Cumulative psychological stress may increase diabetes risk in women

CHICAGO — Cumulative psychological stress was associated with incident diabetes independent of traditional CVD risk factors, according to findings presented at the American Heart Association Scientific Sessions.

“Chronic and acute stressors, referred to as ‘cumulative stress,’ is associated with higher cardiovascular disease risk,” Jonathan Z. Butler, PhD, of the University of California, San Francisco, and colleagues wrote in an abstract. “However, the relationship between cumulative stress and incident diabetes, a CVD risk equivalent in older women, is unknown.”

To examine the prospective relationship between type 2 diabetes and cumulative stress, researchers used data from 22,706 women with no apparent CVD participating in the Women’s Health Study.

Researchers defined cumulative stress as a combination of acute stressors (such as negative and traumatic life events) and chronic stressors (such as work stress, work-family spillover, financial stress, discrimination, relationship stress and neighborhood stress).

Cumulative stress was divided into quartiles and the researchers assessed the association between these quartiles and risk for incident diabetes.

The women were followed up for a mean of 2.95 years. During this time, 197 developed diabetes.

In models adjusted for age, race/ethnicity and socioeconomic status, researchers found that increasing quartiles of cumulative stress were associated with increasing risk for incident diabetes (HR for quartile 2 vs. quartile 1 = 1.95; 95% CI, 1.17-3.27; HR for quartile 3 vs. quartile 1 = 2.82; 95% CI, 1.59-4.99; HR for quartile 4 vs. quartile 1 = 2.51; 95% CI, 1.36-4.65).

After further controlling for CVD risk factors, the relationship between stress and incident diabetes remained, albeit the confidence interval included 1 in quartile 4 (HR for quartile 2 vs. quartile 1 = 1.78; 95% CI, 1.05-3.03; HR for quartile 3 vs. quartile 1 = 2.48; 95% CI, 1.37-4.47; HR for quartile 4 vs. quartile 1 = 1.89; 95% CI, 1-3.58).

“In older women participating in the Women’s Health Study, cumulative psychological stress was significantly associated with incident diabetes, independent of traditional CVD risk factors,” the researchers concluded. – by Melissa J. Webb

Reference:

Butler JZ, et al. Poster Sa1103. Presented at: American Heart Association Scientific Sessions; Nov. 10-12, 2018; Chicago.

Disclosures: The study was funded by grants from the NHLBI, National Institute on Aging and National Cancer Institute. One author reports receiving a research grant from the Iowa Research Institute. The other authors report no relevant financial disclosures.