title: History of sudden unexpected loss is associated with elevated interleukin-6 and decreased insulin-like growth factor-1 in women in an urban primary care setting.
abstract: OBJECTIVE
  To investigate the hypothesis that a history of sudden unexpected loss including number of losses and type of loss (death due to unnatural versus natural causes) would be associated with the magnitude of dysregulation. The sudden unexpected death of a loved one confers risk of morbidity and mortality, perhaps due to dysregulation in the immune/inflammatory and endocrine systems.
  
  
  METHODS
  Female primary care patients aged >or=40 years (n = 75) completed questionnaires, a clinical interview, and a blood draw. Interleukin (IL)-6 and insulin-like growth factor (IGF)-1 were assayed, using standard enzyme-linked immunosorbent assay protocols and anticytokine antibody pairs.
  
  
  RESULTS
  History of sudden loss was positively associated with IL-6 (mean = 4.07 pg/mL; log(10) values, B = 0.314, p = .009) and negatively associated with IGF-1 (mean = 97.05 ng/mL; B = -0.277, p = .023). A linear relationship parsimoniously captured the association between ordered categories of lifetime loss (0, 1, 2-5, 5+) and increases in log(10) IL-6 (B = 0.107, p = .005) and decreases in IGF-1 (B = -0.116, p = .005). Adjusting for illness burden, depressive symptom severity, and obesity did not change the observed associations. The hypothesized effect of type of loss was not supported.
  
  
  CONCLUSIONS
  These preliminary findings encourage further investigations to elucidate pathways from sudden unexpected loss to biomarker changes that increase risk for morbidity and mortality.
authors.affiliation: Rochester Center for Mind-Body Research, Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Banu
authors.initials: B
authors.lastname: Cankaya
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Chapman
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Talbot
authors.forename: Jan
authors.initials: J
authors.lastname: Moynihan
authors.forename: Paul R
authors.initials: PR
authors.lastname: Duberstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001601:Bereavement; D015415:Biomarkers / Q000097:blood*; D002423:Cause of Death; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology; D003645:Death, Sudden / Q000453:epidemiology*; D003863:Depression / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D015850:Interleukin-6 / Q000097:blood*; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009765:Obesity / Q000097:blood / Q000453:epidemiology / Q000276:immunology; D011320:Primary Health Care / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D007334:Insulin-Like Growth Factor I