Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
J Psychosom Res. 2020 Dec;139:110267. doi: 10.1016/j.jpsychores.2020.110267. Epub 2020 Oct 6.
Investigate the association of dispositional optimism with chronic kidney disease (CKD) and rapid kidney function decline (RKFD) and determine if there is modification by age, sex, and educational attainment among African Americans.
Optimism was measured using the 6-item Life Orientation Test-Revised scale (categorized into tertiles and log transformed) among participants from the Jackson Heart Study (n = 1960). CKD was defined as the presence of albuminuria or reduced glomerular filtration rate of <60 mL/min/1.73m, or report of dialysis at baseline examination (2000-2004). RKFD was defined as a decline >3 mL/min/1.73m/year between baseline and exam 3 (2009-2013). The cross-sectional and prospective associations between optimism and kidney outcomes were tested using multivariable logistic regression to obtain odds ratios (OR) and 95% confidence intervals (CI), adjusting for demographics, education, risk factors, behaviors, and depressive symptoms. We tested effect modification by age, sex, and education.
569 participants had CKD and 326 were classified as having RKFD by exam 3. After full adjustment, the OR for CKD was 0.73 for those who reported high (vs. low) optimism (95% CI 0.55-0.99) and 0.56 (95% CI 0.27-1.15) for the optimism score. After 7.21 median years of follow up, the OR for RKFD was 0.51 for those who reported high (vs. low) optimism (95% CI 0.34-0.76), and 0.26 (95% CI 0.10-0.56) for the optimism score, after full adjustment. There was no evidence of effect modification by demographics or educational attainment.
Higher optimism was associated with a lower odds of CKD and a lower odds of RKFD.
调查特质乐观与慢性肾脏病（CKD）和肾功能快速下降（RKFD）的相关性，并确定在非裔美国人中，年龄、性别和教育程度是否会对此产生影响。
在 Jackson Heart 研究（n=1960）中，使用 6 项生活取向测试修订版（分为三分位数并进行对数转换）来衡量乐观程度。CKD 的定义为白蛋白尿或肾小球滤过率<60 mL/min/1.73m 存在，或基线检查时报告透析（2000-2004 年）。RKFD 的定义为基线至第 3 次检查（2009-2013 年）期间每年下降>3 mL/min/1.73m。使用多变量逻辑回归测试乐观与肾脏结局之间的横断面和前瞻性关联，以获得优势比（OR）和 95%置信区间（CI），调整人口统计学、教育、危险因素、行为和抑郁症状。我们测试了年龄、性别和教育的效应修饰作用。
569 名参与者患有 CKD，326 名参与者在第 3 次检查时被归类为 RKFD。经过充分调整，与报告低乐观（vs. 低）的参与者相比，报告高乐观的参与者发生 CKD 的 OR 为 0.73（95%CI 0.55-0.99），而乐观评分的 OR 为 0.56（95%CI 0.27-1.15）。在中位随访 7.21 年后，与报告低乐观（vs. 低）的参与者相比，报告高乐观的参与者发生 RKFD 的 OR 为 0.51（95%CI 0.34-0.76），而乐观评分的 OR 为 0.26（95%CI 0.10-0.56），经过充分调整。在人口统计学或教育程度方面没有证据表明存在效应修饰作用。
更高的乐观程度与较低的 CKD 发生几率和较低的 RKFD 发生几率相关。
