One hundred bi- or homosexual men as well as 100 heterosexual men of similar age were asked about maternal stressful events that may have occurred during their prenatal life. A significantly increased incidence of prenatal stress was found in bisexual and, particularly, in homosexual men. This finding suggests that prenatal stress in males may represent a risk factor for the etiogenesis of sexual deviations in later life.
BackgroundEmerging data suggests that in sub-Saharan Africa β-cell-failure in the absence of obesity is a frequent cause of type 2 diabetes (diabetes). Traditional diabetes risk scores assume that obesity-linked insulin resistance is the primary cause of diabetes. Hence, it is unknown whether diabetes risk scores detect undiagnosed diabetes when the cause is β-cell-failure.AimsIn 528 African-born Blacks living in the United States [age 38 ± 10 (Mean ± SE); 64% male; BMI 28 ± 5 kg/m2] we determined the: (1) prevalence of previously undiagnosed diabetes, (2) prevalence of diabetes due to β-cell-failure vs. insulin resistance; and (3) the ability of six diabetes risk scores [Cambridge, Finnish Diabetes Risk Score (FINDRISC), Kuwaiti, Omani, Rotterdam, and SUNSET] to detect previously undiagnosed diabetes due to either β-cell-failure or insulin resistance.MethodsDiabetes was diagnosed by glucose criteria of the OGTT and/or HbA1c ≥ 6.5%. Insulin resistance was defined by the lowest quartile of the Matsuda index (≤ 2.04). Diabetes due to β-cell-failure required diagnosis of diabetes in the absence of insulin resistance. Demographics, body mass index (BMI), waist circumference, visceral adipose tissue (VAT), family medical history, smoking status, blood pressure, antihypertensive medication, and blood lipid profiles were obtained. Area under the Receiver Operator Characteristics Curve (AROC) estimated sensitivity and specificity of each continuous score. AROC criteria were: Outstanding: >0.90; Excellent: 0.80–0.89; Acceptable: 0.70–0.79; Poor: 0.50–0.69; and No Discrimination: 0.50.ResultsPrevalence of diabetes was 9% (46/528). Of the diabetes cases, β-cell-failure occurred in 43% (20/46) and insulin resistance in 57% (26/46). The β-cell-failure group had lower BMI (27 ± 4 vs. 31 ± 5 kg/m2P < 0.001), lower waist circumference (91 ± 10 vs. 101 ± 10cm P < 0.001) and lower VAT (119 ± 65 vs. 183 ± 63 cm3, P < 0.001). Scores had indiscriminate or poor detection of diabetes due to β-cell-failure (FINDRISC AROC = 0.49 to Cambridge AROC = 0.62). Scores showed poor to excellent detection of diabetes due to insulin resistance, (Cambridge AROC = 0.69, to Kuwaiti AROC = 0.81).ConclusionsAt a prevalence of 43%, β-cell-failure accounted for nearly half of the cases of diabetes. All six diabetes risk scores failed to detect previously undiagnosed diabetes due to β-cell-failure while effectively identifying diabetes when the etiology was insulin resistance. Diabetes risk scores which correctly classify diabetes due to β-cell-failure are urgently needed.
To identify determinants of daily life stress in Africans in America, 156 African-born Blacks (Age: 40 ± 10 years (mean ± SD), range 22–65 years) who came to the United States as adults (age ≥ 18 years) were asked about stress, sleep, behavior and socioeconomic status. Daily life stress and sleep quality were assessed with the Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI), respectively. High-stress was defined by the threshold of the upper quartile of population distribution of PSS (≥16) and low-stress as PSS < 16. Poor sleep quality required PSQI > 5. Low income was defined as <40 k yearly. In the high and low-stress groups, PSS were: 21 ± 4 versus 9 ± 4, p < 0.001 and PSQI were: 6 ± 3 versus 4 ± 3, p < 0.001, respectively. PSS and PSQI were correlated (r = 0.38, p < 0.001). The odds of high-stress were higher among those with poor sleep quality (OR 5.11, 95% CI: 2.07, 12.62), low income (OR 5.03, 95% CI: 1.75, 14.47), and no health insurance (OR 3.01, 95% CI: 1.19, 8.56). Overall, in African-born Blacks living in America, daily life stress appears to be linked to poor quality sleep and exacerbated by low income and lack of health insurance.
Introduction: Beyond the challenge of changing countries, cultures and continents, African-born Blacks living in the United States must cope with the stress of daily life. We assessed daily life stress and evaluated the influence of sleep as well as key socioeconomic and behavioral factors in 156 African-born Blacks (Age: 40±10y (mean±SD), BMI: 27.6±4.2 kg/m 2 , Male: 60%) who came to the United States as adults (≥age 18y). Methods: Daily life stress was assessed with the Perceived Stress Scale 10 (PSS) (range 0 to 40). Stressed was defined as the PSS threshold at the upper quartile for the population distribution (≥16) and Non-Stressed as PSS<16. Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI) (range 0 to 21). Poor Sleep Quality was defined by traditional criteria, specifically PSQI>5. Logistic regression was used to determine the odds of being Stressed because of: Poor Sleep Quality, low income (<40k/y), no health insurance, no college degree, no life partner, smoking, alcohol consumption, sedentary behavior and United States residency≥10y. Results: In the Stressed vs. Non-Stressed, PSS were: 21±4 vs. 9±4, P <0.001 and PSQI were: 6±3 vs. 4±3, P <0.001, respectively. The Pearson correlation coefficient for the relationship between PSS and PSQI was: r=0.38, P <0.001. The odds of being Stressed were significant if income was low (OR 7.1, P <0.001), health insurance was absent (OR 4.7, P <0.001), the person had no life partner (OR 2.5, P =0.017), or was a smoker (OR 5.6, P =0.023). United States residence≥10y tended to decrease the odds of being in the Stressed category (OR 0.5, P =0.058). Of note, the group with United States residence≥10y had a higher rate of income≥40k than the group with US residence<10y (71% vs. 32%, P <0.001). Conclusions: Daily life stress in African-born Blacks is closely tied to poor sleep quality and exacerbated by low income, lack of health insurance and no life partner. The decreased stress associated with longer duration of United States residence may be due to better economic status.
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