Hernandez Rosalba, Lash James P, Burrows Brett, Wilund Kenneth R, Mattix-Kramer Holly J, Peralta Carmen, Durazo-Arvizu Ramon A, Talavera Gregory A, Penedo Frank J, Khambaty Tasneem, Moncrieft Ashley E, Chen Jinsong, Daviglus Martha L
School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America.
Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America.
Prev Med Rep. 2019 Jun 7;15:100916. doi: 10.1016/j.pmedr.2019.100916. eCollection 2019 Sep.
The beneficial influence of positive affect (e.g., joy) remains unexplored in relation to heart health in adults with chronic kidney disease (CKD)-a population at increased risk for poor cardiovascular health (CVH). Therefore, we evaluated the association of positive affect and CVH in a diverse U.S. population of Hispanics/Latinos with CKD. We analyzed cross-sectional data of adults ages 18-74 enrolled between 2008 and 2011 in the Hispanic Community Health Study/Study of Latinos with prevalent CKD (N = 1712). Positively worded items from the Center for Epidemiologic Studies Depression Scale were used to create a composite positive affect score (0-6; higher scores indicate greater positive affect). Prevalent CKD was defined as estimated glomerular filtration <60 ml/min/1.73 m or urine albumin-to-creatinine ratio ≥30 mg/g. A composite CVH score was calculated using diet, body mass index, physical activity, cholesterol, blood pressure, fasting glucose, and smoking status. Each metric was defined as ideal, intermediate, or poor to compute an additive score. Linear regression was used for continuous scores of CVH and logistic regression for binary treatment (e.g., ≥4 Ideal). In participants with CKD, each unit increase in the positive affect score was associated with higher CVH scores when modeling CVH as a continuous outcome (β = 0.06, 95% CI = 0.01, 0.11). Similarly, a 1-unit increase in positive affect was associated with 1.15 times the odds of having >4 (vs. <4) ideal CVH indicators. Positive affect is associated with favorable CVH profiles in Hispanics/Latinos with CKD. Replication and prospective studies are needed to elucidate whether emotional well-being is a potential therapeutic target for intervention.
积极情绪（如愉悦）对慢性肾脏病（CKD）成年患者心脏健康的有益影响尚未得到探索，而这一人群心血管健康状况不佳的风险较高。因此，我们在美国不同的患有CKD的西班牙裔/拉丁裔人群中评估了积极情绪与心血管健康（CVH）之间的关联。我们分析了2008年至2011年期间纳入西班牙裔社区健康研究/拉丁裔研究且患有CKD的18至74岁成年人的横断面数据（N = 1712）。使用流行病学研究中心抑郁量表中措辞积极的项目来创建一个综合积极情绪得分（0 - 6分；得分越高表明积极情绪越强）。将患有CKD定义为估算肾小球滤过率<60 ml/min/1.73 m²或尿白蛋白与肌酐比值≥30 mg/g。使用饮食、体重指数、身体活动、胆固醇、血压、空腹血糖和吸烟状况计算综合CVH得分。每个指标被定义为理想、中等或不佳，以计算累加得分。对CVH的连续得分使用线性回归，对二元治疗（如≥4个理想指标）使用逻辑回归。在患有CKD的参与者中，将CVH作为连续结果进行建模时，积极情绪得分每增加一个单位，与更高的CVH得分相关（β = 0.06，95%置信区间 = 0.01，0.11）。同样，积极情绪增加1个单位与具有>4个（对比<4个）理想CVH指标的几率增加1.15倍相关。积极情绪与患有CKD的西班牙裔/拉丁裔人群良好的CVH状况相关。需要进行重复研究和前瞻性研究以阐明情绪健康是否是一个潜在的干预治疗靶点。
