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A型人格对糖尿病患者血浆C反应蛋白水平的潜在影响。

Potential influence of Type A personality on plasma C-reactive protein levels in people with diabetes.

作者信息

Chauvet-Gélinier J-C, Trojak B, Lemogne C, Aho-Glélé L-S, Brindisi M-C, Bouillet B, Ponavoy E, Meille V, Simoneau I, Chahraoui K, Vaillant G, Petit J-M, Consoli S M, Bonin B, Vergès B

机构信息

Psychiatry unit, department of neurosciences, Marion building, university hospital CHU Le Bocage, 14, rue Gaffarel, 21000 Dijon, France; Laboratory of psychopathology and medical psychology (IFR 100), university of Burgundy, 21000 Dijon, France.

Faculté de médecine, université Paris-Descartes, Sorbonne Paris-Cité, 75015 Paris, France; Service de psychiatrie de l'adulte et du sujet âgé, hôpitaux universitaires Paris-Ouest, AP-HP, 20, rue Leblanc, 75015 Paris, France; Inserm, U894 centre for psychiatry and neuroscience, 75014 Paris, France.

出版信息

Diabetes Metab. 2016 Apr;42(2):88-95. doi: 10.1016/j.diabet.2015.08.001. Epub 2015 Sep 15.

Abstract

AIM

Type A personality, although classically known as a factor linked to increased vascular risk, has recently been associated with increased survival in patients with diabetes. As low-grade inflammation predicts a poor outcome, the present study explored the potential associations between Type A and plasma levels of C-reactive protein (CRP) in diabetes.

METHODS

Type A personality was assessed by the Bortner questionnaire in people with diabetes. The association between Type A and plasma CRP levels was examined by multivariable linear regression, and structural equation modelling (SEM) was performed to determine the impact of the major clinical, biological and psychological confounders.

RESULTS

The study included 626 participants with type 1 and type 2 diabetes from the Diabetes and Psychological Profile study. Multivariable analyses showed an independent inverse association between Type A score and CRP levels. The structural model adjusted for age, gender, diabetes type and duration, body mass index (BMI), smoking status, alcohol abuse, oral antidiabetic and statin treatments, HbA1c levels, lipids, perceived stress, anxiety and depression revealed significant associations between CRP and Type A (β=-0.135, 95% CI: -0.242, -0.028; P=0.014), BMI (β=0.194, 95% CI: 0.038, 0.350; P=0.015) and HDL cholesterol (β=-0.132, 95% CI: -0.245, -0.020; P=0.014).

CONCLUSION

Our present study data indicate that Type A personality is independently associated with lower CRP levels. This lower level of inflammation might explain the better clinical outcomes associated with Type A personality in patients with diabetes.

摘要

目的

A型人格虽然传统上被认为是与血管风险增加相关的一个因素,但最近发现它与糖尿病患者生存率的提高有关。由于低度炎症预示着不良预后,本研究探讨了糖尿病患者中A型人格与血浆C反应蛋白(CRP)水平之间的潜在关联。

方法

通过博特纳问卷对糖尿病患者的A型人格进行评估。采用多变量线性回归分析A型人格与血浆CRP水平之间的关联,并进行结构方程模型(SEM)分析以确定主要临床、生物学和心理混杂因素的影响。

结果

该研究纳入了来自糖尿病与心理特征研究的626名1型和2型糖尿病患者。多变量分析显示,A型得分与CRP水平之间存在独立的负相关。调整年龄、性别、糖尿病类型和病程、体重指数(BMI)、吸烟状况、酒精滥用、口服降糖药和他汀类药物治疗、糖化血红蛋白(HbA1c)水平、血脂、感知压力、焦虑和抑郁后的结构模型显示,CRP与A型人格(β=-0.135,95%可信区间:-0.242,-0.028;P=0.014)、BMI(β=0.194,95%可信区间:0.038,0.350;P=0.015)和高密度脂蛋白胆固醇(β=-0.132,95%可信区间:-0.245,-0.020;P=0.014)之间存在显著关联。

结论

我们目前的研究数据表明,A型人格与较低的CRP水平独立相关。这种较低的炎症水平可能解释了糖尿病患者中与A型人格相关的更好临床结局。

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