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Plasma Levels of Matrix Metalloproteinase-9 are Independently Associated With Psychosocial Factors in a Middle-Aged Normal Population
Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
Linköping University, Department of Medicine and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
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2009 (English)In: PSYCHOSOMATIC MEDICINE, ISSN 0033-3174, Vol. 71, no 3, 292-300 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To test the association between psychosocial factors and circulating levels of matrix metalloproteinase-9 (MMP-9) in a normal population sample. Psychosocial factors have been associated with inflammatory markers and are of prognostic significance for coronary artery disease (CAD). The degrading enzyme MMP-9 is upregulated in inflammatory processes and hypothesized to play a role in the rupture of atherosclerotic plaques. Methods: A total of 402 participants (50% women), aged 45 to 69 years, were drawn randomly from a normal population. Psychosocial instruments covered depression (Center for Epidemiological Studies Depression Questionnaire, CES-D), vital exhaustion, hostile affect, cynicism, mastery, self-esteem, sense of coherence (SOC), emotional support, and social integration. Plasma MMP-9 was measured by an enzyme-linked immunosorbent assay method. Linear regression models were adjusted for age, sex, known CAD, rheumatoid arthritis, cancer, cardiovascular risk factors including C-reactive protein and ongoing medication. Results: After full adjustment, there were independent associations of elevated MMP-9 levels with CES-D (+2.9 ng/ml per SD, p=.02), hostile affect (+3.0 ng/ml per SD, p=.02), cynicism (+3.5 ng/ml per SD, p=.006), and SOC (-2.5 ng/ml per SD, p=.046). A principal component analysis extracted three components. The first was mainly extracted from CES-D, vital exhaustion, self-esteem, mastery, and SOC; the second was mainly extracted from hostile affect and cynicism. Both were independently associated with MMP-9 (p=.02, p=.04) when run in the same model. Conclusions: MMP-9 levels were associated with psychosocial factors in a middle-aged normal population sample, independently of traditional risk factors. The findings may constitute a possible link between psychosocial factors and cardiovascular risk.

Place, publisher, year, edition, pages
2009. Vol. 71, no 3, 292-300 p.
Keyword [en]
depression, hostile affect, cynicism, sense of coherence, metalloproteinases, cardiovascular
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-18140DOI: 10.1097/PSY.0b013e3181960e7fOAI: oai:DiVA.org:liu-18140DiVA: diva2:216479
Note
This is a non-final version of an article published in final form: Peter Garvin, Lennart Nilsson, John Carstensen, Lena Jonasson and Margareta Kristenson , Plasma Levels of Matrix Metalloproteinase-9 are Independently Associated With Psychosocial Factors in a Middle-Aged Normal Population, 2009, PSYCHOSOMATIC MEDICINE, (71), 3, 292-300. http://dx.doi.org/10.1097/PSY.0b013e3181960e7f Copyright: Lippincott, Williams & Wilkins http://www.lww.com/ Available from: 2009-05-14 Created: 2009-05-08 Last updated: 2009-08-18Bibliographically approved
In thesis
1. Plasma levels of matrix metalloproteinase‐9 in a normal population: a psychoneuroendocrinological approach
Open this publication in new window or tab >>Plasma levels of matrix metalloproteinase‐9 in a normal population: a psychoneuroendocrinological approach
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Several large‐scale epidemiological studies have demonstrated the prognostic significance of psychosocial factors and stress for coronary artery disease (CAD). Observations of sudden changes in CAD incidence have led to the proposal of mechanisms regarding atherosclerotic plaque vulnerability. The collagen‐degrading enzyme matrix metalloproteinase-9 (MMP-9) is increased in rupture‐prone plaques with high inflammatory activity, and circulating levels of MMP-9 are raised in patients with acute coronary syndrome. However, the distribution of MMP‐9 levels and its relations to psychosocial factors and the stress hormone cortisol have not been previously explored in a normal population.The aim of this dissertation was to examine in a normal population the association of circulating levels of MMP-9 with traditional cardiovascular risk factors including levels of C-reactive protein (CRP), with psychosocial factors, and with saliva levels of cortisol. In addition, the reliability of a new method of ambulatory saliva sampling for assessment of cortisol levels was evaluated. A sub‐sample of the Life conditions, Stress, and Health (LSH)-study, a population based study exploring psychoneuroendocrinological pathways mediating the differences in CAD incidence over socioeconomic status, was used. Plasma levels of MMP-9 were examined in a sample randomly drawn from the LSH‐study (n=400), aged 45 to 69 years at enrollment.The main findings were: 1) there was a positive association between plasma MMP-9 levels and total risk load of cardiovascular risk factors. The findings were persistent after adjusting for CRP and could not be attributed to a single risk factor. 2) After adjusting for traditional cardiovascular risk factors and CRP, MMP-9 levels were positively associated with psychosocial risk factors and negatively associated with psychosocial resources. 3) Pooling saliva samples prior to laboratory analysis were as reliable as arithmetic means for assessment of diurnal cortisol variation in a field research setting. 4) There was a positive association between circulating levels of MMP‐9 and saliva levels of cortisol, both diurnal peak level and evening level of cortisol. The observed associations between MMP‐9 and traditional cardiovascular risk factors, psychosocial factors, and saliva cortisol levels suggest a psychoneuroendocrinological pathway linking stress to plaque vulnerability and provide increased understanding of the association between psychosocial factors and CAD.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2008. 131 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1072
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14929 (URN)978‐91‐7393‐831‐0 (ISBN)
Public defence
2008-10-03, Berzeliussalen, ingång 63, Campus US, Linköpings universitet, Linköping, 13:00 (English)
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Supervisors
Available from: 2008-09-30 Created: 2008-09-30 Last updated: 2009-08-21Bibliographically approved

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Garvin, PeterNilsson, LennartCarstensen, JohnJonasson, LenaKristenson, Margareta

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