Abstract P213: Psychological Distress and Low Health Locus of Control are Associated with Insulin Resistance

Abstract

Introduction: Comorbidity of depression and type 2 diabetes is common. Less is known about metabolic impairment in association with milder forms of mental health issues, such as psychological distress (PD) and health locus of control (HLoC). Hypothesis: To cross-sectionally assess the hypothesis that PD and low HLoC are associated with insulin resistance in a Swedish population. Methods: In 2002-2005, a random sample of 2816 men and women aged 30-74 years participated (76%) in a survey in two municipalities in southwestern Sweden. Participants answered questionnaires, performed an OGTT and had anthropometric measurements taken. PD was measured by the validated 12-item General Health Questionnaire. HLoC was measured with the question ‘‘Do you believe that you can do anything yourself in order to preserve good health?”. PD and HLoC were both dichotomized and then combined into a risk score to indicate if the participants were positive for none of the factors, for either HLoC or PD , or for both . Insulin resistance was estimated by HOMA-ir. For the present study, 2714 subjects without previously known diabetes were included. Results: In general linear models, using none as reference (Table I), associations with HOMA-ir were seen for participants with either PD or HLoC, as well as for those with both . The strongest association was seen for both and this association remained, as did that for HLoC, when adjusting for multiple confounders. However, when adding physical activity to the model (Table I) the association was lost also for those positive solely for HLoC compared to those positive for none of the factors. In fact, a multiplicative effect on HOMA-ir was indicated with regard to having both factors (Table I). Conclusions: In the present study, a combination of psychological distress and low health locus of control was significantly associated with insulin resistance, highlighting the importance of further implementation of health psychology in primary care in order to prevent type 2 diabetes and ultimately cardiovascular disease.