Key result
Agoraphobia was associated with a significant prospective increase in C-reactive protein (β = 0.087) and tumor necrosis factor-α, and a decrease in cardioprotective adiponectin over 5.5 years.
Why the study?
Does agoraphobia associate with increased chronic low-grade systemic inflammation in a general population?
Cohort (n=2,890)
Does agoraphobia associate with increased chronic low-grade systemic inflammation in a general population?
Mean Difference: 0.087 (95% CI 0.024–0.151)
Absolute Event Rate: 0.14% vs 0.06%
p-value: p=0.007
Agoraphobia is associated with increased chronic low-grade inflammation over time, potentially linking it to an increased risk of atherosclerosis and coronary heart disease.
Agoraphobia may flag rising inflammation; hypothesis-generating for atherosclerosis links and requires prospective confirmation before clinical action.
BACKGROUND: Anxiety disorders have been linked to an increased risk of incident coronary heart disease in which inflammation plays a key pathogenic role. To date, no studies have looked at the association between proinflammatory markers and agoraphobia. METHODS: In a random Swiss population sample of 2890 persons (35-67 years, 53% women), we diagnosed a total of 124 individuals (4.3%) with agoraphobia using a validated semi-structured psychiatric interview. We also assessed socioeconomic status, traditional cardiovascular risk factors (i.e., body mass index, hypertension, blood glucose levels, total cholesterol/high-density lipoprotein-cholesterol ratio), and health behaviors (i.e., smoking, alcohol consumption, and physical activity), and other major psychiatric diseases (other anxiety disorders, major depressive disorder, drug dependence) which were treated as covariates in linear regression models. Circulating levels of inflammatory markers, statistically controlled for the baseline demographic and health-related measures, were determined at a mean follow-up of 5.5 ± 0.4 years (range 4.7 - 8.5). RESULTS: Individuals with agoraphobia had significantly higher follow-up levels of C-reactive protein (p = 0.007) and tumor-necrosis-factor-α (p = 0.042) as well as lower levels of the cardioprotective marker adiponectin (p = 0.032) than their non-agoraphobic counterparts. Follow-up levels of interleukin (IL)-1β and IL-6 did not significantly differ between the two groups. CONCLUSIONS: Our results suggest an increase in chronic low-grade inflammation in agoraphobia over time. Such a mechanism might link agoraphobia with an increased risk of atherosclerosis and coronary heart disease, and needs to be tested in longitudinal studies.
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Wagner et al. (2015) conducted a cohort in Agoraphobia (n=2,890). Agoraphobia vs. No agoraphobia was evaluated on Follow-up levels of C-reactive protein (log10-transformed) (β = 0.087, 95% CI 0.024 to 0.151, p=0.007). Agoraphobia was associated with a significant prospective increase in C-reactive protein (β = 0.087) and tumor necrosis factor-α, and a decrease in cardioprotective adiponectin over 5.5 years.
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