Association of Optimism and Pessimism With Inflammation and Hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

Objective-Optimism and pessimism are associated with cardiovascular disease mortality and progression, however the biological mechanism remains unclear. This study investigates the association between optimism/pessimism and concentrations of seven inflammation and hemostasis markers.Methods-This cross-sectional study used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a study of 6814 persons aged 45-84 with no history of clinical cardiovascular disease. The Life-Orientation Test-Revised (LOT-R) was used to measure dispositional optimism and pessimism. Regression analyses were used to estimate associations of optimism and pessimism with interleukin-6 (IL-6), C-reactive protein (CRP), fibrinogen, homocysteine, factor VIII, D-dimer, and plasmin-antiplasmin, before and after adjustment for sociodemographics, depression, cynicism, health behaviors, BMI, hypertension, and diabetes.Results-Higher scores on the LOT-R (positive disposition) were related to lower concentrations of IL-6 (p=0.001), fibrinogen (p<0.001) and homocysteine (p=0.031). Associations were stronger for the pessimism subscale. After adjustment for demographics, the percentage differences in inflammatory markers corresponding to a 2-standard deviation increase in pessimism were 6.01% (p=0.001) for IL-6; 10.31% (p=0.001) for CRP; 2.47% (p<0.0001) for fibrinogen, and 1.36% (p=0.07) for homocysteine. Associations were attenuated but significant after adjustment for sociodemographics, depression, cynical distrust, and behaviors. Further adjustment for hypertension, BMI and diabetes reduced associations for CRP and IL-6. Pessimism remained associated with a 1.36% (p=0.02) increase in fibrinogen in the fully adjusted model. Factor VIII, D-dimer and plasminantiplasmin were not associated with the LOT-R or subscales.Corresponding Author: Ana V. Diez-Roux, MD, PhD, Center for Social Epidemiology and Population Health, 109 Observatory, 3rd Floor Tower: Ann Arbor, MI, 48109-2029; Phone (734) Fax: (734) adiezrou@umich.edu. Disclosures: No conflicts of interest to disclose.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-Pessimism is related to higher levels of inflammation. Health behaviors, BMI, hypertension and diabetes appear to play a mediating role. NIH Public Access KeywordsPsychosocial factors; inflammation; coagulation; epidemiology; risk factorsSeveral studies have linked life-orientation, as reflected by levels of optimism and pessimism, to cardiovascular disease risk (1-8). Optimism is generally defined as the tendency to believe that future expectations and goals will be ...

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“…Effects for pessimism were stronger than effects for optimism, and optimism was not associated with rate of change in these markers over time. In cross-sectional analyses within the MultiEthnic Study of Atherosclerosis (MESA)-a diverse cohort of nearly 7,000 men and women-greater dispositional optimism was not associated with CRP in analyses adjusted for age, gender, and race (Roy et al, 2010). However, the most optimistic MESA participants had lower levels of IL-6 after adjusting for age, race, and gender (Roy et al, 2010).…”

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