April 23, 2015Open Access

Psychosocial Predictors of Metabolic Syndrome among Latino Groups in the Multi-Ethnic Study of Atherosclerosis (MESA)

MOManuel S. OrtízUniversidad de La Frontera HMHéctor F. MyersVanderbilt University CSChristine Dunkel SchetterUniversity of California, Los Angeles

Structured PICO

Does chronic stress predict the prevalence of metabolic syndrome among different Latino subgroups in the United States?

Population

1,388 Latino adults enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA) without known cardiovascular disease at baseline. The cohort includes Mexican Americans (n=799), Dominican Americans (n=175), Puerto Rican Americans (n=201), and Central/South Americans (n=213). Mean age 60.85 years, 52% female.

Intervention

Psychosocial risk factors including chronic stress (assessed via Chronic Stress Burden Scale), depressive symptoms (CES-D), and social support (ESSI).

Outcome

Metabolic Syndrome (MetS) defined by the National Cholesterol Education Program's Adult Treatment Panel III IDF 2004 criteria (presence of 3 or more of: increased waist size, elevated triglycerides, low HDL cholesterol, elevated fasting glucose, or elevated blood pressure).composite

Chronic stress is independently associated with an increased risk of metabolic syndrome in specific US Latino subgroups, particularly Mexican Americans and Puerto Rican Americans, highlighting the need for culturally tailored risk assessments.

Abstract

OBJECTIVE: We sought to determine the contribution of psychological variables to risk for metabolic syndrome (MetS) among Latinos enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA), and to investigate whether social support moderates these associations, and whether inflammatory markers mediate the association between psychological variables and MetS. RESEARCH DESIGN AND METHODS: Cross-sectional analyses at study baseline were conducted with a national Latino cohort (n = 1,388) that included Mexican Americans, Dominican Americans, Puerto Rican Americans and Central/South Americans. Hierarchical logistic regression analyses were conducted to test the effects of psychosocial variables (chronic stress, depressive symptoms, and social support) on MetS. In addition, separate subgroup-specific models, controlling for nationality, age, gender, socioeconomic position, language spoken at home, exercise, smoking and drinking status, and testing for the effects of chronic stress, depressive symptoms and inflammation (IL-6, CRP, fibrinogen) in predicting risk for MetS were conducted. RESULTS: In the overall sample, high chronic stress independently predicted risk for MetS, however this association was found to be significant only in Mexican Americans and Puerto Rican Americans. Social support did not moderate the associations between chronic stress and MetS for any group. Chronic stress was not associated with inflammatory markers in either the overall sample or in each group. CONCLUSIONS: Our results suggest a differential contribution of chronic stress to the prevalence of MetS by national groups.

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