Perceived stress and progression of cardiometabolic risk factors among South Asians with prediabetes in a lifestyle intervention trial

Nicole D. Fields; K. M.Venkat Narayan; Harish Ranjani; Lisa R. Staimez; Ranjit Mohan Anjana; Shivani A. Patel; Viswanathan Mohan; Mohammed K. Ali; Mary Beth Weber

doi:10.1016/j.pcd.2023.12.002

Perceived stress and progression of cardiometabolic risk factors among South Asians with prediabetes in a lifestyle intervention trial

Nicole D. Fields^*, K. M.Venkat Narayan, Harish Ranjani, Lisa R. Staimez, Ranjit Mohan Anjana, Shivani A. Patel, Viswanathan Mohan, Mohammed K. Ali, Mary Beth Weber

^*Corresponding author for this work

Preventive Medicine

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Abstract

Aims: To examine associations between perceived stress and cardiometabolic risk factors in South Asians with prediabetes and assess whether a diabetes prevention program mitigates the impact of stress on cardiometabolic health. Methods: We conducted a secondary analysis of the Diabetes Community Lifestyle Improvement Program, a lifestyle modification trial for diabetes prevention in India (n = 564). Indicators for cardiometabolic health (weight, waist circumference, blood pressure, glucose, HbA1c, and lipids) were measured at each visit while perceived stress was assessed via questionnaire at baseline. Multivariable linear regression assessed associations between stress and cardiometabolic parameters at baseline and 3-year follow up. Results: At baseline, perceived stress was associated with higher weight (b=0.16; 95% CI: 0.04, 0.29) and waist circumference (b=0.11; 95% CI: 0.01, 0.21) but lower 30-minute postload glucose (b=−0.44; 95% CI: −0.76, −0.14) and LDL cholesterol (b=−0.40; 95% CI: −0.76, −0.03). Over the study period, perceived stress was associated with weight gain (b=0.20; 95% CI: 0.07, 0.33) and increased waist circumference (b=0.14; 95% CI: 0.04, 0.24). Additionally, higher perceived stress was associated with lower HDL cholesterol among the control arm (p_interaction = 0.02). Conclusions: Baseline stress was associated with negative cardiometabolic risk factor outcomes over time in those with prediabetes.

Original language	English (US)
Pages (from-to)	183-187
Number of pages	5
Journal	Primary Care Diabetes
Volume	18
Issue number	2
DOIs	https://doi.org/10.1016/j.pcd.2023.12.002
State	Published - Apr 2024

Funding

Funding Support: The D-CLIP study was supported by a BRIDGES Grant (No: LT07–115) from the International Diabetes Federation and an educational grant from Lilly Diabetes. Additional support was provided by the Emory Global Health Institute at Emory University, Atlanta, GA and the National Institute of Digestive Diabetes and Kidney Diseases (P30DK111024). N.D.F. was supported by the National Heart, Lung, and Blood Institute (T32HL130025). This work was presented at the Annual American Psychosomatic Society Meeting held March 8–11, 2023 in San Juan, Puerto Rico. Funding Support: The D-CLIP study was supported by a BRIDGES Grant (No: LT07-115) from the International Diabetes Federation and an educational grant from Lilly Diabetes. Additional support was provided by the Emory Global Health Institute at Emory University, Atlanta, GA and the National Institute of Digestive Diabetes and Kidney Diseases (P30DK111024). N.D.F. was supported by the National Heart, Lung, and Blood Institute (T32HL130025).

Keywords

Cardiometabolic health
DCLIP
Lifestyle modificationtrial
Perceived stress
Prediabetes
South Asians

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Nutrition and Dietetics

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.pcd.2023.12.002

Cite this

@article{43d6b0405c2b4b368922b9ec9a209a80,

title = "Perceived stress and progression of cardiometabolic risk factors among South Asians with prediabetes in a lifestyle intervention trial",

abstract = "Aims: To examine associations between perceived stress and cardiometabolic risk factors in South Asians with prediabetes and assess whether a diabetes prevention program mitigates the impact of stress on cardiometabolic health. Methods: We conducted a secondary analysis of the Diabetes Community Lifestyle Improvement Program, a lifestyle modification trial for diabetes prevention in India (n = 564). Indicators for cardiometabolic health (weight, waist circumference, blood pressure, glucose, HbA1c, and lipids) were measured at each visit while perceived stress was assessed via questionnaire at baseline. Multivariable linear regression assessed associations between stress and cardiometabolic parameters at baseline and 3-year follow up. Results: At baseline, perceived stress was associated with higher weight (b=0.16; 95\% CI: 0.04, 0.29) and waist circumference (b=0.11; 95\% CI: 0.01, 0.21) but lower 30-minute postload glucose (b=−0.44; 95\% CI: −0.76, −0.14) and LDL cholesterol (b=−0.40; 95\% CI: −0.76, −0.03). Over the study period, perceived stress was associated with weight gain (b=0.20; 95\% CI: 0.07, 0.33) and increased waist circumference (b=0.14; 95\% CI: 0.04, 0.24). Additionally, higher perceived stress was associated with lower HDL cholesterol among the control arm (pinteraction = 0.02). Conclusions: Baseline stress was associated with negative cardiometabolic risk factor outcomes over time in those with prediabetes.",

keywords = "Cardiometabolic health, DCLIP, Lifestyle modificationtrial, Perceived stress, Prediabetes, South Asians",

author = "Fields, \{Nicole D.\} and Narayan, \{K. M.Venkat\} and Harish Ranjani and Staimez, \{Lisa R.\} and Anjana, \{Ranjit Mohan\} and Patel, \{Shivani A.\} and Viswanathan Mohan and Ali, \{Mohammed K.\} and Weber, \{Mary Beth\}",

note = "Publisher Copyright: {\textcopyright} 2024 Primary Care Diabetes Europe",

year = "2024",

month = apr,

doi = "10.1016/j.pcd.2023.12.002",

language = "English (US)",

volume = "18",

pages = "183--187",

journal = "Primary Care Diabetes",

issn = "1751-9918",

publisher = "Elsevier Ltd",

number = "2",

}

TY - JOUR

T1 - Perceived stress and progression of cardiometabolic risk factors among South Asians with prediabetes in a lifestyle intervention trial

AU - Fields, Nicole D.

AU - Narayan, K. M.Venkat

AU - Ranjani, Harish

AU - Staimez, Lisa R.

AU - Anjana, Ranjit Mohan

AU - Patel, Shivani A.

AU - Mohan, Viswanathan

AU - Ali, Mohammed K.

AU - Weber, Mary Beth

PY - 2024/4

Y1 - 2024/4

N2 - Aims: To examine associations between perceived stress and cardiometabolic risk factors in South Asians with prediabetes and assess whether a diabetes prevention program mitigates the impact of stress on cardiometabolic health. Methods: We conducted a secondary analysis of the Diabetes Community Lifestyle Improvement Program, a lifestyle modification trial for diabetes prevention in India (n = 564). Indicators for cardiometabolic health (weight, waist circumference, blood pressure, glucose, HbA1c, and lipids) were measured at each visit while perceived stress was assessed via questionnaire at baseline. Multivariable linear regression assessed associations between stress and cardiometabolic parameters at baseline and 3-year follow up. Results: At baseline, perceived stress was associated with higher weight (b=0.16; 95% CI: 0.04, 0.29) and waist circumference (b=0.11; 95% CI: 0.01, 0.21) but lower 30-minute postload glucose (b=−0.44; 95% CI: −0.76, −0.14) and LDL cholesterol (b=−0.40; 95% CI: −0.76, −0.03). Over the study period, perceived stress was associated with weight gain (b=0.20; 95% CI: 0.07, 0.33) and increased waist circumference (b=0.14; 95% CI: 0.04, 0.24). Additionally, higher perceived stress was associated with lower HDL cholesterol among the control arm (pinteraction = 0.02). Conclusions: Baseline stress was associated with negative cardiometabolic risk factor outcomes over time in those with prediabetes.

AB - Aims: To examine associations between perceived stress and cardiometabolic risk factors in South Asians with prediabetes and assess whether a diabetes prevention program mitigates the impact of stress on cardiometabolic health. Methods: We conducted a secondary analysis of the Diabetes Community Lifestyle Improvement Program, a lifestyle modification trial for diabetes prevention in India (n = 564). Indicators for cardiometabolic health (weight, waist circumference, blood pressure, glucose, HbA1c, and lipids) were measured at each visit while perceived stress was assessed via questionnaire at baseline. Multivariable linear regression assessed associations between stress and cardiometabolic parameters at baseline and 3-year follow up. Results: At baseline, perceived stress was associated with higher weight (b=0.16; 95% CI: 0.04, 0.29) and waist circumference (b=0.11; 95% CI: 0.01, 0.21) but lower 30-minute postload glucose (b=−0.44; 95% CI: −0.76, −0.14) and LDL cholesterol (b=−0.40; 95% CI: −0.76, −0.03). Over the study period, perceived stress was associated with weight gain (b=0.20; 95% CI: 0.07, 0.33) and increased waist circumference (b=0.14; 95% CI: 0.04, 0.24). Additionally, higher perceived stress was associated with lower HDL cholesterol among the control arm (pinteraction = 0.02). Conclusions: Baseline stress was associated with negative cardiometabolic risk factor outcomes over time in those with prediabetes.

KW - Cardiometabolic health

KW - DCLIP

KW - Lifestyle modificationtrial

KW - Perceived stress

KW - Prediabetes

KW - South Asians

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U2 - 10.1016/j.pcd.2023.12.002

DO - 10.1016/j.pcd.2023.12.002

M3 - Article

C2 - 38177017

AN - SCOPUS:85181819375

SN - 1751-9918

VL - 18

SP - 183

EP - 187

JO - Primary Care Diabetes

JF - Primary Care Diabetes

IS - 2

ER -

Perceived stress and progression of cardiometabolic risk factors among South Asians with prediabetes in a lifestyle intervention trial

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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