von Känel Roland, Mausbach Brent T, Dimsdale Joel E, Mills Paul J, Patterson Thomas L, Ancoli-Israel Sonia, Ziegler Michael G, Roepke Susan K, Allison Matthew, Grant Igor
Division of Psychosomatic Medicine, Department of General Internal Medicine, Bern University Hospital and University of Bern, 3010 Bern, Switzerland.
Cardiovasc Psychiatry Neurol. 2012;2012:875876. doi: 10.1155/2012/875876. Epub 2012 Jul 17.
Objective. To investigate the relationship between coping and atherothrombotic biomarkers of an increased cardiovascular disease (CVD) risk in the elderly. Methods. We studied 136 elderly caregiving and noncaregiving men and women who completed the Ways of Coping Checklist to assess problem-focused coping, seeking social support (SSS), blamed self, wishful thinking, and avoidance coping. They had circulating levels of 12 biomarkers measured. We also probed for potential mediator and moderator variables (chronic stress, affect, health behavior, autonomic activity) for the relation between coping and biomarkers. Results. After controlling for demographic and CVD risk factors, greater use of SSS was associated with elevated levels of serum amyloid A (P = 0.001), C-reactive protein (CRP) (P = 0.002), vascular cellular adhesion molecule (VCAM)-1 (P = 0.021), and D-dimer (P = 0.032). There were several moderator effects. For instance, greater use of SSS was associated with elevated VCAM-1 (P < 0.001) and CRP (P = 0.001) levels in subjects with low levels of perceived social support and positive affect, respectively. The other coping styles were not significantly associated with any biomarker. Conclusions. Greater use of SSS might compromise cardiovascular health through atherothrombotic mechanisms, including elevated inflammation (i.e., serum amyloid A, CRP, VCAM-1) and coagulation (i.e., D-dimer) activity. Moderating variables need to be considered in this relationship.
目的。探讨应对方式与老年人心血管疾病（CVD）风险增加的动脉粥样硬化血栓形成生物标志物之间的关系。方法。我们研究了136名老年护理者和非护理者男性及女性，他们完成了应对方式清单以评估问题聚焦应对、寻求社会支持（SSS）、自责、如意算盘和回避应对。测量了他们12种生物标志物的循环水平。我们还探究了应对方式与生物标志物之间关系的潜在中介变量和调节变量（慢性应激、情感、健康行为、自主神经活动）。结果。在控制了人口统计学和CVD风险因素后，更多地使用SSS与血清淀粉样蛋白A水平升高（P = 0.001）、C反应蛋白（CRP）（P = 0.002）、血管细胞黏附分子（VCAM）-1（P = 0.021）和D-二聚体（P = 0.032）相关。存在几种调节作用。例如，在感知社会支持水平低和积极情感水平低的受试者中，更多地使用SSS分别与VCAM-1水平升高（P < 0.001）和CRP水平升高（P = 0.001）相关。其他应对方式与任何生物标志物均无显著关联。结论。更多地使用SSS可能通过动脉粥样硬化血栓形成机制损害心血管健康，包括炎症（即血清淀粉样蛋白A、CRP、VCAM-1）和凝血（即D-二聚体）活性升高。在这种关系中需要考虑调节变量。
