Kupper Nina, Gidron Yori, Winter Jobst, Denollet Johan
Department of Medical Psychology, Tilburg University, Center of Research on Psychology in Somatic diseases, Warandelaan 2, PO box 90153, 5000 LE Tilburg, Netherlands.
Psychosom Med. 2009 Nov;71(9):973-80. doi: 10.1097/PSY.0b013e3181bee6dc. Epub 2009 Oct 15.
To examine whether markers of oxidative stress differ as a function of Type D personality, depression, and chronic heart failure (CHF) etiology. Type D (distressed) personality and depression are related to poor cardiac prognosis. Because patients with CHF are characterized by increased oxidative stress, this may be a candidate mechanism responsible for the adverse prognosis in emotionally distressed patients with CHF.
Serum levels of xanthine oxidase (XO), inducible heat shock protein (Hsp)70, and deoxyribonucleic acid damage marker 8-OHdG were measured in 122 patients, and effects of Type D, depression, and etiology were assessed.
CHF patients with Type D personality had lower levels of Hsp70 than non-Type D patients (6.48 ng/mL versus 7.85 ng/mL, p = .04, d = 0.26), and in case of an ischemic etiology, higher levels of XO (13.57 ng/mL versus 9.84 ng/mL, p = .01, d = 0.98). There were no significant univariate differences for depression. When adding depression as an additional independent variable in the Type D analysis, the effect of Type D personality remained significant (F = 5.460, p = .02) and was independent of depression (F = 0.942, p = .33). The ratio of XO to Hsp70 was significantly higher in Type D patients with CHF as compared with non-Type D patients (6.14 versus 2.83, p = .03, d = 0.39), independent of etiology class.
CHF patients with Type D personality are characterized by an increased oxidative stress burden, apparent in the decreased antioxidant levels and an increased oxidative stress ratio.
研究氧化应激标志物是否因D型人格、抑郁和慢性心力衰竭（CHF）病因的不同而有所差异。D型（痛苦型）人格和抑郁与心脏预后不良有关。由于CHF患者的特征是氧化应激增加，这可能是导致情绪困扰的CHF患者预后不良的一个潜在机制。
对122例患者测量血清黄嘌呤氧化酶（XO）、诱导型热休克蛋白（Hsp）70和脱氧核糖核酸损伤标志物8-羟基脱氧鸟苷水平，并评估D型人格、抑郁和病因的影响。
D型人格的CHF患者Hsp70水平低于非D型患者（6.48 ng/mL对7.85 ng/mL，p = 0.04，d = 0.26），在缺血性病因的情况下，XO水平更高（13.57 ng/mL对9.84 ng/mL，p = 0.01，d = 0.98）。抑郁方面无显著的单变量差异。在D型分析中加入抑郁作为额外的自变量时，D型人格的影响仍然显著（F = 5.460，p = 0.02），且独立于抑郁（F = 0.942，p = 0.33）。与非D型患者相比，D型CHF患者的XO与Hsp70之比显著更高（6.14对2.83，p = 0.03，d = 0.39），与病因类型无关。
D型人格的CHF患者的特征是氧化应激负担增加，表现为抗氧化水平降低和氧化应激比增加。
