Anger, adiposity, and glucose control in nondiabetic adults: findings from MIDUS II

Abstract

OBJECTIVE Anger has been linked to cardiovascular disease, but few studies have examined the relationship between anger and type 2 diabetes. The aim was to investigate associations among different indicators of anger expression, adiposity, and nondiabetic glucose metabolism in a national survey of adults. RESEARCH DESIGN AND METHODS Participants were 939 adults without diabetes in the Midlife in the US study (MIDUS II). Glucose metabolism was characterized by fasting glucose, insulin, insulin resistance, and glycosylated hemoglobin (HbA1c). Spielberger’s Anger Expression inventory was used to measure suppressed anger (anger-in), expressed anger (anger-out), and controlled anger (anger-control). We investigated the relationship between anger and glucose metabolism, and whether anger amplified the adverse relationship between body weight distribution (body mass index=BMI and waist-to-hip ratio=WHR) and glucose metabolism. RESULTS Multivariate-adjusted analyses revealed an association between anger-out and both insulin and insulin resistance. As predicted, anger-in amplified the relationships between BMI and insulin and insulin resistance, while anger-out amplified the association between WHR and insulin and insulin resistance. Low anger-control was associated with higher glucose. None of the three anger measures was significantly associated with HbA1c. CONCLUSIONS Our findings extend previous research on anger as a potential risk factor for type 2 diabetes by demonstrating that anger expression is associated with clinical indicators of glycemic control, especially among those with pre-existing risk due to obesity and high central adiposity.

Synergistic Effect of Neuroticism and Body Mass Index on Glucose Metabolism in Nondiabetic Adults

“…While previous studies by our research group and others [5–8] have shown that the combined influences of obesity and psychosocial variables are associated with higher glucose and HbA 1c , no relationships were detected for glucose or HbA 1c in the present study. The overall pattern of findings underscore the fact that these four clinical indicators of glucose regulation track different steps in the progression from normoglycemia to disease [25].…”

“…Our findings extend previous work showing that other psychosocial vulnerability factors such as stress-induced catecholamine release, perceived discrimination, anger expression, and work stress interact with BMI and central adiposity to predict different clinical indicators of glucose metabolism [5–8]. Taken together, these lines of inquiry suggest that overweight and obese people, who are already at a higher risk for disease due to increased production of free fatty acids and pro-inflammatory cytokines by adipose tissue [26], may be more susceptible to the effects of psychosocial vulnerabilities on clinical indicators of glucose metabolism.…”

“…While more than 80% of people with type 2 diabetes are obese, most obese people never develop diabetes [4], suggesting that other factors are involved, possibly in combination with body mass index (BMI), to influence the preclinical progression to type 2 diabetes. Increasing evidence shows that psychosocial vulnerability factors, such as stress-induced catecholamine release, perceived discrimination, work stress, and anger, moderate the effects of BMI and central adiposity on glucose metabolism [5–8]. …”

Does ‘existential unease’ predict adult multimorbidity? Analytical cohort study on embodiment based on the Norwegian HUNT population

“…Our findings are, for instance, in concordance with studies of the pathogenic impact of perseverative cognition, ruminations and worries 39. Correspondingly, low self-esteem,40 unfairness,41 lack of well-being,25 42 work dissatisfaction,43 loneliness,44 lack of social relationships,45 subjective social–evaluative threat46 and anger47 have been related to impaired health. A perceived lack of purpose in life has recently been connected to allostatic load,48 49 as has compromised sleep quality 50–52…”

Optimism, pessimism, cynical hostility, and biomarkers of metabolic function in the Women's Health Initiative

“…Furthermore, both depression and anger have been shown to interact with obesity in diabetes. [61][62][63][64][65]…”