Ghulam Anwal, Bonaccio Marialaura, Costanzo Simona, Bracone Francesca, Gianfagna Francesco, de Gaetano Giovanni, Iacoviello Licia
Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
Department of Epidemiology and Prevention, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) NEUROMED, Pozzilli, Italy.
Front Psychol. 2022 Feb 24;13:817298. doi: 10.3389/fpsyg.2022.817298. eCollection 2022.
Positive psychosocial factors can play an important role in the development of cardiovascular disease (CVD). Among them, psychological resilience (PR) is defined as the capacity of responding positively to stressful events. Our aim was to assess whether PR is associated with CVD or metabolic disturbances through a systematic review.
We gathered articles from PubMed, Web of Science, PsycInfo, and Google Scholar up to October 28, 2021. We included articles that were in English, were observational, and had PR examined as exposure. The CVD outcomes were either clinical or metabolic outcomes (i.e., dyslipidemia, obesity, metabolic syndrome, hypertension, and diabetes).
Our literature search identified 3,800 studies, of which 17 met the inclusion criteria. Of them, seven were longitudinal and 10 cross-sectional, and 13 were on adults and four on children. The exposure assessment was heterogeneous, i.e., 12 studies used different kinds of self-administered questionnaires and five used interviews with a psychologist. Regarding outcomes, five studies investigated CVD, seven obesity, one metabolic syndrome, two hypertension, four dyslipidemia, and four diabetes. In longitudinal studies, PR was found to have an inverse association with included outcomes in five studies from the Swedish military conscription cohort but had no association with CVD in a study on African-American women and was associated with slower progression of diabetes in a general population. The cross-sectional studies showed that the prevalence of disease was not associated with PR in many cases but the progression of disease was associated with PR.
PR seems to have a possibly favorable association with CVD and metabolic disturbances that differs according to the type of outcome and population. Our study limitations are given by the small number of studies available and the heterogeneity in PR measurement.
[https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=237109], identifier [CRD42021237109].
积极的社会心理因素在心血管疾病（CVD）的发生发展中可能起重要作用。其中，心理韧性（PR）被定义为对压力事件做出积极反应的能力。我们的目的是通过系统评价来评估PR是否与CVD或代谢紊乱有关。
我们从PubMed、科学网、PsycInfo和谷歌学术搜索截至2021年10月28日的文章。我们纳入了英文的观察性文章，且将PR作为暴露因素进行研究。CVD结局包括临床结局或代谢结局（即血脂异常、肥胖、代谢综合征、高血压和糖尿病）。
我们的文献检索共识别出3800项研究，其中17项符合纳入标准。其中，7项为纵向研究，10项为横断面研究，13项针对成年人，4项针对儿童。暴露评估方法各异，即12项研究使用了不同类型的自填问卷，5项研究采用了与心理学家的访谈。关于结局，5项研究调查了CVD，7项研究调查了肥胖，1项研究调查了代谢综合征，2项研究调查了高血压，4项研究调查了血脂异常，4项研究调查了糖尿病。在纵向研究中，在瑞典征兵队列的5项研究中发现PR与纳入的结局呈负相关，但在一项针对非裔美国女性的研究中PR与CVD无关联，而在普通人群中PR与糖尿病进展较慢有关。横断面研究表明许多情况下疾病患病率与PR无关，但疾病进展与PR有关。
PR似乎与CVD和代谢紊乱可能存在有益关联，且这种关联因结局类型和人群而异。我们研究的局限性在于可用研究数量较少以及PR测量方法的异质性。
[https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=237109]，标识符[CRD42021237109]
