Abstract
BackgroundChronic stress may facilitate the development of metabolic diseases. Insulin resistance is present long before the clinical manifestations of individual metabolic abnormalities. To explore whether chronic stress is an independent risk factor of insulin resistance, we investigated the relationship between the stress system, selected parameters of energy homeostasis, and insulin resistance in a Chinese population.MethodsWe recruited 766 workers employed at four companies in Beijing. The degree of insulin resistance was determined using the homeostasis model assessment of insulin resistance (HOMA-IR). The highest quartile of HOMA-IR among all study subjects was further defined as insulin resistance in our study. The short standard version of the Copenhagen Psychosocial Questionnaire (COPSOQ) was used to assess job-related psychosocial stress. Pearson’s correlation coefficients were calculated between cortisol level and HOMA-IR and components of metabolic syndrome, with stratification by gender. The relationship between cortisol and HOMA-IR independent of obesity was analyzed using a linear mixed model with company as a cluster unit.ResultsThe values of the two scales of COPSOQ, including “demands at work” and “insecurity at work”, were significantly associated with insulin resistance and cortisol concentration (P < 0.05). Cortisol was significantly positively correlated with glucose, HOMA-IR, and waist circumference in males and females (P < 0.05). After adjusting for potential confounders, cortisol was an independent positive predictor for HOMA-IR (P < 0.05).ConclusionsThese findings showed that chronic stress was associated with insulin resistance and may contribute to the development of insulin resistance.
Highlights
Insulin resistance (IR) is a state in which physiologic concentrations of insulin produce a subnormal biologic response.[1]
To explore whether chronic stress is an independent risk factor of IR, we investigated the relationship between the stress system, selected parameters of energy homeostasis, and IR in a Chinese population
The 766 subjects were divided into two groups by the highest quartile of homeostasis model assessment of insulin resistance (HOMA-IR) (2.37): an IR group (HOMA-IR ≥2.37) and a non-IR group (HOMA-IR
Summary
Insulin resistance (IR) is a state in which physiologic concentrations of insulin produce a subnormal biologic response.[1] IR is directly related to the risk of developing metabolism-related disorders, including type 2 diabetes mellitus (T2DM), cardiovascular disease, and even cancer.[2] China has experienced an epidemic of major chronic diseases, such as stroke, coronary heart disease, cancer, diabetes, and hypertension, in recent decades. To explore whether chronic stress is an independent risk factor of insulin resistance, we investigated the relationship between the stress system, selected parameters of energy homeostasis, and insulin resistance in a Chinese population. The relationship between cortisol and HOMA-IR independent of obesity was analyzed using a linear mixed model with company as a cluster unit. Results: The values of the two scales of COPSOQ, including “demands at work” and “insecurity at work”, were significantly associated with insulin resistance and cortisol concentration (P < 0.05). Conclusions: These findings showed that chronic stress was associated with insulin resistance and may contribute to the development of insulin resistance
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