Stressful life events and incident metabolic syndrome: the Hoorn study

Abstract

Stressful life events are associated with the metabolic syndrome in cross-sectional studies, but prospective studies addressing this issue are rare and limited. We therefore evaluated whether the number of stressful life events is associated with incident metabolic syndrome. We assessed the association between the number of stressful life events experienced in the 5 years up until baseline and incident metabolic syndrome after 6.5 years at follow-up in the Hoorn study, a middle-aged and elderly population-based cohort. Participants with prevalent metabolic syndrome at baseline were excluded. Metabolic syndrome was defined according to the Adult Treatment Panel III, including fasting plasma glucose levels, HDL-C levels, triglyceride levels, waist circumference and hypertension. We included 1099 participants (47% male; age 60 ± 7 years). During 6.5 years of follow-up, 238 participants (22%) developed the metabolic syndrome. Logistic regression adjusted for age, sex, education level and follow-up duration showed a positive association between the number of stressful life events at baseline and incident metabolic syndrome [OR 1.13 (1.01-1.27) per event, p = 0.049]. In addition, a Poisson model showed a significant positive association between the number of stressful life events at baseline and the number of metabolic syndrome factors at follow-up [OR 1.05 (1.01-1.11) per event, p = 0.018]. Finally, we observed a significant association between the number of stressful life events at baseline and waist circumference at follow-up [adjusted for confounders β 0.86 (0.39-1.34) cm per event, p < 0.001]. Overall, we concluded that persons who reported more stressful life events at baseline had a significantly increased risk for developing metabolic syndrome during 6.5 years of follow-up, in a middle-aged and elderly population-based cohort.

Perceived weight discrimination and chronic medical conditions in adults with overweight and obesity

“…This finding is consistent with those reported by Meyer et al 35 that reported prejudice-related acute stress was associated with more general stressful life events and that racial/ethnic and sexual minority groups reported higher levels than their less socially disadvantaged counterparts. In addition to being linked with chronic medical conditions, [26][27][28] stressful life events have also been linked with increases in weight, BMI and waist circumference. 36,37 Our analyses revealed that after adjusting for stressful life events (in addition to BMI, sociodemographic variables and physical activity), perceived weight discrimination was no longer significantly associated with significantly elevated prevalence risk of high cholesterol and incidence of myocardial infarction.…”

“…Using the data from the National Survey of Alcohol and Related Conditions (NESARC), the current study examined whether perceived discrimination increased risk of reporting new diagnosis of chronic medical conditions. Given that stressful life events may also increase risk for cardiovascular conditions, metabolic conditions and arthritis, we additionally examined whether perceived weight discrimination confers an additional or unique contribution to observed associations with medical conditions. In addition to the analyses with a total sample, we completed gender‐stratified analyses to explore whether the patterns of associations between perceived weight discrimination and chronic medical conditions differed by gender.…”

Associations between Lifetime Adversity and Obesity Treatment in Patients with Morbid Obesity

“…the response to experience-based changes in cognitive, emotional and/or behavioral phenotypes [39]. Psychological stress has furthermore been associated with the development of metabolic syndrome and its components in prospective studies [19, 40]. The role of bariatric surgery in resetting biological alterations associated with long-term stress exposure is however not clear, and the potential mechanisms for weight regain after bariatric surgery remain unknown.…”

Environmental/lifestyle factors in the pathogenesis and prevention of type 2 diabetes

“…perceived stress. Thus, the results of cross-sectional or prospective studies on the association of stress with T2D have been variable [86–90]. However, a 35-year study of perceived stress in Swedish men reported a significant association with later diabetes, and a similar result was observed in persons with burn-out syndrome [91, 92].…”