title: Elevated serum levels of interleukin-10 and tumor necrosis factor α [corrected] are both associated with vital exhaustion in patients with cardiovascular risk factors.
abstract: BACKGROUND
  Vital exhaustion, a psychological state characterized by unusual fatigue, irritability, and feelings of demoralization, has been identified as a risk factor for cardiovascular diseases and linked to elevated levels of pro-inflammatory cytokines.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the relationship between vital exhaustion and cytokine levels in patients with cardiovascular risk factors.
  
  
  METHODS
  The entire cohort consisted of 356 primary-care patients with cardiovascular risk factors who participated in a study of early recognition of heart failure. All participants completed the Maastricht questionnaire (MQ) for assessing vital exhaustion. Cytokine serum levels were measured in all those subjects (N=178) who were assigned to the highest and lowest quartiles of the MQ, respectively.
  
  
  RESULTS
  We found that elevated serum concentrations of IL-6, TNFα, and IL-10, but not IL-1β or natriuretic peptides were associated with high MQ scores indicative of vital exhaustion. Using logistic regression analyses controlling for clinical variables and Type D personality, both TNFα (multivariate odds ratio [OR] =1.86; 95%-confidence interval [CI] =1.30-2.68; p=0.001) and IL-10(OR=1.62; 95%-CI=1.15-2.28; p=0.006), but not other cytokines significantly predicted vital exhaustion independently of other clinical and laboratory parameters examined [corrected].
  
  
  CONCLUSIONS
  The subjective state of vital exhaustion is linked to a substantial alteration in the pattern of secreted cytokines. Data suggest that a disturbance in the levels of both pro-inflammatory and anti-inflammatory mediators, rather than isolated stimulation by pro-inflammatory cytokines, is associated with the mental and physical changes of vital exhaustion.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, von-Siebold-Str. 5, D-37075 Göttingen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Meyer
authors.forename: Beate
authors.initials: B
authors.lastname: Stanske
authors.forename: Michael M
authors.initials: MM
authors.lastname: Kochen
authors.forename: Andreas
authors.initials: A
authors.lastname: Cordes
authors.forename: Iraz
authors.initials: I
authors.lastname: Yüksel
authors.forename: Rolf
authors.initials: R
authors.lastname: Wachter
authors.forename: Claus
authors.initials: C
authors.lastname: Lüers
authors.forename: Martin
authors.initials: M
authors.lastname: Scherer
authors.forename: Lutz
authors.initials: L
authors.lastname: Binder
authors.forename: Burkert
authors.initials: B
authors.lastname: Pieske
authors.forename: Christoph
authors.initials: C
authors.lastname: Herrmann-Lingen
mesh_terms: D000368:Aged; D001317:Austria; D002318:Cardiovascular Diseases / Q000235:genetics / Q000276:immunology* / Q000523:psychology*; D015331:Cohort Studies; D003327:Coronary Disease / Q000235:genetics / Q000276:immunology / Q000523:psychology; D005221:Fatigue / Q000235:genetics / Q000276:immunology* / Q000523:psychology*; D005260:Female; D006333:Heart Failure / Q000235:genetics / Q000276:immunology / Q000523:psychology; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D007508:Irritable Mood / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009013:Morale; D010555:Personality Inventory / Q000706:statistics & numerical data; D011320:Primary Health Care; D011594:Psychometrics; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10