Optimism, pessimism, cynical hostility, and biomarkers of metabolic function in the Women's Health Initiative

• Published in: Journal of diabetes 2018-06, Vol.10 (6), p.512-523
• Main Authors: Tindle, Hilary A., Duncan, Meredith S., Liu, Simin, Kuller, Lewis H., Fugate Woods, Nancy, Rapp, Steve R., Kroenke, Candyce H., Coday, Mace, Loucks, Eric B., Lamonte, Michael J., Progovac, Ana M., Salmoirago‐Blotcher, Elena, Walitt, Brian T., Yuo, Nai‐Chieh Y., Freiberg, Matthew S.
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers; Biomarkers - analysis; Body mass index; Cross-Sectional Studies; cynical hostility; Diabetes; Female; Follow-Up Studies; Health Behavior; Health risk assessment; Homeostasis; Hormone replacement therapy; Hostility; Humans; Insulin Resistance; Metabolic Diseases - diagnosis; Metabolic Diseases - epidemiology; Metabolic Diseases - metabolism; Metabolic Diseases - psychology; Metabolism; Middle Aged; Optimism; Optimism - psychology; Pessimism; Pessimism - psychology; Prognosis; Risk Factors; United States - epidemiology; Women's Health; Womens health; 乐观情绪; 悲观情绪; 愤世嫉俗型敌意; 糖尿病; 胰岛素抵抗
• ISSN: 1753-0393; 1753-0407
• DOI: 10.1111/1753-0407.12584

Background Psychological attitudes reflecting expectations about the future (optimism, pessimism) and people (cynical hostility) independently predict incident cardiovascular disease and possibly diabetes, but underlying biologic pathways are incompletely understood. Herein we examined the cross‐sectional relationship between optimism, pessimism, and cynicism and biomarkers of metabolic function in the Women's Health Initiative. Methods Among 3443 postmenopausal women, biomarkers of metabolic function (fasting insulin [FINS] and glucose) were measured at baseline and used to calculate insulin resistance (homeostasis model assessment of insulin resistance [HOMA‐IR]) and pancreatic β‐cell activity (homeostasis model assessment of β‐cell function [HOMA‐B]). Psychological attitudes were assessed by the Life Orientation Test, Revised (full scale, and optimism and pessimism subscales) and the Cook–Medley cynicism subscale. Multivariable linear regression modeled the association of psychological attitudes with biomarker levels, adjusting for sociodemographics, health conditions, and health behaviors. Because obesity promotes insulin resistance and obese individuals tend to report higher levels of pessimism and cynical hostility, an interaction with body mass index (BMI) was explored. Results In fully adjusted models, only pessimism remained independently associated with higher FINS and insulin resistance (HOMA‐IR). Scoring 1 point higher on the pessimism subscale was associated with a 1.2% higher FINS, whereas scoring 1 SD higher was associated with a 2.7% higher FINS (P = 0.03); results were similar for HOMA‐IR. An interaction term with BMI was not significant. Conclusions In multivariable models, higher dispositional pessimism was associated with worse metabolic function; these findings were not modified by obesity status. Results extend prior work by linking pessimism to an objective biomarker of insulin resistance in elderly women. 摘要 背景 反映对未来(乐观情绪、悲观情绪)和对人(愤世嫉俗型敌意)的期望的心理态度都独立预测心血管疾病甚至是糖尿病的发生,  但是其潜在的生物学途径目前却尚未完全明确。因此我们在妇女健康倡议研究中调查了乐观情绪、悲观情绪、愤世嫉俗与代谢功能生物标志物之间的横向关系。 方法 在3443名绝经后妇女中,  对其基线时代谢功能的生物标志物(空腹胰岛素[fasting insulin,  FINS]与血糖)进行了测定,  计算胰岛素抵抗(使用稳态模型评估的胰岛素抵抗[HOMA‐IR])与胰岛β细胞活性(使用稳态模型评估的β细胞功能[HOMA‐B])。使用修订过的生活取向测验表(全面量表,  乐观情绪与悲观情绪分量表)以及Cook‐Medley愤世嫉俗分量表来评估心理态度。校正社会人口学、健康状况以及健康行为后,  使用多元logistic线性回归模型评估心理态度与生物标志物水平之间的关系。因为肥胖可以导致胰岛素抵抗,  并且肥胖患者倾向于报告更高程度的悲观情绪与愤世嫉俗型敌意,  所以也探讨了与体重指数(BMI)之间的相互作用。 结果 在完全校正后的模型中,  只有悲观情绪与高FINS以及胰岛素抵抗(HOMA‐IR)独立相关。在悲观情绪分量表上的得分每升高1分就会