Emotional distress increases diabetes risk in men
Israeli army recruits who report experiencing emotional distress are more likely to develop incident diabetes when compared with men who do not report distress, according to research in American Journal of Preventive Medicine.
Emotional distress was found in 4.1% of the cohort and increased the risk for incident diabetes by 1.53-fold, independent of other known clinical and biochemical diabetes risk factors,” Gilad Twig, MD, PhD, of the department of medicine at Chaim Sheba Medical Center in Israel, and colleagues wrote. “When emotional distress persisted in two consecutive visits, cumulative diabetes incidence exceeded 15%, whereas normalization of the distress level restored the diabetes incidence to levels similar to those without distress.”
Researchers analyzed data from 32,586 men without diabetes participating in the Metabolic, Lifestyle and Nutrition Assessment in Young Adults (MELANY) study, an ongoing prospective study in Israel assessing the effect of clinical and biochemical parameters on cardiometabolic morbidity (mean age, 31 years). The cohort was followed between 1995 and 2011 (mean follow-up, 6.3 years). Participants provided blood samples and completed a questionnaire that included the question, “Are you preoccupied by worries or concerns that affect your overall wellbeing?” Researchers used time-dependent Cox regression analysis to estimate hazard ratios for diabetes after adjustment for age, and again after adjusting for additional risk factors, including genetic, lifestyle-related, metabolic and psychosocial characteristics.
Within the cohort, 723 men developed diabetes during 206,382 person-years; 1,341 participants reported emotional distress at initial screening. The incident rate for diabetes among men reporting no emotional distress was 3.32 cases per 1,000 person-years vs. 6.35 cases per 1,000 person-years for men who did report emotional distress; the difference persisted after adjustment for genetic, lifestyle and metabolic risk factors for diabetes.
Emotional distress was strongly associated with incident diabetes (HR = 1.53; 95% CI, 1.08-2.18) after adjusting for age, BMI, fasting plasma glucose, family history, lipid profile, cognitive performance, white blood cell count, physical activity and sleep quality.
In an analysis of men who reported emotional distress at two time points (n = 10,709), 8,935 men denied emotional distress in both screenings; 117 men confirmed distress in both screenings. Men reporting emotional distress in both visits had a higher likelihood of incident diabetes (HR = 2.14; 95% CI, 1.04-4.47) when compared with men who persistently denied distress.
When researchers treated distress as a time-dependent variable, there was a higher likelihood of diabetes among those reporting distress after adjusting for BMI, physical activity and smoking status (HR = 1.66; 95% CI, 1.21-2.17)