The association between chronic stress type and C-reactive protein in the multi-ethnic study of atherosclerosis: does gender make a difference?

Shivpuri, Smriti; Gallo, Linda C.; Crouse, John R.; Allison, Matthew A.

doi:10.1007/s10865-011-9345-5

Cited by 54 publications

(58 citation statements)

References 85 publications

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“…For men, however, the loss of normal regulatory feedback reflected an imbalance characterized by an enhanced release of CORT coupled with attenuated inflammation, a pattern that was associated with increasing trait anxiety, diminishing quality of sleep, and increasing frequency of daytime dysfunction. Although previous studies have reported gender differences in the relation of the individual components of the CORT/CRP ratio to MDD, severity of depressive symptoms, and vulnerability factors (e.g., Maes et al, 1988; Shivpuri et al, 2011; Zobel et al, 2004), to our knowledge these are the first data to suggest gender specificity in the relation of vulnerability factors to distinct and gender-specific uncoupling of neuro-immune feedback mechanisms.…”

Section: Discussionmentioning

confidence: 49%

Depressogenic vulnerability and gender-specific patterns of neuro-immune dysregulation: What the ratio of cortisol to C-reactive protein can tell us about loss of normal regulatory control

Suarez

Sundy

Erkanli

2015

Brain, Behavior, and Immunity

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We examined whether the ratio of cortisol (CORT) to high-sensitivity C-reactive protein (hsCRP), an index that captures the integrity of homeostatic regulation between the hypothalamic-pituitary-adrenal (HPA) axis and inflammatory processes, is associated with vulnerability to depression in a gender specific manner and whether glucocorticoid receptor (GR) sensitivity plays a role in these associations. Fasting blood samples were collected between 0845 and 0915 and assayed for CORT, hsCRP, and leukocyte count in 213 healthy, medication-free men and women. The NEO-Personality Inventory was used to assess neuroticism, extraversion and anxiety. We used the Hamilton Depression Interview to assess depressive symptoms, the Buss-Perry anger subscale to measure anger, and the Pittsburgh Sleep Quality Index to evaluate subjective sleep quality and its components. Log-transformed CORT/CRP values were analyzed using multiple regression with Holms’ adjusted p-values and age, body mass index (BMI), and race as covariates. GR sensitivity was estimated using the log-transformed ratio of neutrophils (N)-to-monocytes (M). The log-transformed ratio of CORT/CRP did not differ between men and women but was significantly and negatively associated with age and BMI. Severity of depressive symptoms, extraversion, anxiety, and sleep quality were associated with the CORT/CRP ratio in a gender-specific manner. For women, decreasing CORT/CRP ratios, suggestive of an insufficient release of CORT coupled with a heightened inflammatory state, were associated with increasing severity of depressive symptoms, decreasing quality of sleep, increasing frequency of sleep disturbance, and decreasing extraversion. For men, increasing frequency of daytime disturbance and levels of anxiety were associated with increasing CORT/CRP ratio, suggestive of an enhanced release of CORT relative to attenuated levels of hsCRP. For both genders, increasing anger was associated with decreasing CORT/CRP ratios. Although results suggested GR downregulation in women but not men, such differences did not mediate the observed associations. With the use of the CORT/CRP ratio, we showed that vulnerability factors for depression are associated with a loss of normal regulatory controls resulting in gender-specific patterns of neuro-immune dysregulation. That GR downregulation did not influence these associations suggests that the loss of regulatory controls in at risk individuals is primarily at the level of the hormone. Beyond the individual contribution of each component of the CORT/CRP ratio, disruption of normal neuroimmune regulatory feedback provides a plausible biological framework useful in understanding biobehavioral vulnerabilities to depression in a gender specific manner. The CORT/CRP ratio may be a viable biomarker not only for delineating risk for MDD but also progression and treatment responses among patients with MDD; possibilities that are testable in future studies.

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Section: Discussionmentioning

confidence: 49%

Depressogenic vulnerability and gender-specific patterns of neuro-immune dysregulation: What the ratio of cortisol to C-reactive protein can tell us about loss of normal regulatory control

Suarez

Sundy

Erkanli

2015

Brain, Behavior, and Immunity

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“…Chronic stress burden (8 items) 20,21 asked participants about ongoing stressors in important life domains (health, work, relationships) that have lasted for at least 6 months. A score was created by summing the number of ongoing stressors reported (range 0–8), which was later categorized into number of reported stressors (0, 1, 2, ≥3).…”

Section: Methodsmentioning

confidence: 99%

Psychosocial stress is associated with obesity and diet quality in Hispanic/Latino adults

Isasi

Parrinello

Jung

et al. 2015

Annals of Epidemiology

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133

123

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Purpose To examine the association of psychosocial stress with obesity, adiposity, and dietary intake in a diverse sample of Hispanic/Latino adults. Methods Participants were 5077 men and women, 18–74 years old, from diverse Hispanic/Latino ethnic backgrounds. Linear regression models were used to assess the association of ongoing chronic stressors and recent perceived stress with measures of adiposity (waist circumference and percentage body fat) and dietary intake (total energy, saturated fat, alternative healthy eating index [AHEI-2010]). Multinomial logistic models were used to describe the odds of obesity or overweight relative to normal weight. Results Greater number of chronic stressors and greater perceived stress were associated with higher total energy intake. Greater recent perceived stress was associated with lower diet quality as indicated by AHEI-2010 scores. Compared to no stressors, reporting ≥ 3 chronic stressors was associated with higher odds of being obese (OR = 1.5, 95%CI 1.01–2.1), greater waist circumference (β = 3.3, 95%CI 1.0–5.5) and percentage body fat (β = 1.5, 95%CI 0.4, 2.6). Conclusions The study found an association between stress and obesity and adiposity measures, suggesting that stress management techniques may be useful in obesity prevention and treatment programs that target Hispanic/Latino populations.

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“…This measure has been used in prior multi-ethnic cohort studies (29, 30). The 10-item Perceived Stress Scale (PSS10) was used to assess appraisals of recent stress (e.g., In the past month, how often have you found that you could not cope with all the things that you had to do?…”

Section: Methodsmentioning

confidence: 99%

Associations of Chronic Stress Burden, Perceived Stress, and Traumatic Stress With Cardiovascular Disease Prevalence and Risk Factors in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

Gallo

Roesch

Fortmann

et al. 2014

Psychosomatic Medicine

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118

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Objective The current study examined multiple stress indicators (chronic, perceived, traumatic) in relation to prevalent coronary heart disease (CHD), stroke, and major cardiovascular disease (CVD) risk factors (i.e., diabetes, dyslipidemia, hypertension, current smoking) in the multi-site Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study (2010–2011). Methods Participants were 5313 men and women, 18–74 years old, representing diverse Hispanic/Latino ethnic backgrounds, who underwent a comprehensive baseline clinical exam and sociocultural exam with measures of stress. Results Chronic stress burden was related to a higher prevalence of CHD after adjusting for sociodemographic, behavioral and biological risk factors [OR (95% CI) = 1.22, (1.10–1.36)] and related to stroke prevalence in the model adjusted for demographic and behavioral factors [OR (95% CI) = 1.26, (1.03–1.55∂)]. Chronic stress was also related to a higher prevalence of diabetes [OR=1.20, (1.11–1.31)] and hypertension [OR=1.10 (1.02–1.19)] in individuals free from CVD (N=4926). Perceived stress [OR=1.03 (1.01–1.05)] and traumatic stress [OR=1.15 (1.05–1.26)] were associated with a higher prevalence of smoking. Participants who reported a greater number of lifetime traumatic events also unexpectedly showed a lower prevalence of diabetes [OR=.89 (.83–.97)] and hypertension [OR=.88 (.82–.93)]. Effects were largely consistent across age and sex groups. Conclusions The study underscores the utility of examining multiple indicators of stress in relation to health, since the direction and consistency of associations may vary across distinct stress conceptualizations. In addition, the study suggests that chronic stress is related to higher CVD risk and prevalence in Hispanics/Latinos, the largest U.S. ethnic minority group.

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The association between chronic stress type and C-reactive protein in the multi-ethnic study of atherosclerosis: does gender make a difference?

Cited by 54 publications

References 85 publications

Depressogenic vulnerability and gender-specific patterns of neuro-immune dysregulation: What the ratio of cortisol to C-reactive protein can tell us about loss of normal regulatory control

Depressogenic vulnerability and gender-specific patterns of neuro-immune dysregulation: What the ratio of cortisol to C-reactive protein can tell us about loss of normal regulatory control

Psychosocial stress is associated with obesity and diet quality in Hispanic/Latino adults

Associations of Chronic Stress Burden, Perceived Stress, and Traumatic Stress With Cardiovascular Disease Prevalence and Risk Factors in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

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