Shimanoe Chisato, Otsuka Yasuko, Hara Megumi, Nanri Hinako, Nishida Yuichiro, Nakamura Kazuyo, Higaki Yasuki, Imaizumi Takeshi, Taguchi Naoto, Sakamoto Tatsuhiko, Horita Mikako, Shinchi Koichi, Tanaka Keitaro
Department of Preventive Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan,
Int J Behav Med. 2014;21(5):821-32. doi: 10.1007/s12529-013-9341-y.
Perceived stress and coping strategies may influence the risk of cardiovascular disease through their possible association with inflammation, but data remain controversial for perceived stress or scanty for coping strategies.
We examined the associations of perceived stress and coping strategies with serum high-sensitivity C-reactive protein (CRP) in a Japanese general population.
This cross-sectional study included 2,971 men and 4,902 women aged 40-69 years who were enrolled between 2005 and 2007. Subjects with possible inflammation-related disease, CRP levels ≥3,000 ng/mL, or currently used analgesics or lipid-lowering drugs were excluded. Analyses were performed by gender with adjustment for lifestyle, socioeconomic, and psychosocial factors.
Unexpectedly, elevated perceived stress was significantly associated with lower CRP levels in men (P trend < 0.001) but not in women (P trend = 0.90) after adjustment for age and covariates. Among five items of coping strategies evaluated, "disengagement" showed a significant inverse association with CRP in men only (P trend = 0.027). In addition, a possible interaction between "emotional support seeking" and perceived stress on CRP was detected in men (P interaction = 0.021); "emotional support seeking" was associated with lower CRP at the high stress level only (P trend = 0.028).
Both perceived stress and coping strategies may be associated with systemic inflammation in Japanese men, yet caution must be exercised before accepting the stress-inflammation-disease pathway.
感知到的压力和应对策略可能通过与炎症的潜在关联影响心血管疾病风险，但关于感知到的压力的数据仍存在争议，而应对策略的数据则较为匮乏。
我们在日本普通人群中研究了感知到的压力和应对策略与血清高敏C反应蛋白（CRP）之间的关联。
这项横断面研究纳入了2005年至2007年期间招募的2971名40 - 69岁男性和4902名女性。排除患有可能与炎症相关疾病、CRP水平≥3000 ng/mL或目前正在使用镇痛药或降脂药物的受试者。按性别进行分析，并对生活方式、社会经济和心理社会因素进行调整。
出乎意料的是，在调整年龄和协变量后，感知到的压力升高在男性中与较低的CRP水平显著相关（P趋势<0.001），而在女性中则无此关联（P趋势 = 0.90）。在评估的五项应对策略中，“脱离接触”仅在男性中与CRP呈显著负相关（P趋势 = 0.027）。此外，在男性中检测到“寻求情感支持”与感知到的压力对CRP可能存在相互作用（P相互作用 = 0.021）；“寻求情感支持”仅在高压力水平下与较低的CRP相关（P趋势 = 0.028）。
在日本男性中，感知到的压力和应对策略可能都与全身炎症有关，但在接受压力 - 炎症 - 疾病途径之前必须谨慎。
