Variables and co-variables.

Objective Unfavorable blood lipid profiles are robust risk factors in predicting atherosclerotic disease. Studies have shown that positive affect (PA) is associated with a favorable lipid profile. However, longitudinal studies regarding the course of PA and lipid profiles in myocardial infarction (MI) patients are lacking. Therefore, the aim of this study was to prospectively explore the association between PA and blood lipid levels across three inv estigations over 12 months following acute MI. Methods Patients following an acute MI were examined at hospital admission (n = 190), and at 3 months (n = 154) and 12 months (n = 106) thereafter. Linear mixed effect regression models were used to evaluate the relation between PA, assessed with the Global Mood Scale, and blood lipid levels. Potential confounding variables were controlled for in the analysis. Results Higher PA was significantly associated with higher high-density lipoprotein cholesterol (HDL-C) levels and a lower total cholesterol (TC)/HDL-C ratio over time, independent of demographic factors, indices of cardiac disease severity, comorbidity, medication use, health behaviors, serum cortisol and negative affect (p≤0.040). No association was found between PA and the two blood lipids low-density lipoprotein-cholesterol (LDL-C) and triglycerides (TG). Conclusions Positive affect was independently associated with HDL-C levels and the TC/HDL-C ratio in patients up to 1 year after MI. The findings support a potential role of PA for cardiovascular health through an association with a favorable blood lipid profile.研究目的：血脂异常是预测动脉粥样硬化性疾病的强有力危险因素。已有研究表明，积极情感（Positive Affect, PA）与良好的血脂谱存在关联。然而，目前针对急性心肌梗死（Myocardial Infarction, MI）患者的积极情感变化轨迹与血脂谱的纵向研究仍较为匮乏。因此，本研究旨在前瞻性探讨急性心肌梗死患者发病后12个月内三次随访中积极情感与血脂水平的关联。 研究方法：本研究对急性心肌梗死患者分别于入院时（n=190）、发病后3个月（n=154）及12个月（n=106）进行随访评估。采用线性混合效应回归模型，分析通过整体心境量表（Global Mood Scale）评估的积极情感与血脂水平之间的关联，并在分析中控制了潜在混杂变量。 研究结果：随着时间推移，更高的积极情感水平与更高的高密度脂蛋白胆固醇（High-density lipoprotein cholesterol, HDL-C）水平及更低的总胆固醇（Total Cholesterol, TC）/HDL-C比值显著相关，且该关联不受人口统计学因素、心脏疾病严重程度指标、共病情况、用药情况、健康行为、血清皮质醇及消极情感的影响（p≤0.040）。未发现积极情感与另外两种血脂指标——低密度脂蛋白胆固醇（Low-density lipoprotein-cholesterol, LDL-C）和甘油三酯（Triglycerides, TG）——存在关联。 研究结论：急性心肌梗死患者发病后1年内，积极情感与HDL-C水平及TC/HDL-C比值存在独立相关性。本研究结果表明，积极情感可通过与良好血脂谱的关联，在心血管健康中发挥潜在作用。