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"Associations of psychosocial factors with inflammatory markers were reduced by 20 percent to 55 percent after adjustment for behavioral factors and by 45 percent to 100 percent after adjustment for body mass index (BMI) and diabetes, mostly owing to the effect of BMI," they continue. "No associations remained after controlling for socioeconomic position, behaviors, BMI and diabetes."

According to the authors, this suggests that at least part of the link may be due to the mediating role of behaviors--for instance, psychosocial factors may increase the chance that an individual takes up behaviors such as smoking, which results in higher levels of inflammatory markers. Stress and psychosocial factors may contribute to obesity and related metabolic problems, thus explaining the weakening of the association after controlling for BMI and diabetes. In addition, "socioeconomic position is likely to be an antecedent to psychosocial characteristics, as well as to other factors (e.g. behaviors, BMI and diabetes) associated with inflammation," the authors write. However, further studies are needed to determine the nature of the relationship between inflammation and these mediating factors.

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Contact: Nancy Ross-Flanigan
734-647-1853
JAMA and Archives Journals
22-Jan-2007