Phobic anxiety is associated with higher serum concentrations of adipokines and cytokines in women with diabetes
- Aoife M. Brennan, MD1,
- Jessica L. Fargnoli, BA1,
- Catherine J. Williams, MPH1,
- Tricia Li, MPH2,
- Walter Willett, MD, DrPH2,3,4,
- I Kawachi, PhD3,
- Lu Qi, MD, PhD2,4,
- Frank B. Hu, MD, PhD2,3,4 and
- Christos S. Mantzoros, MD (cmantzor{at}bidmc.harvard.edu)1
- 1 Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
- 2 Department of Nutrition, Harvard School of Public Health, Boston, MA
- 3 Department of Epidemiology, Harvard School of Public Health, Boston, MA
- 4 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
Abstract
Objective: Phobic anxiety has been associated with increased risk of cardiovascular disease, but the underlying mechanisms are poorly understood. We aimed to determine whether associations of phobic anxiety with several known markers of cardiovascular disease might be contributors.
Research design and methods: We used a 16-point validated index (Crown-Crisp) measured in 1988 to categorize 984 women with type 2 diabetes from the Nurses' Health Study as having low, moderate, or high phobic anxiety. Groups were then compared for differences in adipokines (adiponectin and leptin), inflammatory markers (C-reactive protein and TNF-α receptor II) and markers of endothelial function (sE-selectin, sICAM-1) measured on blood samples provided between 1989 and 1990.
Results: Higher levels of phobic anxiety were associated with higher BMI and lower education. Higher levels of phobic anxiety were also associated with higher leptin and sTNF-α receptor II in both crude analyses and after adjustment for potential confounders. sICAM and sE-selectin were higher in the highest tertile compared to the middle tertile but there was no significant trend across tertiles. We found no association between phobic anxiety and adiponectin.
Conclusions: High levels of phobic anxiety are associated with increased levels of leptin and inflammatory markers, which may in part explain the previously observed relationship between anxiety and other psychosocial disorders with cardiovascular disease.
Footnotes
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- Received November 3, 2008.
- Accepted February 2, 2009.
- Copyright © American Diabetes Association
