Yang Yang Claire, Li Ting, Frenk Steven M
a Lineberger Comprehensive Cancer Center , University of North Carolina-Chapel Hill , Chapel Hill , North Carolina , USA.
Biodemography Soc Biol. 2014;60(1):21-37. doi: 10.1080/19485565.2014.899452.
The growing evidence linking social connectedness and chronic diseases such as cancer calls for a better understanding of the underlying biophysiological mechanisms. This study assessed the associations between social network ties and multiple measures of inflammation in a nationally representative sample of adults with a history of cancer (N = 1,075) from the National Health and Nutrition Examination Survey III (1988-94). Individuals with lower social network index (SNI) scores showed significantly greater inflammation marked by C-reactive protein and fibrinogen, adjusting for age and sex. Compared to fully socially integrated individuals (SNI = 4), those who were more socially isolated or had a SNI score of 3 or less exhibited increasingly elevated inflammation burdens. Specifically, the age- and sex-adjusted odds ratios (95%CI) for SNIs of 3, 2, and 0-1 were 1.49 (1.08, 2.06), 1.69 (1.21, 2.36), and 2.35 (1.62, 3.40), respectively (p < .001). Adjusting for other covariates attenuated these associations. The SNI gradients in the risks of inflammation were particularly salient for the lower socioeconomic status groups and remained significant after adjusting for other social, health behavioral, and illness factors. This study provided initial insights into the immunological pathways by which social connections are related to morbidity and mortality outcomes of cancer in particular and aging-related diseases in general.
越来越多的证据表明社会联系与诸如癌症等慢性疾病之间存在关联,这就需要更好地理解其潜在的生物生理机制。本研究在来自第三次全国健康和营养检查调查(1988 - 1994年)的具有癌症病史的全国代表性成年样本(N = 1,075)中,评估了社会网络关系与多种炎症指标之间的关联。社会网络指数(SNI)得分较低的个体,在调整年龄和性别后,以C反应蛋白和纤维蛋白原标记的炎症反应显著更强。与社会完全融入的个体(SNI = 4)相比,那些社会隔离程度更高或SNI得分在3分及以下的个体,炎症负担日益加重。具体而言,SNI为3、2以及0 - 1时,经年龄和性别调整后的优势比(95%置信区间)分别为1.49(1.08,2.06)、1.69(1.21,2.36)和2.35(1.62,3.40)(p <.001)。调整其他协变量后,这些关联有所减弱。炎症风险方面的SNI梯度在社会经济地位较低的群体中尤为显著,在调整其他社会、健康行为和疾病因素后仍具有统计学意义。本研究为社会联系通过何种免疫途径与癌症尤其是与衰老相关疾病的发病和死亡结局相关提供了初步见解。