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From the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
Address correspondence and reprint requests to Dr. Suarez at Duke University Medical Center, PO Box 3328, Durham, NC 27710. E-mail: suare001{at}mc.duke.edu
OBJECTIVE: The current study examined the relation of anger, hostility, and severity of depressive symptoms, alone and in combination, to C-reactive protein (CRP) in healthy men and women.
METHODS: A high sensitivity enzyme linked immuno sorbent assay (ELISA) was used to evaluate CRP levels in a multiethnic sample of 127 healthy, nonsmoking men and women. Fasting blood samples were collected the same day the assessments were done of anger and hostility using the Buss-Perry Aggression Questionnaire (BPAQ) and depressive symptomatology using the Beck Depression Inventory (BDI). A psychological risk factor (PRF) score representing a composite summary indicator of BDI and BPAQ-anger and -hostility was generated using principal component analysis. Log-transformed CRP values were examined using univariate and multivariate analyses adjusting for control variables of age, gender, body mass index (BMI), alcohol use, exercise frequency, ratio of total to high-density lipoprotein cholesterol, and family history of premature coronary heart disease (CHD).
RESULTS: Log-normalized CRP was correlated with BDI (r = 0.21, p = .02) and BPAQ anger (r = 0.20, p = .02), but not with BPAQ hostility. After adjustment for control variables, BDI (ß = 0.05, p = .011), BPAQ anger (ß = 0.05, p = .007), and the PRF composite score (ß = 0.27, p = .005), but not BPAQ hostility (ß = 0.03, p = .11), were significantly associated with log-normalized CRP.
CONCLUSIONS: Greater anger and severity of depressive symptoms, separately and in combination with hostility, were significantly associated with elevations in CRP in apparently healthy men and women. These associations were independent of potential confounding factors.
Key Words: C-reactive protein • anger • hostility • severity of depressive symptoms • men • women
Abbreviations: BDI = Beck Depression Inventory;; BMI = body mass index;; BPAQ = Buss-Perry Aggression Questionnaire;; CHD = coronary heart disease;; CVD = cardiovascular disease;; ELISA = enzyme linked immuno sorbent assay;; hsCRP = high sensitivity C-reactive protein;; IL = interleukin;; MCP-1 = monocyte chemoattractant protein-1;; MI = myocardial infarction;; MIP-1a = monocyte inflammatory protein-1a;; NHANES III = Third National Health and Nutrition Examination Survey;; OTC = over-the-counter;; PRF = psychological risk factor;; TNF-
= tumor necrosis factor-.
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