心理弹性可预测美国中年研究中成年人的心脏代谢状况。

Psychological resilience predicting cardiometabolic conditions in adulthood in the Midlife in the United States Study.

机构信息

Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121;

Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA 94143.

出版信息

Proc Natl Acad Sci U S A. 2021 Aug 10;118(32). doi: 10.1073/pnas.2102619118.

DOI:10.1073/pnas.2102619118

PMID:34341103

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8364125/

Abstract

Early adversity is associated with poor cardiometabolic health, potentially via psychological distress. However, not everyone exposed to adversity develops significant distress. Psychological resilience and positive psychological health despite adversity may protect against unfavorable cardiometabolic outcomes that are otherwise more likely. We examined early adversity, psychological resilience, and cardiometabolic risk among 3,254 adults in the Midlife in the United States Study. Psychological resilience was defined according to both early psychosocial adversity and adult psychological health (characterized by low distress and high wellbeing) at Wave 1 (1994 to 1995). Categorical resilience was derived by cross-classifying adversity (exposed versus unexposed) and psychological health (higher versus lower). We also assessed count of adversities experienced and psychological symptoms as separate variables. Incident cardiometabolic conditions (e.g., heart attack, stroke, and diabetes) were self-reported at Waves 2 (2004 to 2005) and 3 (2013 to 2014). Secondary analyses examined biological cardiometabolic risk using a composite of biomarkers available within a Wave-2 subsample. Logistic and Poisson regressions evaluated associations of resilience with cardiometabolic health across 20 follow-up y, adjusting for relevant covariates. In this initially healthy sample, nonresilient (adversity-exposed, lower psychological health) versus resilient (adversity-exposed, high psychological health) individuals had 43% higher odds of cardiometabolic conditions (95% CI 1.10 to 1.85). Odds of cardiometabolic conditions were similar among resilient versus unexposed, psychologically healthy individuals. More adversity experiences were associated with increased odds, while better psychological health with decreased odds of cardiometabolic conditions, and effects were largely independent. Patterns were similar for objectively assessed cardiometabolic risk. Psychological resilience in midlife may protect against negative cardiometabolic impacts of early adversity.

摘要

早期逆境与较差的心血代谢健康有关，可能是通过心理困扰。然而，并非每个经历逆境的人都会产生明显的困扰。尽管逆境存在，但心理弹性和积极的心理健康可能会防止不利的心脑血管代谢结果，否则这些结果更有可能发生。我们在美国中年生活研究中检查了 3254 名成年人的早期逆境、心理弹性和心血管代谢风险。根据早期心理社会逆境和成人心理健康（表现为低压力和高幸福感），在第 1 波（1994 年至 1995 年）定义心理弹性。通过交叉分类逆境（暴露与未暴露）和心理健康（较高与较低）得出分类弹性。我们还评估了经历的逆境数量和心理症状作为单独的变量。心血管代谢疾病的发生情况（如心脏病发作、中风和糖尿病）在第 2 波（2004 年至 2005 年）和第 3 波（2013 年至 2014 年）时自我报告。二次分析使用第 2 波子样本中可用的生物标志物组合评估生物心血管代谢风险。逻辑和泊松回归调整相关协变量后，评估了 20 年随访期间弹性与心血管代谢健康之间的关联。在这个最初健康的样本中，非弹性（逆境暴露，心理健康水平较低）与弹性（逆境暴露，心理健康水平较高）个体发生心血管代谢疾病的几率高出 43%（95%CI1.10 至 1.85）。弹性与未暴露、心理健康良好的个体之间发生心血管代谢疾病的几率相似。更多的逆境经历与更高的几率相关，而更好的心理健康与更低的心血管代谢疾病几率相关，且这些影响在很大程度上是独立的。对于客观评估的心血管代谢风险，模式是相似的。中年时期的心理弹性可能会保护早期逆境对负面心血管代谢影响。