title: Association of optimism and pessimism with inflammation and hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA).
abstract: OBJECTIVE
  To investigate the association between optimism/pessimism and concentrations of seven inflammation and hemostasis markers. Optimism and pessimism are associated with cardiovascular disease mortality and progression; however, the biological mechanism remains unclear.
  
  
  METHODS
  This cross-sectional study used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a study of 6814 persons aged 45 to 84 years with no history of clinical cardiovascular disease. The Life-Orientation Test-Revised (LOT-R) was used to measure dispositional optimism and pessimism. Regression analyses were used to estimate associations of optimism and pessimism with interleukin (IL)-6, C-reactive protein (CRP), fibrinogen, homocysteine, Factor VIII, D-dimer, and plasmin-antiplasmin, before and after adjustment for sociodemographics, depression, cynicism, health behaviors, body mass index (BMI), hypertension, and diabetes.
  
  
  RESULTS
  Higher scores on the LOT-R (positive disposition) were related to lower concentrations of IL-6 (p = .001), fibrinogen (p < .001), and homocysteine (p = .031). Associations were stronger for the pessimism subscale. After adjustment for demographics, the percentage differences in inflammatory markers corresponding to a 2-standard deviation increase in pessimism were 6.01% (p = .001) for IL-6, 10.31% (p = .001) for CRP, 2.47% (p < .0001) for fibrinogen, and 1.36% (p = .07) for homocysteine. Associations were attenuated but significant after adjustment for sociodemographics, depression, cynical distrust, and behaviors. Further adjustment for hypertension, BMI, and diabetes reduced associations for CRP and IL-6. Pessimism remained associated with a 1.36% (p = .02) increase in fibrinogen in the fully adjusted model. Factor VIII, D-dimer, and plasmin-antiplasmin were not associated with the LOT-R or subscales.
  
  
  CONCLUSIONS
  Pessimism is related to higher levels of inflammation. Health behaviors, BMI, hypertension, and diabetes seem to play a mediating role.
authors.affiliation: Center for Social Epidemiology and Population Health, Ann Arbor, MI 48109-2029, USA.
authors.forename: Brita
authors.initials: B
authors.lastname: Roy
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez-Roux
authors.forename: Teresa
authors.initials: T
authors.lastname: Seeman
authors.forename: Nalini
authors.initials: N
authors.lastname: Ranjit
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood / Q000453:epidemiology* / Q000523:psychology; D001294:Attitude to Health; D015415:Biomarkers / Q000032:analysis; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000209:etiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000523:psychology; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D015438:Health Behavior; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000208:ethnology; D007249:Inflammation / Q000097:blood / Q000523:psychology*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010551:Personality / Q000145:classification*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D005340:Fibrinogen; D002097:C-Reactive Protein