To assess, to control, to exclude: effects of biobehavioral factors on circulating inflammatory markers

Brain Behav Immun. 2009 Oct;23(7):887-97. doi: 10.1016/j.bbi.2009.04.005. Epub 2009 Apr 21.


Behavioral scientists have increasingly included inflammatory biology as mechanisms in their investigation of psychosocial dynamics on the pathobiology of disease. However, a lack of standardization of inclusion and exclusion criteria and assessment of relevant control variables impacts the interpretation of these studies. The present paper reviews and discusses human biobehavioral factors that can affect the measurement of circulating markers of inflammation. Keywords relevant to inflammatory biology and biobehavioral factors were searched through PubMed. Age, sex, and hormonal status, socioeconomic status, ethnicity and race, body mass index, exercise, diet, caffeine, smoking, alcohol, sleep disruption, antidepressants, aspirin, and medications for cardiovascular disease are all reviewed. A tiered set of recommendations as to whether each variable should be assessed, controlled for, or used as an exclusion criteria is provided. These recommendations provide a framework for observational and intervention studies investigating linkages between psychosocial and behavioral factors and inflammation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticholesteremic Agents / adverse effects
  • Antidepressive Agents, Second-Generation / adverse effects
  • Antihypertensive Agents / adverse effects
  • Biomarkers / blood
  • Body Mass Index
  • Diet
  • Epidemiologic Factors
  • Exercise
  • Humans
  • Inflammation / blood*
  • Inflammation / ethnology
  • Inflammation / psychology*
  • Interleukins / blood
  • Patient Selection
  • Physical Fitness
  • Research Design
  • Risk Factors
  • Risk-Taking
  • Smoking
  • Social Class
  • Tumor Necrosis Factor-alpha / blood


  • Anticholesteremic Agents
  • Antidepressive Agents, Second-Generation
  • Antihypertensive Agents
  • Biomarkers
  • Interleukins
  • Tumor Necrosis Factor-alpha