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Social isolation, C-reactive protein, and coronary heart disease mortality among community-dwelling adults

The Rochester Center for Mind-Body Research, Department of Psychiatry, University of Rochester, 300 Crittenden Boulevard, Box PSYCH-BPSM, Rochester, NY 14642, United States.
Social Science [?] Medicine (Impact Factor: 2.56). 05/2011; 72(9):1482-8. DOI: 10.1016/j.socscimed.2011.03.016
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ABSTRACT Social isolation confers increased risk for coronary heart disease (CHD) events and mortality. In two recent studies, low levels of social integration among older adults were related to higher levels of C-reactive protein (CRP), a marker of inflammation, suggesting a possible biological link between social isolation and CHD. The current study examined relationships among social isolation, CRP, and 15-year CHD death in a community sample of US adults aged 40 years and older without a prior history of myocardial infarction. A nested case-cohort study was conducted from a parent cohort of community-dwelling adults from the southeastern New England region of the United States (N = 2321) who were interviewed in 1989 and 1990. CRP levels were measured from stored sera provided by the nested case-cohort (n = 370), which included all cases of CHD death observed through 2005 (n = 48), and a random sample of non-cases. We found that the most socially isolated individuals had two-and-a-half times the odds of elevated CRP levels compared to the most socially integrated. In separate logistic regression models, both social isolation and CRP predicted later CHD death. The most socially isolated continued to have more than twice the odds of CHD death compared to the most socially integrated in a model adjusting for CRP and more traditional CHD risk factors. The current findings support social isolation as an independent risk factor of both high levels of CRP and CHD death in middle-aged adults without a prior history of myocardial infarction. Prospective study of inflammatory pathways related to social isolation and mortality are needed to fully delineate whether and how CRP or other inflammatory markers contribute to mechanisms linking social isolation to CVD health.

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    • "People who are socially isolated have increased risk of all-cause mortality (Cacioppo and Hawkley, 2003; Seeman, 1996), and several infectious , neoplastic, and cardiovascular diseases (Caspi et al., 2006; Cohen et al., 1997; Cole et al., 2003; Kroenke et al., 2006). A possible biological mechanism of these effects is systemic inflammation, as social isolation has been shown to predict heightened systemic inflammation as assessed by circulating levels of inflammatory markers (Heffner et al., 2011). Furthermore, it is thought that social isolation is associated with sleep disturbance through a disruption of social zeitgebers (i.e., social cues that maintain the sleep–wake activity schedule), which are increasingly viewed as being critical in the homeostatic regulation of sleep–wake activity (Mistlberger and Skene, 2004). "
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