Sex as a predictor and moderator of psychosocial determinants of cardiometabolic risks for Métis People in Canada

Introduction Métis People, one Indigenous group in Canada, have distinct culture, identity, and experiences. The determinants of Métis People's health, including stroke risk, may differ from other groups. This study examined relationships between psychosocial and lifestyle factors with cardiometabolic risk, a stroke risk indicator, and the moderating role of sex among Métis adults living in Saskatchewan, Canada. Methods A community-based cross-sectional observation study was conducted with 70 Métis adults (39 ± 16 years; 66% female). Hierarchical multiple regression, moderated by sex, assessed psychosocial and lifestyle predictors of cardiometabolic risks (blood cholesterol, fasting glucose, glycosylated hemoglobin, blood pressure, and waist circumference). Results Psychosocial factors were significantly associated with cardiometabolic risk components. Psychological distress, adverse childhood experiences, age and sex explained 30% of the variance in average blood pressure, F (4, 65) = 6.997, p = 0.01. Well-being, discrimination experiences, age and sex significantly explained 27% of the variance in average blood pressure, F (4, 65) = 5.89, p = 0.04. Sex moderated relationships of wellbeing with glycosylated hemoglobin, F (6, 63) = 7.374, p = 0.02, R 2 = 0.414, with age (β = −0.497, p < 0.01), wellbeing (β = 0.593, p = 0.01), and wellbeing × sex (β = −0.53, p = 0.01) being significant predictors. Psychological distress moderated by sex also predicted total cholesterol. Lifestyle factors did not significantly predict cardiometabolic risk. Discussion Psychosocial determinants, particularly wellbeing, play a central role in Métis People's cardiometabolic risk, with effects differing by sex. This emphasized the need for Métis-specific, trauma, and sex-informed approaches to cardiovascular health promotion.