Abstract 18000: Cumulative Psychological Stress and Type II Diabetes Mellitus in Women
Background: Data support an association between psychological stress and cardiovascular disease (CVD) risk. However, the relationship between psychological stress and type II diabetes (diabetes), a CVD risk equivalent is uncertain.
Methods and Results: We assessed the association between cumulative psychological stress and diabetes among 26,744 women participating in the ongoing follow-up cohort of the Women’s Health Study (WHS). Utilizing a questionnaire that assessed acute and chronic stress domains, a weighted summed cumulative stress score was computed that included the 8 domains (acute: negative and traumatic life events; chronic: work stress, work-family spillover, financial stress, discrimination, relationship stress, neighborhood stress; score range: 16-394). Physician confirmed diabetes status (n=2984) at the time of questionnaire administration was the primary outcome measure. Mean age was 72.3 ± 6.1 years old at baseline (stress questionnaire administration). Increasing quartiles of cumulative stress were associated with lower age and alcohol use, and with several traditional CVD risk factors (including less physical activity, increased smoking, body mass index) plus depression and anxiety. Logistic regression analyses adjusted for age, race/ethnicity, and socioeconomic status (income and education) demonstrated increased odds of diabetes with increasing quartiles of cumulative stress [Odds Ratio (OR) and 95% Confidence Interval (95% CI): 1.00 (referent), 1.26 (1.11-1.43), 1.64 (1.47-1.91), 2.34 (2.27-2.75) Ptrend=<0.01]. These associations remained significant after additionally controlling for traditional CVD risk factors and depression/anxiety [OR, 95% CI: 1.00, 1.05 (0.90-1.22), 1.21 (1.01-1.46), 1.43 (1.17-1.76) ptrend=<0.01]. Subgroup analyses by categories of BMI or socioeconomic status did not reveal heterogeneity in the association between cumulative stress and diabetes.
Conclusion: Among women participating in the Women’s Health Study, cumulative stress levels were positively associated with prevalence of diabetes. These findings are hypothesis generating and suggest exploration of potential mechanistic links between chronic psychological stress burden and metabolic status.
Author Disclosures: J.Z. Butler: None. A. Zaslavsky: None. D.R. Williams: None. N. Slopen: None. A. Pradhan: None. J. Buring: None. M.A. Albert: None.
- © 2016 by American Heart Association, Inc.