Are psychological characteristics related to risk of the metabolic syndrome? A review of the literature

Personality and the physician-patient relationship as predictors of quality of life of cardiac patients after rehabilitation

BACKGROUND

Numerous studies document the influence of psychosocial variables on the course of coronary heart disease. This study examines the influence of personality traits (trait anger, cynicism) and aspects of the physician-patient relationship (promoting patient participation by the physician, active communication behavior of the patient, trust in the physician) on the health related quality of life (HRQOL) of cardiac patients after rehabilitation.

METHODS

N = 331 patients with chronic ischemic heart disease were surveyed using questionnaires at two time points (beginning and end of 3-weeks inpatient rehabilitation). In addition, characteristics of the disease and cardiac risk factors were provided by the physician. HRQOL was measured using a total of six scales and three instruments: SF-12, MacNew questionnaire, and SAQ. Hierarchical regression analyses were carried out to predict HRQOL after rehabilitation, in which the baseline values of HRQOL, sociodemographic variables, characteristics of the disease and risk factors, personality traits, and finally the aspects of the physician-patient relationship were included stepwise. As a number of variables were used for the regression models, multiple imputation was conducted.

RESULTS

The baseline values explain most of the variance (42%-60%). After controlling the baseline values, the sociodemographic variables explain up to 5% incremental variance of HRQOL, with income being the most important predictor. The characteristics of the disease and cardiac risk factors explain between 0.4% and 3.8% incremental variance, however, variance increase is often not significant. The personality traits added in the fourth step explain up to 2% additional variance; trait anger is a significant predictor of HRQOL in three of the six scales. The features of the physician-patient relationship included in the last step lead to a significant increase in explained variance (between 1.3% and 3.9%) for all six scales. In particular, the physician's promotion of patient participation has a significant influence. The overall explanation of variance for HRQOL is between 50% and 64%.

CONCLUSIONS

Low income, a high level of trait anger, and low patient participation are significant risk factors, even if a number of potential confounders are adjusted. Research is needed that shows which causal pathway low income functions on and what therapies in rehabilitation can mitigate the disadvantage of persons with a high level of trait anger. The providers should implement measures to actively integrate rehabilitation patients in treatment (e.g. encourage them to ask questions).

Prevalence of neck pain in subjects with metabolic syndrome--a cross-sectional population-based study

BACKGROUND

Metabolic syndrome (MetS) is increasingly common. Obesity has been suggested to associate with neck pain but prevalence of neck pain in subjects with MetS has not been studied. Aim of this study was to analyse the association between MetS and neck pain.

METHODS

The study population consisted of 1294 middle-aged subjects in Pieksämäki, Finland. A total of 399 males and 500 females participated (69%). The mean age of both males and females was 46 years. Clinical and biochemical measurements were taken. The participants filled out a standard questionnaire. Psychological distress was assessed with the 12-item General Health Questionnaire (GHQ-12). Neck pain was defined as neck pain perceived daily. MetS was defined using National Cholesterol Education Program (NCEP) criteria. Statistical comparisons between the groups were performed using a bootstrap-type t-test or Chi-Square test. Risk ratios of having neck pain were calculated using generalised linear models with age, smoking, alcohol use, exercise and GHQ-12 score as covariates.

RESULTS

The prevalence of MetS was 33% in males and 29% in females. Neck pain was present in 11% (N = 42) of males and 19% (N = 93) of females (P < 0.001). The prevalence of neck pain was 7.9% (95% CI, 4.9% to 12%) among male subjects without MetS and 16% (95% CI, 10% to 23%) among those with MetS. The respective proportions among females were 16% (95% CI, 12% to 20%) and 25% (95% CI, 18% to 33%). The multivariate analysis showed an increased risk of neck pain in males with MetS (RR 2.1, 95% CI, 1.2 to 3.7, P = 0.010) and in females with MetS (RR 1.5, 95% CI, 1.0 to 2.1, P = 0.040).

CONCLUSIONS

MetS was associated with neck pain. This association was stronger in males, but the prevalence of neck pain was higher in females. Prospective studies should explore the potential causal association between neck pain and MetS and the potential common background factors of neck pain and MetS.

Diet choice, cortisol reactivity, and emotional feeding in socially housed rhesus monkeys

Chronic psychosocial stress produces an array of adverse health consequences that are highly comorbid, including emotional eating, affective disorders, and metabolic syndrome. The consumption of high caloric diets (HCDs) is thought to provide comfort in the face of unrelenting psychosocial stress. Using social subordination in female rhesus monkeys as a model of continual exposure to daily stressors in women, we tested the hypothesis that subordinate females would consume significantly more calories from a HCD compared to dominant females, and this pattern of food intake would be associated with reduced cortisol release and reduced frequency of anxiety-like behaviors. Food intake, parameters of cortisol secretion, and socio-emotional behavior were assessed for 3 weeks during a no choice phase when only a low caloric diet (LCD) was available and during a choice condition when both a LCD and HCD were available. While all animals preferred the HCD, subordinate females consumed significantly more of the HCD than did dominant females. A flattening of the diurnal cortisol rhythm and a greater increase in serum cortisol to an acute social separation occurred during the diet choice condition in all females. Furthermore, the rate of anxiety-like behavior progressively declined during the 3-week choice condition in subordinate but not dominant females. These data provide support for the hypothesis that daily exposure to psychosocial stress increases consumption of calorically dense foods. Furthermore, consumption of HCDs may be a metabolic stressor that synergizes with the psychosocial stress of subordination to further increase the consumption of these diets.

Leptin-deficient mice retain normal appetitive spatial learning yet exhibit marked increases in anxiety-related behaviours

RATIONALE

The individual's emotional state influences food intake in both humans and rodents. Moreover, specific cognitive processes regulating the salient aspects of food reward are also critical for ingestive behaviour. However, the molecular mechanisms underlying such influence remain unclear. Genetic mouse models thus are important tools in dissecting the molecular and pathophysiological processes which cause complex human diseases. Leptin, encoded by the ob gene, plays an important part in the energy homeostasis and is critical for the development of obesity.

OBJECTIVES

In these studies, we assess the impact of leptin on behaviours relevant to anxiety and appetitive learning.

METHODS

Anxiety-related behaviour was assessed in the light dark box and two tests of hyponeophagia. Spatial learning and behavioural flexibility by re-learning was assessed in an appetitive Y-maze task.

RESULTS

Leptin-deficient (ob/ob) mice displayed higher levels of anxiety-related behaviour in both anxiety tests. In the appetitive Y-maze task, leptin deficiency caused no deficit in learning or re-learning and acute restrained stress had no influence on the learning process.

CONCLUSIONS

These results emphasise that whilst leptin has previously been shown to modulate aversively motivated learning we found no difference between leptin-deficient mice and their controls in an appetitive learning task. Moreover, both groups showed behavioural flexibility under stressful conditions. On the other hand, leptin deficiency resulted in marked alterations in behaviours relevant to anxiety.

Associations of depressive symptoms, trait hostility, and gender with C-reactive protein and interleukin-6 response after emotion recall

OBJECTIVE

To examine the effects of depressive symptoms and hostility on changes in C-reactive protein (CRP) and interleukin (IL)-6 in response to an acute laboratory stressor. Depressive symptoms moderate the effect of trait hostility on circulating levels of CRP and IL-6.

METHODS

The study included 307 men and 218 women, affording the opportunity to examine moderation by gender. Regression analyses were performed to examine depressive symptoms, hostility ratings, gender, and their interactions as predictors of CRP and IL-6 response to an emotion recall task. Analyses were adjusted for age, race, body mass index, and prerecall task levels of either CRP or IL-6.

RESULTS

The product term for Depressive Symptoms x Hostility x Gender was not significantly related to CRP nor IL-6 response. However, Depressive Symptoms x Hostility did interact to predict CRP response (p = .002); those with the combination of high symptoms of depression and hostility had the largest CRP response. The Depressive Symptoms x Gender interaction was also a predictor of both CRP (p = .001) and IL-6 (p = .04) response; for each inflammatory marker, depressive symptoms were significantly associated with higher CRP response in women, as compared with men. Hostility did not moderate depressive symptoms, nor gender for IL-6.

CONCLUSIONS

Our findings extend prior research by suggesting that, broadly speaking, depression is related to inflammatory markers; however, this relationship seems complex. Depression seems to be related to inflammation more strongly among hostile individuals and more strongly among women than among men.

Sense of mastery and metabolic risk: moderating role of the local fast-food environment

OBJECTIVE

To test the moderating role of the extent of fast-food restaurants in one's immediate environment in the association between mastery and metabolic risk. Higher sense of mastery (perceived control over one's circumstances) has been associated with better metabolic outcomes. Mastery may be instrumental in resisting unhealthful environmental food cues when these become ubiquitous, resulting in a greater health impact of mastery.

METHODS

Blood samples were obtained from 344 individuals (50% men), aged 18 to 57 years (mean, 34.9 years), sampled from seven census tracts representing the spectrum of census tract-level socioeconomic status and language (French/English) in Montreal. Risk factors based on standards for high-density lipoprotein and total cholesterol, waist circumference, body mass index, triglycerides, and glycated hemoglobin were summed to obtain a cumulative metabolic risk score. Mastery was self-reported, using a validated scale. The proportion of restaurants classified as fast-food within 500 m of participants' residences was determined, using a geographic information system. Main and interactive effects were tested with Poisson regression, accounting for clustering of observations and participants' age, gender, education, and income.

RESULTS

Mastery interacted with fast-food exposure in relation to metabolic risk (p = .03). Higher mastery was significantly associated with lower metabolic risk for participants surrounded by a high proportion of fast food (relative risk, 0.80; 95% confidence interval, 0.76-0.84; p < .0001), but not for those living in areas with low proportion of fast-food restaurants (relative risk, 0.94; 95% confidence interval, 0.82-1.08; p = .37).

CONCLUSIONS

A positive relationship between mastery and lower metabolic risk was most apparent in environments with higher fast-food exposure.

The interactive effects of metabolic syndrome, blood pressure, and mental health in worksite employees

BACKGROUND

Cardiovascular disease (CVD), CVD-related conditions, and mental health disorders are prevalent in the US workforce. We examined associations between metabolic syndrome (METS), blood pressure (BP), and mental health indicators in 1813 employees (25.4% women; 74.6% men) from a large manufacturing firm.

METHODS

Employees participated in a health screen. Biometric measures were body mass index, waist circumference, BP, and fingerstick determinations of blood lipid-lipoproteins and glucose. Mental health was assessed with 5 self-reported questions regarding anger, depression, anxiety, and family and work stress. Multivariate analysis of covariance tested for differences in BP and mental health indicators in employees (370 employees with METS, and 1443 employees without).

RESULTS

Participants were primarily middle-aged (44.8 +/- 0.3 years), overweight (27.9 +/- 0.1 kg/m(2)) men (n = 1352) and women (n = 461) with a resting BP of 122.5 +/- 0.3 mm Hg and 79.8 +/- 0.2 mm Hg, respectively. Diastolic BP (DBP) was found to be 5 mm Hg higher in men with METS compared with men who did not have METS. When questioned, men with higher DBP stated that they often experienced anxiety (n = 39; 91.0 +/- 2 mm Hg) compared with men who reported they rarely experienced anxiety (n = 112; 86.2 +/- 1.9 mm Hg) (P = 0.020). Similarly, systolic BP (SBP) tended to be 4 mm Hg higher in men with METS who stated they often experienced anxiety (n = 39; 138.9 +/- 2 mm Hg) compared with men who reported they rarely experienced anxiety (n = 112; 134.5 +/- 1.2 mm Hg) (P = 0.119). Diastolic BP tended to be 2 mm Hg higher among men with METS who stated they often experienced anger (n = 117; 89.4 +/- 0.9 mm Hg) compared with those who indicated they rarely experienced anger (n = 157; 87.3 +/- 0.8 mm Hg) (P = 0.086), and DBP was 3 mm Hg higher in men with METS who reported overwhelming work stress (n = 83; 89.7 +/- 1.1 mm Hg) compared with those reporting little work stress (n = 79; 86.6 +/- 1.2 mm Hg) (P = 0.176). In contrast, no associations were found between BP and mental health in men without METS, and in women, regardless of the presence or absence of METS (P > 0.05).

CONCLUSIONS

Men with METS who reported higher levels of anxiety, anger, and work stress had higher BP than men without METS, who also reported lower levels of these mental health indicators. The METS appeared to adversely interact with BP and mental health in men at this worksite. Our findings suggest worksite health promotion programs can improve the cardiometabolic and mental health profile of US employees.

Functional polymorphisms in the serotonin 1B receptor gene (HTR1B) predict self-reported anger and hostility among young men

We examined associations between haplotypes of the serotonin 1B receptor gene and individual differences in anger and hostility. Data were analyzed from a study of 361 university students (47% male). Participants were genotyped at five polymorphisms in the HTR1B gene (rs11568817, rs130058, rs6296, rs6297, rs13212041), including promoter and 3'UTR polymorphisms with opposite functional effects on gene expression. Participants reported their emotional states across 30 consecutive days for up to 4 years. Haplotype pairs were constructed statistically and assigned to a level of HTR1B expression based on the presence of the functional polymorphisms. Six haplotypes accounted for >97% of chromosomes. Three low expression haplotypes contained the 3'UTR variant (rs13212041 A-allele) that enables a microRNA-mediated reduction in expression. One intermediate expression haplotype contained the 3'UTR A-allele paired with the high-activity promoter. Two high expression haplotypes contained the 3'UTR variant (rs13212041 G-allele) that attenuates microRNA-mediated reduction in expression. Men with low expression haplotypes reported greater anger and hostility than men with one or two high expression haplotypes. Diplotype classification accounted for 8.4% of the variance in men's anger and hostility, primarily due to the 3'UTR polymorphism (rs13212041), but with some contribution of the functional promoter combination (rs11568817, rs130058). Associations with anger and hostility were not found in women. These findings extend our understanding of the genetic basis of anger and hostility by showing that newly characterized HTR1B haplotypes, particularly those with rs13212041, which modulates microRNA-mediated regulation of HTR1B expression, may have important implications for aggression-related phenotypes among young men.

Physical, psychological, and functional comorbidities of multisymptom illness in Australian male veterans of the 1991 Gulf War

Multisymptom illness is more prevalent in 1991 Gulf War veterans than in military comparison groups; less is known about comorbidities. The authors compared physical, psychological, and functional comorbidities in Australian male Gulf War I veterans with those in actively (non-Gulf) deployed and nondeployed military personnel by using a questionnaire and medical assessment in 2000-2002. Multisymptom illness was more common in male Gulf War veterans than in the comparison group (odds ratio (OR) = 1.80, 95% confidence interval (CI): 1.48, 2.19). Stratifying by deployment status in the comparison group made little difference in this association. Gulf War veterans with multisymptom illness had increased psychiatric disorders, including major depression (OR = 6.31, 95% CI: 4.19, 9.52) and posttraumatic stress disorder (OR = 9.77, 95% CI: 5.39, 18.59); increased unexplained chronic fatigue (OR = 13.32, 95% CI: 7.70, 23.05); and more reported functional impairment and poorer quality of life, but objective physical and laboratory outcomes were similar to those for veterans without multisymptom illness. Similar patterns were found in the comparison groups; differences across the 3 groups were statistically significant for only hospitalization, obstructive liver disease, and Epstein-Barr virus exposure. Multisymptom illness is more prevalent in Gulf War I veterans, but the pattern of comorbidities is similar for actively deployed and nondeployed military personnel.

Serotonin 5-HT(2A) Receptor Function as a Contributing Factor to Both Neuropsychiatric and Cardiovascular Diseases

There are high levels of comorbidity between neuropsychiatric and cardiovascular disorders. A key molecule central to both cognitive and cardiovascular function is the molecule serotonin. In the brain, serotonin modulates neuronal activity and is actively involved in mediating many cognitive functions and behaviors. In the periphery, serotonin is involved in vasoconstriction, inflammation, and cell growth, among other processes. It is hypothesized that one component of the serotonin system, the 5-HT(2A) receptor, is a common and contributing factor underlying aspects of the comorbidity between neuropsychiatric and cardiovascular disorders. Within the brain this receptor participates in processes such as cognition and working memory, been implicated in effective disorders such as schizophrenia, and mediate the primary effects of hallucinogenic drugs. In the periphery, 5-HT(2A) receptors have been linked to vasoconstriction and hypertension, and to inflammatory processes that can lead to atherosclerosis.

Generalized anxiety disorder is associated with metabolic syndrome in the Vietnam experience study

BACKGROUND

Few studies have explored the relationship between major mental health disorders and metabolic syndrome (MetS), although both have been linked to cardiovascular disease. The present study examined the cross-sectional associations of major depressive disorder (MDD) and generalized anxiety disorder (GAD) with MetS in a large study of male US veterans.

METHODS

The analyses were cross-sectional. Participants (n = 4256) were drawn from the Vietnam Experience Study. From military service files, telephone interviews, and a medical examination, occupational, socio-demographic, and health data were collected. One-year prevalence of MDD and GAD was determined with DSM-III criteria. Metabolic syndrome was ascertained from data on: body mass index, fasting blood glucose or a diagnosis of diabetes, blood pressure, high-density lipoprotein cholesterol, and triglyceride levels.

RESULTS

In models that adjusted for age (p = .01) and additionally for place of service, ethnicity, marital status, smoking, alcohol consumption, IQ at enlistment, household income in midlife, and education grade achieved (p = .02), GAD was positively associated with MetS. Major depressive disorder was not related to MetS.

CONCLUSIONS

Depression has very much been the focal condition for studies on mental health and physical health outcomes. The current data suggest that future research should perhaps pay equal attention to GAD.

No association of depression and anxiety with the metabolic syndrome: the Norwegian HUNT study

OBJECTIVE

To examine the associations of depression and anxiety with the metabolic syndrome.

METHOD

Cross-sectional study of 9571 participants aged 20-89 years in the Nord-Trøndelag Health Study (HUNT 2). We assessed anxiety and depression with the Hospital Anxiety and Depression Scale and the metabolic syndrome with the International Diabetes Federation criteria.

RESULTS

Despite generous statistical power and use of both continuous and categorical approaches, we found no association between anxiety or depression and the metabolic syndrome in models adjusted for age, gender, educational level, smoking, physical activity and pulse rate. When adjusted for age and gender only, we found a weak positive association for depression when a continuous measure was used, but not at the case level. The findings were similar across sexes, and robust for exclusion of cardiovascular disease and antidepressants.

CONCLUSION

In this largest study to date we found no association of anxiety and depression with the metabolic syndrome.

Metabolic syndrome in the pediatric population: a short overview

The metabolic syndrome (MS) in adults is defined as a concurrence of obesity, disturbed glucose and insulin metabolism, hypertension and dyslipidemia, and is associated with increased morbidity and mortality from cardiovascular diseases and type 2 diabetes. Studies now indicate that many of its components are also present in children and adolescents. Moreover, the clustering of these risk factors has been documented in some children, who are at increased cardiovascular risk in adulthood. The MS is highly prevalent among overweight children and adolescents. Identifying these children is important for early prevention and treatment of different components of the syndrome. The first-line treatment comprises lifestyle modification consisting of diet and exercise. The most effective tool for prevention of the MS is to stop the development of childhood obesity. The first attempt at consensus-based pediatric diagnostic criteria was published in 2007 by the International Diabetes Federation. Nevertheless, national prevalence data, based on uniform pediatric definition, protocols for prevention, early recognition and effective treatment of pediatric MS are still needed.The aim of this article is to provide a short overview of the diagnosis and treatment options of childhood MS, as well as to present the relationships between MS and its individual components.

Body composition in psychotic disorders: a general population survey

BACKGROUND

The literature suggests an association between obesity and schizophrenia but fat mass and fat-free mass, which have been shown to be more predictive of all-cause mortality than only waist circumference and obesity [body mass index (BMI) 30 kg/m2], have not been reported in psychotic disorders. We examined the detailed body composition of people with different psychotic disorders in a large population-based sample.

METHOD

We used a nationally representative sample of 8082 adult Finns aged 30 years with measured anthropometrics (height, weight, waist circumference, fat percentage, fat-free mass and segmental muscle mass). Psychiatric diagnoses were based on a consensus procedure utilizing the Structured Clinical Interview for DSM-IV (SCID)-interview, case-notes and comprehensive register data.

RESULTS

Schizophrenia (including schizo-affective disorder) was associated with obesity [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.5-3.6], abdominal obesity (waist circumference 88 cm for women, 102 cm for men) (OR 2.2, 95% CI 1.3-3.6) and with higher fat percentage (mean difference 3.8%, 95% CI 2.0-5.7%), adjusted for age and gender, than in the remaining sample. The associations between schizophrenia and low fat-free mass and decreased muscle mass on trunk and upper limbs became statistically significant after adjusting for BMI. After further adjusting for current antipsychotic medication, education, diet and smoking, schizophrenia remained associated with obesity (OR 1.9, 95% CI 1.1-3.6) and abdominal obesity (OR 3.8, 95% CI 1.5-9.4). Participants with affective psychoses did not differ from the general population.

CONCLUSIONS

Individuals with schizophrenia have metabolically unfavorable body composition, comprising abdominal obesity, high fat percentage and low muscle mass. This leads to increased risk of metabolic and cardiovascular diseases.

Phobic anxiety is associated with higher serum concentrations of adipokines and cytokines in women with diabetes

OBJECTIVE

Phobic anxiety has been associated with increased risk of cardiovascular disease (CVD), but the underlying mechanisms are poorly understood. We aimed to determine whether associations of phobic anxiety with several known markers of CVD might be contributors.

RESEARCH DESIGN AND METHODS

We used a 16-point validated index (Crown-Crisp) measured in 1988 to categorize 984 women with type 2 diabetes from the Nurses' Health Study as having low, moderate, or high phobic anxiety. Groups were then compared for differences in adipokines (adiponectin and leptin), inflammatory markers (C-reactive protein and tumor necrosis factor [TNF]-alpha receptor II), and markers of endothelial function (sE-selectin, soluble intercellular adhesion molecule [sICAM]-1) measured on blood samples provided between 1989 and 1990.

RESULTS

Higher levels of phobic anxiety were associated with higher BMI and lower education. Higher levels of phobic anxiety were also associated with higher leptin and soluble TNF-alpha receptor II in both crude analyses and after adjustment for potential confounders. sICAM and sE-selectin were higher in the highest tertile compared with the middle tertile, but there was no significant trend across tertiles. We found no association between phobic anxiety and adiponectin.

CONCLUSIONS

High levels of phobic anxiety are associated with increased levels of leptin and inflammatory markers, which may in part explain the previously observed relationship between anxiety and other psychosocial disorders with CVD.

Lifetime history of major depression predicts the development of the metabolic syndrome in middle-aged women

OBJECTIVE

To prospectively examine the association of major depression with incidence of the metabolic syndrome in women.

METHODS

Data were drawn from one of seven sites of the Study of Women's Health Across the Nation (SWAN), a prospective cohort study of the menopausal transition. Participants were 429 (34.5% African-American) women. Major depression and comorbid diagnoses were assessed via the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I Disorders at baseline and seven annual follow-up evaluations. The metabolic syndrome was measured at baseline and each follow-up evaluation (except the second) based on National Cholesterol Education Program (NCEP) criteria.

RESULTS

Longitudinal generalized estimating equations (GEE) models indicated that, in women who were free of the metabolic syndrome at baseline, a lifetime major depression history or current major depressive episode at baseline was significantly associated with the onset and presence of the metabolic syndrome during the follow-up (odds ratio = 1.82; 95% Confidence Interval (CI) = 1.06-3.14). Survival analyses showed that, in women who were free of the metabolic syndrome at baseline, a lifetime major depression history or current major depressive episode at baseline predicted increased risk of developing the metabolic syndrome during the follow-up (hazard ratio = 1.66; 95% CI = 0.99-3.75). Lifetime history of alcohol abuse or dependence predicted incident metabolic syndrome and attenuated the association between depression and the metabolic syndrome in both models.

CONCLUSIONS

This study documents that major depression is a significant predictor of the onset of the metabolic syndrome. Intervention studies targeting depression may prevent the development of the metabolic syndrome in women.

Association between socioeconomic status and metabolic syndrome in women: testing the reserve capacity model

OBJECTIVE

Low socioeconomic status (SES) environments may impede the development of a bank of resources, labeled reserve capacity, and may also be stressful, thereby depleting available reserves. In consequence, lower SES persons may experience more negative emotions, leading to adverse health consequences. The authors tested the reserve capacity model in relation to the metabolic syndrome.

DESIGN

There were 401 initially healthy women who followed longitudinally for 12 years. Self-reported characteristics, stressors, and cardiovascular risk factors were measured repeatedly. Structural equation modeling was used to evaluate hypothesized relationships.

MAIN OUTCOME MEASURE

Metabolic syndrome factor.

RESULTS

Confirmatory factor analysis verified reserve capacity as the aggregate of optimism, self-esteem, and social support, and negative emotion as the aggregate of depressive symptoms, anger, and tension. Structural equation modeling showed two pathways to the metabolic syndrome factor, (chi2(59) = 111.729, p < .0001 chi2/df = 1.894; CFI = .956; RMSEA = .047): direct from low SES to the metabolic syndrome factor (B = -0.19, t = -3.24, p = .001); and indirect, from low SES to low reserve capacity to high negative emotions to the metabolic syndrome factor (B = -0.024, t = -2.05, p = .04).

CONCLUSION

Low SES may increase risk for metabolic syndrome, in part, through reserve capacity and negative emotions.

Individual and area-based indicators of acculturation and the metabolic syndrome among low-income Mexican American women living in a border region

OBJECTIVES

We sought to examine the relationships between individual and area-based indicators of acculturation and metabolic syndrome (MetS) risk among a sample of Mexican American women living in the California-Baja California border region.

METHODS

We examined data collected between October 2003 and December 2004 from 141 women (mean age = 47.07 years) who completed physical and psychosocial assessments. We reviewed medical records for laboratory values.

RESULTS

Individual-level US acculturation was associated with a greater consumption of fruits, vegetables, and fiber; increased odds of engaging in health-enhancing levels of physical activity; and decreased odds of meeting the clinical criteria for MetS. Moreover, beyond the influence of individual-level factors, US neighborhood acculturation was associated with less fat intake.

CONCLUSIONS

These findings provide preliminary evidence for a relationship between acculturation and the development of MetS in this population. Such information may assist efforts aimed at understanding and eliminating ethnic disparities in MetS risk and related health conditions.