Association of psychosocial stressors with metabolic syndrome severity among African Americans in the Jackson Heart Study

Background . Metabolic derangements such as diabetes (DM) and metabolic syndrome (MetS) are common in African Americans (AA) and contribute to the higher cardiovascular disease (CVD) mortality in this group. A greater prevalence of subclinical disease (ScD) among those with DM and MetS in the AA community may be an explanatory factor. Objective . We assessed the CVD risk factor profile and distribution of ScD among AA with DM and MetS in the Jackson Heart Study (JHS). Methods . We evaluated 4,365 AA participants [mean age (SD) of 53.8 (12.3) years, 64.5% women] free of overt CVD who attended JHS Exam 1 (between 2000- 2004), when ScD assessment was routinely performed(with the exception of CT for coronary calcium that occurred in Exam2). SCD measures included 1) peripheral artery disease (PAD, defined as ankle-brachial index<0.9), 2) high coronary artery calcium (CAC, defined as score>100), 3) left ventricular (LV) hypertrophy (LVH defined as left ventricular mass index>51 g/m 2.7 , 4) low LV ejection fraction (low EF, defined as an EF<50%), and 5) microalbuminuria (MA, defined as an albumin-to-creatinine ratio>25 μg/mg in men and >35 μg/mg in women). We compared the distribution of standard CVD risk factors and ScD prevalence in 1) those without DM or MetS (referent), 2) those with MetS but no DM and 3) those with DM. Results . In our study sample, 1,089 (24.9%) had MetS with no DM and 752 (17.2%) had DM. Compared to the referent group, groups with metabolic derangement tended to be older, female, hypertensive, obese, and had lower HDL, higher fasting glucose, and higher triglycerides levels. Table 1 compares the distribution of ScD for the three groups, and demonstrates the greater odds of. CAC, LVH and microalbuminuria in participants with MetS or DM. Conclusion . In our large community-based sample of AAs, we observed a significantly high prevalence of ScD overall, especially so in participants with MetS and DM. These findings likely contribute to the high CVD rates in AA with MetS and DM. -->

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Prevalence, associated factors and heritabilities of metabolic syndrome and its individual components in African Americans: the Jackson Heart Study

BMJ Open ◽

10.1136/bmjopen-2015-008675 ◽

2015 ◽

Vol 5 (10) ◽

pp. e008675 ◽

Cited By ~ 22

Author(s):

Rumana J Khan ◽

Samson Y Gebreab ◽

Mario Sims ◽

Pia Riestra ◽

Ruihua Xu ◽

...

Keyword(s):

Metabolic Syndrome ◽

African Americans ◽

Associated Factors ◽

Jackson Heart Study ◽

Heart Study

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Abstract P307: Association of Psychosocial Factors With Leukocyte Telomere Length Among African Americans in the Jackson Heart Study

Circulation ◽

10.1161/circ.137.suppl_1.p307 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Christina D Jordan

Keyword(s):

Depressive Symptoms ◽

African Americans ◽

Negative Affect ◽

Telomere Length ◽

Psychosocial Factors ◽

Psychosocial Stressors ◽

Leukocyte Telomere Length ◽

Jackson Heart Study ◽

Heart Study ◽

Unit Increase

Introduction: Leukocyte telomere length (LTL), a biomarker of cellular aging, is associated with human longevity. Psychosocial stressors are associated with shorter LTL. African Americans (AAs) experience greater stressor levels compared to other racial and ethnic groups. Research on associations of psychosocial factors with LTL among AAs is not well understood. Using Jackson Heart Study (JHS) data, we examined associations of psychosocial factors (negative affect and stressors) with LTL among AAs. Hypothesis: We hypothesized that psychosocial factors are inversely associated with LTL. Methods: Analysis was restricted to 2,516 JHS participants with LTL and psychosocial data between 2000-2004. Cross-sectional associations of negative affect [cynical distrust, anger-in, anger-out, depressive symptoms] and stressors [perceived stress, weekly stress inventory event (WSI-event), WSI-impact, major life event (MLE)] were examined with LTL among participants aged 21-95 years old (women=1,542; men=974). Psychosocial variables were measured by standardized questionnaires; LTL was measured by Southern blot. Summations of the four psychosocial measures were created for negative affect and stressors, with scores ranging from 4-12. We expressed each individual psychosocial measure into categories (tertiles: low, moderate, high) and in continuous standard deviation (SD) units. Using multivariable linear regression we evaluated the associations of psychosocial factors with mean differences (beta coefficient, b) in LTL adjusting for demographics (Model 1), socioeconomic status (SES) (Model 2), health behaviors, cardiovascular disease (CVD) risk factors (Model 3), and coping (Model 4). Results: High (vs low) anger-out was inversely associated with LTL in Model 1 (b = -0.043, p=0.008) and Model 2 (b = -0.0395, p=0.03), where 1-SD unit increase in anger-out was associated with shorter LTL. High (vs low) cumulative negative affect was marginally associated with insignificantly shorter LTL in Model 1 (b = -0.09, p=0.06) and Model 2 (b = -0.09, p=0.07) before transformation to SD units. There was no association between psychosocial stressors and shorter LTL in this sample. Paradoxically, high (vs low) WSI-event was positively associated with LTL (b =0.042, p=0.016), where 1-SD unit increase in WSI-event was associated with longer LTL after full adjustment. Conclusion: Depressive symptoms were associated with LTL shortening in the literature. The current study associates anger-out with shorter LTL, while WSI-event was associated with longer LTL among AAs in the JHS. Possibly, stress pathways that effect telomere length vary, where high stress can trigger LTL lengthening or shortening. Mechanisms of the paradoxical association between stress and telomere length must be further explored among AAs.

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Metabolic syndrome and masked hypertension among African Americans: The Jackson Heart Study

Journal of Clinical Hypertension ◽

10.1111/jch.12974 ◽

2017 ◽

Vol 19 (6) ◽

pp. 592-600 ◽

Cited By ~ 9

Author(s):

Lisandro D. Colantonio ◽

D. Edmund Anstey ◽

April P. Carson ◽

Gbenga Ogedegbe ◽

Marwah Abdalla ◽

...

Keyword(s):

Metabolic Syndrome ◽

African Americans ◽

Masked Hypertension ◽

Jackson Heart Study ◽

Heart Study

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Abstract P015: Plasma Brain Natriuretic Peptide Concentration Is Inversely Associated With Prevalent Metabolic Syndrome and Metabolic Syndrome Components: Findings From the Jackson Heart Study

Circulation ◽

10.1161/circ.125.suppl_10.ap015 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Harsha Nagarajarao ◽

Solomon K Musani ◽

Vasan S Ramachandran ◽

Aurelian Bidulescu ◽

Herman A Taylor ◽

...

Keyword(s):

Metabolic Syndrome ◽

African Americans ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Assessment Model ◽

Jackson Heart Study ◽

Men And Women ◽

Plasma Brain Natriuretic Peptide ◽

Heart Study ◽

Metabolic Syndrome Components

Introduction: There is emerging evidence that brain natriuretic peptide (BNP) may play a role in human metabolism. Suppressed concentrations in BNP in obese individuals may contribute to clinical phenotypes of metabolic syndrome. There is limited data on the relation of BNP to metabolic syndrome in African Americans. Methods: To assess the association between plasma brain natriuretic peptide (BNP) concentration and metabolic syndrome (MetS) and MetS risk factors in blacks, we analyzed cross-sectional data from 3,729 Jackson Heart Study participants free of heart failure (mean age, 54 years; 64% women). We performed sex-specific Tobit regression analysis on log transformed BNP to account for the left censored BNP distribution and adjusted for clinical and echocardiographic variables. Prevalence of MetS was 44% and 35% in women and men, respectively. We estimated percent changes for the underlying variables by back-transformation. Results: Plasma BNP concentration was inversely associated with metabolic syndrome components (fasting glucose and waist circumference in both men and women; and triglycerides in women). Sex-specific multivariable adjusted BNP concentrations were significantly lower in subjects with MetS than those without. In men, BNP concentration was 35% lower (P < 0.0001); and in women it was 31% lower (P < 0.0001). Men and women with insulin resistance represented by elevated homeostasis assessment model (HOMA-IR) index had significantly (P < 0.0001) lower BNP concentration compared to those with low HOMA-IR index. Discussion and Conclusion: We found in a community based cohort of African Americans a significant relation of low BNP concentration to MetS and individual components of MetS. This data supports a growing body of evidence that BNP plays a potential crucial role in total body metabolism.

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Distinct Component Profiles and High Risk Among African Americans With Metabolic Syndrome: The Jackson Heart Study

Diabetes Care ◽

10.2337/dc07-1810 ◽

2008 ◽

Vol 31 (6) ◽

pp. 1248-1253 ◽

Cited By ~ 41

Author(s):

H. Taylor ◽

J. Liu ◽

G. Wilson ◽

S. H. Golden ◽

E. Crook ◽

...

Keyword(s):

Metabolic Syndrome ◽

High Risk ◽

African Americans ◽

Jackson Heart Study ◽

Distinct Component ◽

Heart Study

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The Association between Individual and Combined Components of Metabolic Syndrome and Chronic Kidney Disease among African Americans: The Jackson Heart Study

PLoS ONE ◽

10.1371/journal.pone.0101610 ◽

2014 ◽

Vol 9 (7) ◽

pp. e101610 ◽

Cited By ~ 17

Author(s):

Vincent L. Mendy ◽

Mario J. Azevedo ◽

Daniel F. Sarpong ◽

Sylvia E. Rosas ◽

Olugbemiga T. Ekundayo ◽

...

Keyword(s):

Metabolic Syndrome ◽

Chronic Kidney Disease ◽

African Americans ◽

Kidney Disease ◽

Jackson Heart Study ◽

Heart Study

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Discrimination Associated with Metabolic Syndrome among African Americans from the Jackson Heart Study

Austin Journal of Obesity & Metabolic Syndromes ◽

10.26420/austinjobesmetabsynd.2021.1025 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Gao X ◽

◽

Liu J ◽

Bidulescu A ◽

◽

...

Keyword(s):

Metabolic Disease ◽

Metabolic Syndrome ◽

African Americans ◽

Disease Risk ◽

Fasting Blood Glucose ◽

Z Score ◽

Jackson Heart Study ◽

Prediction Ability ◽

Underlying Assumption ◽

Heart Study

We enthusiastically read the paper entitled “Experiences of Discrimination Are Associated with Worse Metabolic Syndrome Severity Among African Americans in the Jackson Heart Study” by Cardel et al. [1]. Despite the detected association between experiences of discrimination and metabolic syndrome (MetS) severity (using the Z-score described), some limitations in the methodology should be further discussed. First, the validity of the MetS Z-score used remains debatable. The underlying assumption in the calculation of this Z-score is based on simultaneous use of the known five biomarkers namely blood pressure, fasting blood glucose, abdominal fat/circumference, fasting blood triglycerides, and fasting blood high-density cholesterol as a cluster of circumstances that bundle together to define MetS by Adult Treatment Panel III (ATP III) criteria [2]. Even though previous research may be in support of this approach [3-6], the assumption has major limitations. Each biomarker has a defined threshold, with the value above that threshold showing a certain amount of future cardiovascular and metabolic disease risk. However, the value below that threshold has no distinct risk prediction capability. In other words, adding these biomarker scores together has more limited prediction ability because any increase risk detected by these individual biomarkers only increases the opportunity of creating a new parameter with relatively lower prediction ability. As an exemplification; in this study, there are higher baseline MetS scores among the older / aging participants, especially in 46 to 64 years group. Nevertheless this phenomenon is expected given that 1) interaction with time will enhance the correlation; and 2) the MetS older individuals criteria is determined by extreme measurements of at least three MetS biomarkers [2]. Second, although the prevalence of MetS diagnosed by ATP III is ascertained, the authors did not provide any data to compare proposed MetS Z-score with traditional ATP III dichotomous criteria to see whether the effect of discrimination on MetS is different. If there is no significantly better prediction of discrimination for MetS between the two methods, why MetS Z-score should be calculated and used? Third, the linkage between discrimination and MetS remains unclear (and underdeveloped) because 1) MetS is the risk predictor for later cardiovascular and metabolic disease instead of the health outcome caused by certain psychological factor like discrimination [2]; and 2) the process that affects MetS development is complex. Both intrapersonal determinants like awareness and interpersonal factors like social network may contribute to MetS progression. Therefore, a theoretical mechanism/model for discrimination associated with MetS is needed to unravel the interplay with personal and societal correlates that can holistically describe how MetS progresses among African Americans. Clearly, the statistical approach used to generate MetS Z-score warrants further validation. A theorized framework supporting the relationship between the MetS and its predictive ability is needed in order to explain how MetS’ consequences develop and inform future use of MetS per se or its derived Z-score for risk assessment.

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