多民族动脉粥样硬化研究（MESA）中乐观和悲观与炎症和止血的关系。
Association of optimism and pessimism with inflammation and hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA).
机构信息
Center for Social Epidemiology and Population Health, Ann Arbor, MI 48109-2029, USA.
出版信息
Psychosom Med. 2010 Feb;72(2):134-40. doi: 10.1097/PSY.0b013e3181cb981b. Epub 2010 Jan 25.
OBJECTIVE
To investigate the association between optimism/pessimism and concentrations of seven inflammation and hemostasis markers. Optimism and pessimism are associated with cardiovascular disease mortality and progression; however, the biological mechanism remains unclear.
METHODS
This cross-sectional study used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a study of 6814 persons aged 45 to 84 years with no history of clinical cardiovascular disease. The Life-Orientation Test-Revised (LOT-R) was used to measure dispositional optimism and pessimism. Regression analyses were used to estimate associations of optimism and pessimism with interleukin (IL)-6, C-reactive protein (CRP), fibrinogen, homocysteine, Factor VIII, D-dimer, and plasmin-antiplasmin, before and after adjustment for sociodemographics, depression, cynicism, health behaviors, body mass index (BMI), hypertension, and diabetes.
RESULTS
Higher scores on the LOT-R (positive disposition) were related to lower concentrations of IL-6 (p = .001), fibrinogen (p < .001), and homocysteine (p = .031). Associations were stronger for the pessimism subscale. After adjustment for demographics, the percentage differences in inflammatory markers corresponding to a 2-standard deviation increase in pessimism were 6.01% (p = .001) for IL-6, 10.31% (p = .001) for CRP, 2.47% (p < .0001) for fibrinogen, and 1.36% (p = .07) for homocysteine. Associations were attenuated but significant after adjustment for sociodemographics, depression, cynical distrust, and behaviors. Further adjustment for hypertension, BMI, and diabetes reduced associations for CRP and IL-6. Pessimism remained associated with a 1.36% (p = .02) increase in fibrinogen in the fully adjusted model. Factor VIII, D-dimer, and plasmin-antiplasmin were not associated with the LOT-R or subscales.
CONCLUSIONS
Pessimism is related to higher levels of inflammation. Health behaviors, BMI, hypertension, and diabetes seem to play a mediating role.
目的
探讨乐观/悲观与七种炎症和止血标志物浓度之间的关系。乐观和悲观与心血管疾病死亡率和进展有关；然而，其生物学机制尚不清楚。
方法
本横断面研究使用了来自动脉粥样硬化多民族研究（MESA）的数据，该研究纳入了 6814 名年龄在 45 岁至 84 岁之间、无临床心血管疾病史的人群。采用生活取向测试修订版（LOT-R）测量特质性乐观和悲观。回归分析用于估计乐观和悲观与白细胞介素（IL）-6、C 反应蛋白（CRP）、纤维蛋白原、同型半胱氨酸、VIII 因子、D-二聚体和纤溶酶-抗纤溶酶之间的关联，在调整社会人口统计学、抑郁、犬儒主义、健康行为、体重指数（BMI）、高血压和糖尿病之前和之后进行。
结果
LOT-R 评分较高（正向倾向）与 IL-6（p =.001）、纤维蛋白原（p <.001）和同型半胱氨酸（p =.031）浓度降低有关。悲观倾向亚量表的相关性更强。在调整人口统计学因素后，与悲观情绪 2 个标准差增加相对应的炎症标志物的百分比差异为：IL-6 为 6.01%（p =.001）、CRP 为 10.31%（p =.001）、纤维蛋白原为 2.47%（p <.0001）、同型半胱氨酸为 1.36%（p =.07）。在调整社会人口统计学、抑郁、犬儒不信任和行为因素后，相关性仍然显著但有所减弱。进一步调整高血压、BMI 和糖尿病后，CRP 和 IL-6 的相关性降低。在完全调整模型中，悲观情绪与纤维蛋白原增加 1.36%（p =.02）相关。VIII 因子、D-二聚体和纤溶酶-抗纤溶酶与 LOT-R 或亚量表均无关联。
结论
悲观与更高水平的炎症有关。健康行为、BMI、高血压和糖尿病似乎发挥了中介作用。
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