Epidemiology of Stress and the Metabolic Syndrome
Epidemiology of Stress and the Metabolic Syndrome
To examine the effects of psychological stress on the metabolic syndrome.
BACKGROUND:

 The metabolic syndrome identifies the clustering of lipid abnormalities, hypertension,
 hyperglycemia and abdominal obesity. It is a common and strong contributor to heart disease
 and diabetes and disproportionably affects older persons. Animal and small clinical studies
 have suggested that psychosocial stress is a risk factor for the metabolic syndrome.
 Underlying mechanisms may be through activation of the hypothalamopituitary-adrenal (HPA)
 axis causing hypercortisolemia, and, partly in turn, elevated inflammation and decreased sex
 hormone levels. However, longitudinal data showing that psychosocial stress indeed
 contributes to the onset and sequelae of the metabolic syndrome in the population at large,
 are lacking.

 DESIGN NARRATIVE:

 The primary objectives are to conduct data-analyses and biological sample analyses to examine
 the effect of psychosocial stress, as indicated by mood problems (depressive symptoms) and
 stressful social circumstances (poverty, negative life events, occupational stress, lack of
 emotional support), on the onset and sequelae of the metabolic syndrome. Secondary objectives
 are to examine underlying biological mechanisms in the effect of psychosocial stress on the
 metabolic syndrome. The investigators will use available data from two ongoing longitudinal
 community-based studies among older persons: the Health Aging and Body Composition (Health
 ABC) study (n=3,075, mean age=74 years, 52%=female, 42% African American) and the InChianti
 study (n=1,453, mean age=69 years, 56%=female). In both studies psychosocial stress and the
 metabolic syndrome are well defined, longitudinal data on sequelae (CVD events and diabetes
 onset) and onset of the metabolic syndrome are available, and potentially underlying
 biological variables were, or will be, assessed including 24-h urinary cortisol, serum sex
 steroid hormones (estradiol, testosterone, SHBG, DHEAS) and inflammatory markers (IL-6,
 IL-10, TNF-alpha, CRP, and various soluble cytokine receptors). The results of this study
 will help in designing future intervention trials that evaluate whether reducing stress
 and/or its physiological consequences, either by pharmacological treatment or behavioral
 intervention, could reduce incidence of the metabolic syndrome in the older general
 population.
Age >70 years Community swelling