Sex differences in the relation of depressive symptoms, hostility, and anger expression to indices of glucose metabolism in nondiabetic adults.

Abstract

This study examined the relation of depressive symptomatology, hostility, and anger expression to indices of glucose metabolism and tested whether gender moderates these associations in a sample of 135 healthy, nondiabetic adults (75 men, 60 women). The severity of depressive symptoms, hostility, and anger expression was positively associated with estimated insulin resistance (IR) and insulin in women but not in men. Anger expression was positively associated with glucose in women only. A summary score of depressive symptoms, hostility, and anger expression was positively associated with estimated IR, insulin, and glucose in women but not in men. Hence, in women, IR and elevated levels of fasting insulin and glucose may be one pathophysiological mechanism mediating the increased risk of cardiovascular disease and Type 2 diabetes associated with these psychological attributes.

The Prospective Contribution of Hostility Characteristics to High Fasting Glucose Levels

“…Several reasons may explain this discrepancy. First, as prior studies compared sex differences, they demonstrated that the link between personality risk factors and indexes of glucose metabolism was seen among women but not men (10,11,13). The lack of cross-sectional findings in our sample of older men appeared to be consistent with the literature.…”

“…Several previous studies showed that hostility, anger, and type A behavior were cross-sectionally correlated with higher fasting glucose (7)(8)(9)(10)(11). Although hostility-related characteristics were not correlated with concurrent fasting glucose in this study, they, in combination with marital status, predicted higher fasting glucose ϳ9 years later.…”

“…Among women, but not men, Suarez (10) observed that anger-out and hostility were concurrently associated with fasting insulin and the homeostasis model assessment of insulin resistance, while anger-out was also correlated with fasting glucose. Similarly, in a group of 98 individuals, Surwit et al (11) found that hostility was correlated with fasting glucose and the homeostasis model assessment index only among women or among African Americans.…”

“…Nevertheless, few studies have investigated whether depression may affect glucose metabolism. One study (10) showed that elevated depressive symptoms were associated with higher insulin levels and greater insulin resistance in nondiabetic women but not in men. Some studies (16) demonstrated that individuals diagnosed with depression showed greater insulin and glucose response to glucose tolerance tests.…”

Psychological trauma and physical health: A psychoneuroimmunology approach to etiology of negative health effects and possible interventions.

“…In his study of 135 healthy patients with no symptoms of diabetes, Suarez (2006) found that women with higher levels of depression and hostility had higher levels of fasting insulin, glucose, and insulin resistance. These findings did not hold true for men and they were independent of other risk factors for metabolic syndrome including BMI, age, fasting triglycerides, exercise regularity, or ethnicity.…”