Garvin Peter, Nilsson Lennart, Carstensen John, Jonasson Lena, Kristenson Margareta
Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, Linköping 581 83, Sweden.
Psychosom Med. 2009 Apr;71(3):292-300. doi: 10.1097/PSY.0b013e3181960e7f. Epub 2009 Feb 5.
To test the association between psychosocial factors and circulating levels of matrix metalloproteinase-9 (MMP-9) in a normal population sample. Psychosocial factors have been associated with inflammatory markers and are of prognostic significance for coronary artery disease (CAD). The degrading enzyme MMP-9 is upregulated in inflammatory processes and hypothesized to play a role in the rupture of atherosclerotic plaques.
A total of 402 participants (50% women), aged 45 to 69 years, were drawn randomly from a normal population. Psychosocial instruments covered depression (Center for Epidemiological Studies Depression Questionnaire, CES-D), vital exhaustion, hostile affect, cynicism, mastery, self-esteem, sense of coherence (SOC), emotional support, and social integration. Plasma MMP-9 was measured by an enzyme-linked immunosorbent assay method. Linear regression models were adjusted for age, sex, known CAD, rheumatoid arthritis, cancer, cardiovascular risk factors including C-reactive protein and ongoing medication.
After full adjustment, there were independent associations of elevated MMP-9 levels with CES-D (+2.9 ng/ml per SD, p = .02), hostile affect (+3.0 ng/ml per SD, p = .02), cynicism (+3.5 ng/ml per SD, p = .006), and SOC (-2.5 ng/ml per SD, p = .046). A principal component analysis extracted three components. The first was mainly extracted from CES-D, vital exhaustion, self-esteem, mastery, and SOC; the second was mainly extracted from hostile affect and cynicism. Both were independently associated with MMP-9 (p = .02, p = .04) when run in the same model.
MMP-9 levels were associated with psychosocial factors in a middle-aged normal population sample, independently of traditional risk factors. The findings may constitute a possible link between psychosocial factors and cardiovascular risk.
在正常人群样本中检测心理社会因素与基质金属蛋白酶-9（MMP-9）循环水平之间的关联。心理社会因素已与炎症标志物相关联，并且对冠状动脉疾病（CAD）具有预后意义。降解酶MMP-9在炎症过程中上调，并被认为在动脉粥样硬化斑块破裂中起作用。
从正常人群中随机抽取402名参与者（50%为女性），年龄在45至69岁之间。心理社会测量工具包括抑郁（流行病学研究中心抑郁问卷，CES-D）、倦怠、敌对情绪、愤世嫉俗、掌控感、自尊、连贯感（SOC）、情感支持和社会融合。采用酶联免疫吸附测定法测量血浆MMP-9。线性回归模型针对年龄、性别、已知CAD、类风湿性关节炎、癌症、心血管危险因素（包括C反应蛋白）和正在服用的药物进行了调整。
经过全面调整后，MMP-9水平升高与CES-D（每标准差增加2.9 ng/ml，p = .02）、敌对情绪（每标准差增加3.0 ng/ml，p = .02）、愤世嫉俗（每标准差增加3.5 ng/ml，p = .006）和SOC（每标准差减少2.5 ng/ml，p = .046）存在独立关联。主成分分析提取了三个成分。第一个主要从CES-D、倦怠、自尊、掌控感和SOC中提取；第二个主要从敌对情绪和愤世嫉俗中提取。当在同一模型中运行时，两者均与MMP-9独立相关（p = .02，p = .04）。
在中年正常人群样本中，MMP-9水平与心理社会因素相关，独立于传统危险因素。这些发现可能构成心理社会因素与心血管风险之间的一个可能联系。
