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International Journal of Behavioral Medicine

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Open Access 01-10-2016

Psychological Resources Are Independently Associated with Markers of Inflammation in a Middle-Aged Community Sample

Authors: Ina Marteinsdottir, Jan Ernerudh, Lena Jonasson, Margareta Kristenson, Peter Garvin

Published in: International Journal of Behavioral Medicine | Issue 5/2016

Abstract

Purpose

To elucidate possible independent associations of psychological resources with inflammatory markers, all linked with coronary heart disease (CHD).

Method

In a middle-aged general population (n = 944), psychological resources (coping, self-esteem, and sense of coherence (SOC)), a global measure of quality of life (Cantril’s self-anchoring ladder, also called “ladder of life”), and psychological risk factors (hopelessness, vital exhaustion, and depressive symptoms) were used in linear regression models to evaluate associations with the inflammatory markers interleukin (IL)-6, C-reactive protein (CRP), and matrix metalloproteinase (MMP)-9. Adjustments were done for age, sex, medical conditions, and cardiovascular risk factors.

Results

After full adjustments, self-esteem was independently associated with all three biomarkers. Ladder of life was associated with IL-6 and log-CRP; coping, vital exhaustion, and depressive symptoms with IL-6; and SOC with MMP-9 (p < 0.05 for all associations).

Conclusion

Numerous significant associations of psychological resources and risk factors with IL-6, CRP, and MMP-9 were found in a community-based sample. The associations of psychological resources were mostly independent, while the psychological risk factors seemed preferentially dependent on lifestyle factors as smoking, physical activity, and body mass index (BMI). This suggests that the psychological resources’ (in particular self-esteem) protective effects on CHD are linked to inflammatory markers.

Cohen S, Janicki-Deverts D, Miller GE. Psychological stress and disease. Jama. 2007;298:1685–7.CrossRefPubMed

Albus C. Psychological and social factors in coronary heart disease. Ann Med. 2010;42:487–94. doi:10.3109/07853890.2010.515605.CrossRefPubMed

Sher Y, Lolak S, Maldonado JR. The impact of depression in heart disease. Curr Psychiatry Rep. 2010;12:255–64. doi:10.1007/s11920-010-0116-8.CrossRefPubMed

Hemingway H, Marmot M. Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. BMJ. 1999;318:1460–7.CrossRefPubMedPubMedCentral

Rosengren A, Hawken S, Ounpuu S, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case–control study. Lancet. 2004;364:953–62.CrossRefPubMed

Appels A, Mulder P. Excess fatigue as a precursor of myocardial infarction. Eur Heart J. 1988;9:758–64.CrossRefPubMed

Everson SA, Goldberg DE, Kaplan GA, et al. Hopelessness and risk of mortality and incidence of myocardial infarction and cancer. Psychosom Med. 1996;58:113–21.CrossRefPubMed

Surtees PG, Wainwright NW, Luben R, Khaw KT, Day NE. Mastery, sense of coherence, and mortality: evidence of independent associations from the EPIC-Norfolk prospective cohort study. Health Psychol. 2006;25:102–10.CrossRefPubMed

Giltay EJ, Kamphuis MH, Kalmijn S, Zitman FG, Kromhout D. Dispositional optimism and the risk of cardiovascular death: the Zutphen elderly study. Arch Intern Med. 2006;166:431–6. doi:10.1001/.431.PubMed

10.

Kubzansky LD, Thurston RC. Emotional vitality and incident coronary heart disease: benefits of healthy psychological functioning. Arch Gen Psychiatry. 2007;64:1393–401. doi:10.1001/archpsyc.64.12.1393.CrossRefPubMed

11.

Shirai K, Iso H, Ohira T, et al. Perceived level of life enjoyment and risks of cardiovascular disease incidence and mortality: the Japan public health center-based study. Circulation. 2009;120:956–63. doi:10.1161/CIRCULATIONAHA.108.834176.CrossRefPubMed

12.

Lundgren O, Garvin P, Jonasson L, Andersson G, Kristenson M. Psychological resources are associated with reduced incidence of coronary heart disease. An 8-year follow-up of a community-based Swedish sample. Int J Behav Med. 2014. doi:10.1007/s12529-014-9387-5.PubMedCentral

13.

Ridker PM. Inflammation, C-reactive protein, and cardiovascular disease: moving past the marker versus mediator debate. Circ Res. 2014;114:594–5. doi:10.1161/CIRCRESAHA.114.303215.CrossRefPubMed

14.

Ridker PM. C-reactive protein and the prediction of cardiovascular events among those at intermediate risk: moving an inflammatory hypothesis toward consensus. J Am Coll Cardiol. 2007;49:2129–38. doi:10.1016/j.jacc.2007.02.052.CrossRefPubMed

15.

Libby P, Ridker PM, Hansson GK. Inflammation in atherosclerosis: from pathophysiology to practice. J Am Coll Cardiol. 2009;54:2129–38. doi:10.1016/j.jacc.2009.09.009.CrossRefPubMedPubMedCentral

16.

Lett HS, Blumenthal JA, Babyak MA, et al. Depression as a risk factor for coronary artery disease: evidence, mechanisms, and treatment. Psychosom Med. 2004;66:305–15.PubMed

17.

Steptoe A, Dockray S, Wardle J. Positive affect and psychobiological processes relevant to health. J Pers. 2009;77:1747–76. doi:10.1111/j.1467-6494.2009.00599.x.CrossRefPubMedPubMedCentral

18.

Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med. 2009;71:171–86. doi:10.1097/PSY.0b013e3181907c1b.CrossRefPubMed

19.

Wium-Andersen MK, Orsted DD, Nielsen SF, Nordestgaard BG. Elevated C-reactive protein levels, psychological distress, and depression in 73, 131 individuals. JAMA Psychiatry. 2013;70:176–84. doi:10.1001/2013.jamapsychiatry.102.CrossRefPubMed

20.

Gidron Y, Gilutz H, Berger R, Huleihel M. Molecular and cellular interface between behavior and acute coronary syndromes. Cardiovasc Res. 2002;56:15–21.CrossRefPubMed

21.

Sjogren E, Leanderson P, Kristenson M, Ernerudh J. Interleukin-6 levels in relation to psychosocial factors: studies on serum, saliva, and in vitro production by blood mononuclear cells. Brain Behav Immun. 2005.

22.

Nabi H, Singh-Manoux A, Shipley M, Gimeno D, Marmot MG, Kivimaki M. Do psychological factors affect inflammation and incident coronary heart disease: the Whitehall II study. Arterioscler Thromb Vasc Biol. 2008;28:1398–406.CrossRefPubMed

23.

Garvin P, Nilsson L, Carstensen J, Jonasson L, Kristenson M. Plasma levels of matrix metalloproteinase-9 are independently associated with psychosocial factors in a middle-aged normal population. Psychosom Med. 2009;71:292–300.CrossRefPubMed

24.

Galis ZS, Sukhova GK, Lark MW, Libby P. Increased expression of matrix metalloproteinases and matrix degrading activity in vulnerable regions of human atherosclerotic plaques. J Clin Invest. 1994;94:2493–503.CrossRefPubMedPubMedCentral

25.

Blankenberg S, Rupprecht HJ, Poirier O, et al. Plasma concentrations and genetic variation of matrix metalloproteinase 9 and prognosis of patients with cardiovascular disease. Circulation. 2003;107:1579–85.CrossRefPubMed

26.

Dubois CM, Beach SR, Kashdan TB, et al. Positive psychological attributes and cardiac outcomes: associations, mechanisms, and interventions. Psychosomatics. 2012;53:303–18. doi:10.1016/j.psym.2012.04.004.CrossRefPubMed

27.

Hollman G, Kristenson M. The prevalence of the metabolic syndrome and its risk factors in a middle-aged Swedish population—mainly a function of overweight? Eur J Cardiovasc Nurs. 2007.

28.

Khani BR, Ye W, Terry P, Wolk A. Reproducibility and validity of major dietary patterns among Swedish women assessed with a food-frequency questionnaire. J Nutr. 2004;134:1541–5.PubMed

29.

Kallings LV, Leijon M, Hellenius ML, Stahle A. Physical activity on prescription in primary health care: a follow-up of physical activity level and quality of life. Scand J Med Sci Sports. 2007.

30.

Pearlin LI, Schooler C. The structure of coping. J Health Soc Behav. 1978;19:19.

31.

Rosenberg M. The association between self-esteem and anxiety. J Psychiatr Res. 1962;1:135–52.CrossRefPubMed

32.

Antonovsky A. Unraveling the mystery of health: how people manage stress and stay well. 1st ed. San Francisco: Jossey-Bass; 1987.

33.

Cantril H. The pattern of human concerns. New Brunswick: Rutgers University Press; 1965.

34.

The RL, Scale CES-D. A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRef

35.

Appels A, Hoppener P, Mulder P. A questionnaire to assess premonitory symptoms of myocardial infarction. Int J Cardiol. 1987;17:15–24.CrossRefPubMed

36.

Gerlach RF, Demacq C, Jung K, Tanus-Santos JE. Rapid separation of serum does not avoid artificially higher matrix metalloproteinase (MMP)-9 levels in serum versus plasma. Clin Biochem. 2007;40:119–23.CrossRefPubMed

37.

Steptoe A, O’Donnell K, Badrick E, Kumari M, Marmot M. Neuroendocrine and inflammatory factors associated with positive affect in healthy men and women: the Whitehall II study. Am J Epidemiol. 2008;167:96–102.CrossRefPubMed

38.

Ikeda A, Schwartz J, Peters JL, et al. Optimism in relation to inflammation and endothelial dysfunction in older men: the VA normative aging study. Psychosom Med. 2011;73:664–71. doi:10.1097/PSY.0b013e3182312497.CrossRefPubMed

39.

Roy B, Diez-Roux AV, Seeman T, Ranjit N, Shea S, Cushman M. Association of optimism and pessimism with inflammation and hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA). Psychosom Med. 2010;72:134–40. doi:10.1097/PSY.0b013e3181cb981b.CrossRefPubMedPubMedCentral

40.

Chapman BP, van Wijngaarden E, Seplaki CL, Talbot N, Duberstein P, Moynihan J. Openness and conscientiousness predict 34-week patterns of interleukin-6 in older persons. Brain Behav Immun. 2011;25:667–73.CrossRefPubMedPubMedCentral

41.

Raison CL, Capuron L, Miller AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol. 2006;27:24–31.CrossRefPubMed

Title: Psychological Resources Are Independently Associated with Markers of Inflammation in a Middle-Aged Community Sample
Authors: Ina Marteinsdottir
Jan Ernerudh
Lena Jonasson
Margareta Kristenson
Peter Garvin
Publication date: 01-10-2016
Publisher: Springer US
Published in: International Journal of Behavioral Medicine / Issue 5/2016
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-016-9553-z

At a glance: The STEP trials

Springer Medicine

Psychological Resources Are Independently Associated with Markers of Inflammation in a Middle-Aged Community Sample

Abstract

Purpose

Method

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

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