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在日本 COVID-19 大流行期间,社会隔离和孤独与慢性系统性炎症之间的相互作用:U-CORONA 研究的结果。

Interplay between social isolation and loneliness and chronic systemic inflammation during the COVID-19 pandemic in Japan: Results from U-CORONA study.

机构信息

Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.

Department of Medical Education Research and Development, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.

出版信息

Brain Behav Immun. 2021 May;94:51-59. doi: 10.1016/j.bbi.2021.03.007. Epub 2021 Mar 9.

Abstract

In the face of the global coronavirus disease 2019 (COVID-19) pandemic, billions of people were forced to stay at home due to the implementation of social distancing and lockdown policies. As a result, individuals lost their social relationships, leading to social isolation and loneliness. Both social isolation and loneliness are major risk factors for poor physical and mental health status through enhanced chronic inflammation; however, there might be an interplay between social isolation and loneliness on the association with chronic inflammation. We aimed to clarify the link between social relationships and inflammation in the context of the COVID-19 pandemic by distinguishing whether social isolation only, loneliness only, or both were associated with chronic inflammation markers among community-dwelling adults. The data of 624 people (aged 18-92 years, mean 51.4) from the Utsunomiya COVID-19 seROprevalence Neighborhood Association (U-CORONA) study, which targeted randomly sampled households in Utsunomiya city, Japan, were analyzed. Social isolation was assessed as a structural social network by asking the number of social roles they have on a daily basis. Loneliness was measured with the UCLA loneliness scale. As chronic inflammation biomarkers, neutrophil-to-lymphocyte ratio (NLR) and the concentration of high-sensitivity C-reactive protein (CRP) were measured. Generalized estimating equations method was employed to take into account the correlations within households. Isolated-Lonely condition (i.e., being both socially isolated and feeling lonely) was associated with higher NLR among men (B = 0.141, 95%CI = -0.01 to 0.29). Interestingly, Nonisolated-Lonely condition (i.e., not socially isolated but feeling lonely) was associated with lower CRP among women (B = -0.462, 95%CI = -0.82 to -0.10) and among the working-age population (B = -0.495, 95%CI = -0.76 to -0.23). In conclusion, being both socially isolated and feeling lonely was associated with chronic inflammation. Assessing both social isolation and loneliness is critical for proper interventions to mitigate the impact of poor social relationships on health, especially in the context of the COVID-19 pandemic.

摘要

在全球 2019 年冠状病毒病(COVID-19)大流行面前,由于实施了社交距离和封锁政策,数亿人被迫呆在家里。因此,个人失去了社交关系,导致社会孤立和孤独。社会隔离和孤独都是通过增强慢性炎症导致身心健康状况不佳的主要风险因素;然而,社会隔离和孤独之间可能存在相互作用,影响与慢性炎症的关联。我们旨在通过区分社会孤立、孤独或两者是否与社区居住成年人的慢性炎症标志物相关,在 COVID-19 大流行背景下阐明社会关系与炎症之间的联系。这项研究的数据来自日本宇都宫市 COVID-19 血清流行率邻里协会(U-CORONA)研究的 624 人(年龄 18-92 岁,平均 51.4 岁),该研究针对日本宇都宫市的随机抽样家庭。社会隔离通过询问他们每天拥有的社会角色数量来评估其结构性社会网络。孤独感用洛杉矶孤独量表来衡量。作为慢性炎症生物标志物,中性粒细胞与淋巴细胞比值(NLR)和高敏 C 反应蛋白(CRP)的浓度进行了测量。广义估计方程方法被用来考虑家庭内的相关性。孤立-孤独状态(即,既社会孤立又感到孤独)与男性的 NLR 升高相关(B=0.141,95%CI=0.01-0.29)。有趣的是,非孤立-孤独状态(即,不孤立但感到孤独)与女性(B=-0.462,95%CI=-0.82 至-0.10)和劳动年龄人口(B=-0.495,95%CI=-0.76 至-0.23)的 CRP 降低相关。总之,既社会孤立又感到孤独与慢性炎症相关。评估社会隔离和孤独感对于适当的干预措施至关重要,以减轻不良社会关系对健康的影响,特别是在 COVID-19 大流行背景下。

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