Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
Department of Psychology, Chapman University, One University Drive, Orange, CA 92866, USA.
Soc Sci Med. 2018 Jul;209:59-66. doi: 10.1016/j.socscimed.2018.05.025. Epub 2018 May 14.
Psychological well-being is associated with better cardiovascular health, but the underlying mechanisms are unclear.
This study investigates one possible mechanism by examining psychological well-being's prospective association with lipid levels, focusing on high-density lipoprotein cholesterol (HDL-C).
Participants were 4757 healthy men and women ages ≥50 from the English Longitudinal Study of Ageing with clinical data from three times, three to five years apart. Psychological well-being was assessed at baseline using the Control, Autonomy, Satisfaction, and Pleasure scale; HDL-C, triglycerides, and total cholesterol were assayed from blood samples. Descriptive statistics and linear mixed models were used to examine associations between psychological well-being and lipid levels over time; the latter controlled for confounders and health behaviours.
In descriptive analyses, HDL-C levels were initially higher in people with greater psychological well-being. Among those who met recommended levels of HDL-C at baseline, fewer individuals with higher versus lower psychological well-being dropped below HDL-C recommendations over time. Mixed models indicated that HDL-C increased over time (β = 0.64; 95% CI = 0.58 to 0.69) and higher baseline psychological well-being was associated with higher baseline HDL-C (β = 0.51; 95% CI = 0.03 to 0.99). A significant well-being by time interaction indicated individuals with higher versus lower well-being exhibited a more rapid rate of increase in HDL-C over follow-up. Higher psychological well-being was also significantly associated with lower triglycerides, but main effects for both HDL-C and triglycerides were attenuated after accounting for health behaviours.
Higher psychological well-being is associated with healthier HDL-C levels; these effects may compound over time. This protective effect may be partly explained by health behaviours.
心理健康与心血管健康状况的改善有关，但潜在机制尚不清楚。
本研究通过考察心理健康与血脂水平（重点是高密度脂蛋白胆固醇，HDL-C）的前瞻性关联，探讨一种可能的机制。
参与者为年龄≥50 岁的 4757 名健康男性和女性，他们来自英国老龄化纵向研究，有三次相隔三到五年的临床数据。基线时使用控制、自主、满足和愉悦量表评估心理健康状况；通过血液样本测定 HDL-C、甘油三酯和总胆固醇。使用描述性统计和线性混合模型来考察随着时间的推移，心理健康状况与血脂水平之间的关联；后者控制了混杂因素和健康行为。
在描述性分析中，HDL-C 水平在心理健康状况较好的人群中最初较高。在基线时符合 HDL-C 推荐水平的人群中，与心理健康状况较低的人群相比，心理健康状况较高的人群中较少有人在随访期间的 HDL-C 推荐值以下。混合模型表明，HDL-C 随时间增加（β=0.64；95%置信区间 0.58 至 0.69），基线心理健康状况较高与基线时 HDL-C 较高相关（β=0.51；95%置信区间 0.03 至 0.99）。较高的心理健康状况与时间的交互作用显著，表明与心理健康状况较低的人群相比，较高的心理健康状况人群的 HDL-C 随随访的增加呈更快的增长速度。较高的心理健康状况也与较低的甘油三酯显著相关，但在考虑健康行为后，HDL-C 和甘油三酯的主要效应均减弱。
较高的心理健康状况与更健康的 HDL-C 水平相关；这些影响可能随着时间的推移而累积。这种保护作用可能部分归因于健康行为。
