Understanding the association between psychosocial stress and the various components of the metabolic syndrome in African American and white adolescents, ages 18–19 years
Interest in the metabolic syndrome has been dramatic in recent years. Individuals with the metabolic syndrome have an increased risk of developing diabetes and cardiovascular disease. Cardiovascular disease is the leading cause of death, with a disproportionately higher rate in African Americans and those of lower socioeconomic status (SES). The existence of health disparities may be partially explained by the differential exposure to stress that low SES people face, which leaves them vulnerable to disease. Psychosocial stress has been implicated in playing a role in the development of the metabolic syndrome. Excessive stress can dysregulate the stress system (via the sympathetic-adrenal-medullary pathway [SAM] and the hypothalamic-pituitary-adrenal axis [HPA]) which may lead to insulin resistance and visceral adiposity, which are key underlying features of the metabolic syndrome.
The effect of stress during youth as a precursor to metabolic disturbances and chronic diseases later in life has not been well examined. This cross-sectional study explored the association of perceived stress with race, SES, and the various components of the metabolic syndrome, using the Berkeley site of the National Growth and Health Study which included n = 369 healthy, non-pregnant African American and white adolescent females, ages 18--19 years. Stress was assessed using the Perceived Stress Scale.
The overall prevalence of overweight/obesity was 38%, with a two-fold higher prevalence of obesity among the African American adolescents (27.7%) compared to the white adolescents (12.3%). Unadjusted analyses indicated that the obese adolescents had significantly higher stress (p=0.003) than the normal weight adolescents. Additionally, those with waist circumference >88cm had significantly higher stress (p=0.04) compared to those with waist circumference ≤88cm. By race, white adolescents had significantly higher perceived stress than the African American adolescents (p=0.01), after adjusting for parental education, total calories, physical activity, and BMI. Stress did not differ by SES. Stress was positively associated with triglycerides in the low calorie group (p=0.002), and with BMI (p=0.02) and waist circumference (p=0.02) in the low activity group.
Implications of this research reinforces the importance of policies and interventions in supporting community-wide stress prevention efforts, focused on improving physical activity, coping mechanisms, and social support for youth.
0325: African Americans