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Psychosocial Stress Over the Lifespan, Psychological Factors, and Cardiometabolic Risk in the Community

Gebreab, Sirak Zenebe, MSc; Vandeleur, Caroline L., PhD; Rudaz, Dominique, MSc; Strippoli, Marie-Pierre F., MSc; Gholam-Rezaee, Mehdi, PhD; Castelao, Enrique, MSc; Lasserre, Aurélie M., MD, PhD; Glaus, Jennifer, PhD; Pistis, Giorgio, PhD; Kuehner, Christine, PhD; von Känel, Roland, MD; Marques-Vidal, Pedro, MD, PhD; Vollenweider, Peter, MD; Preisig, Martin, MD, MPH

doi: 10.1097/PSY.0000000000000621

Objective The complex relationship between psychosocial stress over the lifetime, psychological factors, and cardiometabolic risk is still poorly understood. Accordingly, our aims were (1) to independently assess the associations between childhood adversity, life-event stress in remote (earlier than the last 5 years), and recent adulthood and cardiometabolic risk, and (2) to determine the role of psychological factors including personality, coping, and depression in these associations.

Methods The sample included 2674 adults, aged 35 to 66 years, randomly selected from urban area. Participants underwent a physical examination including the assessment of obesity markers, blood pressure, and blood lipid and glucose levels. Stress during adulthood was determined using the severity scores of 52 stressful life events. Information on adverse childhood experiences and major depressive disorders was collected using semistructured interviews, whereas personality traits and coping mechanisms were evaluated through questionnaires.

Results Both childhood adversity and stress in remote adulthood were associated with elevated body mass index (β [95% confidence interval {CI}] = 0.249 [0.029 to 0.468]; 0.020 [0.006 to 0.034]), waist circumference (β [95% CI] = 0.061 [0.024 to 0.099]; 0.08 [0.04 to 0.11]), and the global cardiometabolic risk score (β [95% CI] = 0.278 [0.017 to 0.540]; 0.017 [0.001 to 0.033]) after adjustment for sociodemographic, lifestyle, and psychological factors. In addition, childhood adversity was associated with low high density lipoprotein levels (β [95% CI] = −0.021 [−0.042 to 0.000]), as well as increased fat mass and systolic blood pressure levels (β [95% CI] = 0.506 [0.165 to 0.846]; 0.952 [0.165 to 1.740]) and stress in remote adulthood with apolipoprotein B levels (β [95% CI] = 0.607 [0.312 to 0.901]). Psychological factors did not account for these associations and were not effect modifiers.

Conclusions Our data demonstrate that psychosocial stress during childhood and remote adulthood favor adiposity and abnormal lipid metabolism.

From the Department of Psychiatry, Center for Psychiatric Epidemiology and Psychopathology (Gebreab, Vandeleur, Rudaz, Strippoli, Gholam-Rezaee, Castelao, Lasserre, Glaus, Pistis, Preisig), and Department of Medicine, Internal Medicine (Marques-Vidal, Vollenweider), Lausanne University Hospital, Switzerland; Genetic Epidemiology Research Branch (Glaus), Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland; Longitudinal and Intervention Research (Kuehner), Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; and Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine (von Känel), Zürich University Hospital, Switzerland.

Address correspondence to Sirak Zenebe Gebreab, MSc, Lausanne University Hospital, Department of Psychiatry, Center for Psychiatric Epidemiology and Psychopathology, Site de Cery, 1008 Prilly, Switzerland. E-mail:

Supplemental Content

Received for publication August 30, 2017; revision received April 30, 2018.

Copyright © 2018 by American Psychosomatic Society
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