Biological and psychological stress correlates are linked to glucose metabolism, obesity and gender roles in women.

Kautzky, Alexander; Heneis, Kathrin; Stengg, Karin; Fröhlich, Sabine; Kautzky-Willer, Alexandra

OBJECTIVE Psychological stress affects central as well as peripheral metabolism and hormone trafficking via the hypothalamic-pituitary-adrenal axis. Stress thereby plays a decisive role in the etiology and progression of overweight and obesity, leading to several chronic diseases such as diabetes, and mental health disorders. The interplay of biological and psychometric correlates of stress, anthropometric, immunological and metabolic parameters and psychosocial factors such as gender roles, however, remains poorly understood. METHODS In this exploratory study, 43 healthy women were assessed for glucose metabolism by an oral glucose tolerance test (OGTT) and computation of functional parameters for insulin secretion, sensitivity and resistance. Further, the fatty liver index and anthropometric parameters body mass index (BMI), waist-to-hip ratio (WHR), body fat and lean mass were assessed. Psychological stress assessment included the "brief symptom inventory" (BSI), the "burn-out dimensions inventory" (BODI) and perceived stress scale (PSS). Biological stress response was evaluated with heart rate variability (HRV) and cortisol levels. Finally, gender role self-identification was assessed with the "Bem sex role inventory" (BSRI). Generalized linear models were computed for exploratory association with psychometric outcome. Uncorrected p-values are reported. RESULTS Burn-out and perceived stress scores were associated with insulin secretion, sputum cortisol, TSH, anthropometric measures and gender role. BSI ratings for psychiatric symptom dimensions were associated with insulin resistance, sex hormones, anthropometric measures and gender role. Female self-identification was associated with higher BMI as well as body fat and a higher fatty liver index. CONCLUSION Considering the increased risk of unfavorable metabolic, cardiovascular and also mental health outcome in obese women, a higher BMI in women with predominant female gender self-identification may be relevant for clinical risk assessment. The broad range of interacting biological, psychological and gender-related parameters calls for an integrative management of both mental and endocrinological health. However, the exploratory nature of the study calls for replication in larger samples before definite conclusion can be drawn.