FMD的变化百分比（%FMD）呈负相关。HOMA - R和L/A比值与颈动脉IMT呈正相关，L/A比值与%FMD呈负相关。这些数据显示了特质焦虑、IR指标与内皮功能障碍或动脉粥样硬化进展之间的关联。这项采用横断面设计的初步研究支持了IR在阐明焦虑导致动脉粥样硬化风险增加的病理生理机制方面的重要作用。
