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Anger, adiposity, and glucose control in nondiabetic adults: findings from MIDUS II

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Abstract

Anger has been linked to cardiovascular disease, but few studies have examined the relationship between anger and type 2 diabetes. The aim was to investigate associations among different indicators of anger expression, adiposity, and nondiabetic glucose metabolism in a national survey of adults. Participants were 939 adults without diabetes in the Midlife in the US study (MIDUS II). Glucose metabolism was characterized by fasting glucose, insulin, insulin resistance, and glycosylated hemoglobin (HbA1c). Spielberger’s Anger Expression inventory was used to measure suppressed anger (anger-in), expressed anger (anger-out), and controlled anger (anger-control). We investigated the relationship between anger and glucose metabolism, and whether anger amplified the adverse relationship between body weight distribution (body mass index = BMI and waist-to-hip ratio = WHR) and glucose metabolism. Multivariate-adjusted analyses revealed an association between anger-out and both insulin and insulin resistance. As predicted, anger-in amplified the relationships between BMI and insulin and insulin resistance, while anger-out amplified the association between WHR and insulin and insulin resistance. Low anger-control was associated with higher glucose. None of the three anger measures was significantly associated with HbA1c. Our findings extend previous research on anger as a potential risk factor for type 2 diabetes by demonstrating that anger expression is associated with clinical indicators of glycemic control, especially among those with pre-existing risk due to obesity and high central adiposity.

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References

  • al’Absi, M., & Bongard, S. (2006). Neuroendocrine and behavioral mechanisms mediating the relationship between anger expression and cardiovascular risk: Assessment considerations and improvements. Journal of Behavioral Medicine, 29, 573–591.

    Article  PubMed  Google Scholar 

  • Attie, A. D. (2004). Genetic and genomic studies of type 2 diabetes in mice. International Congress Series, 1262, 220–223.

    Article  Google Scholar 

  • Cohen, B. E., Panguluri, P., Na, B., & Whooley, M. A. (2010). Psychological risk factors and the metabolic syndrome in patients with coronary heart disease: Findings from the Heart and Soul Study. Psychiatry Research, 175, 133–137.

    Article  PubMed Central  PubMed  Google Scholar 

  • Costa, P. T., McCrae, R. R., & Dembroski, T. M. (1989). Agreeableness vs. antagonism: Explication of a potential risk factor for CHD. In A. Siegman & T. M. Dembroski (Eds.), In search of coronary-prone behavior: Beyond type A (pp. 41–63). Hillsdale, NJ: Erlbaum.

  • Everson, S. A., Goldberg, D. E., Kaplan, G. A., Julkunen, J., & Salonen, J. T. (1998). Anger expression and incident hypertension. Psychosomatic Medicine, 60, 730–735.

    CAS  PubMed  Google Scholar 

  • Fried, L. P., Kronmal, R. A., Newman, A. B., Bild, D. E., Mittelmark, M. B., Polak, J. F., et al. (1998). Risk factors for 5-year mortality in older adults: The Cardiovascular Health Study. JAMA, 279, 585–592.

    Article  CAS  PubMed  Google Scholar 

  • Georgiades, A., Lane, J. D., Boyle, S. H., Brummett, B. H., Barefoot, J. C., Kuhn, C. M., et al. (2009). Hostility and fasting glucose in African American women. Psychosomatic Medicine, 71, 642–645.

    Article  PubMed Central  PubMed  Google Scholar 

  • Gleiberman, L., Greenwood, T. A., Luke, A., Delgado, M. C., & Weder, A. B. (2008). Anger types: Heritability and relation to blood pressure, body mass index, and left ventricular mass. Journal of Clinical Hypertension (Greenwich), 10, 700–706.

    Article  Google Scholar 

  • Golden, S. H., Williams, J. E., Ford, D. E., Yeh, H. C., Sanford, C. P., Nieto, F. J., et al. (2006). Anger temperament is modestly associated with the risk of type 2 diabetes mellitus: The Atheroslcerosis risk in communities study. Psychoneuroendocrinology, 31, 325–332.

    Article  PubMed  Google Scholar 

  • Gouin, J. P., Kiecolt-Glaser, J. K., Malarkey, W. B., & Glaser, R. (2008). The influence of anger expression on wound healing. Brain, Behavior, and Immunity, 22, 699–708.

    Article  PubMed Central  PubMed  Google Scholar 

  • Gremigni, P. (2006). Cynical hostility and the metabolic syndrome: A case-control study. Monaldi Archives for Chest Disease, 66, 224–229.

    PubMed  Google Scholar 

  • Haukkala, A., Konttinen, H., Laatikainen, T., Kawachi, I., & Uutela, A. (2010). Hostility, anger control, and anger expression as predictors of cardiovascular disease. Psychosomatic Medicine, 72, 556–562.

    Article  PubMed  Google Scholar 

  • Heraclides, A. M., Chandola, T., Witte, D. R., & Brunner, E. J. (2012). Work stress, obesity and the risk of type 2 diabetes: Gender-specific bidirectional effect in the Whitehall II Study. Obesity (Silver Spring), 20(2), 428–433.

    Article  Google Scholar 

  • Igna, C. V., Julkunen, J., & Vanhanen, H. (2009). Anger expression styles and blood pressure: Evidence for different pathways. Journal of Hypertension, 27, 1972–1979.

    Article  CAS  PubMed  Google Scholar 

  • Izawa, S., Eto, Y., Yamada, K. C., Nakano, M., Yamada, H., Nagayama, M., et al. (2011). Cynical hostility, anger expression style, and acute myocardial infarction in middle-aged Japanese men. Behavioral Medicine, 37, 81–86.

    Article  PubMed  Google Scholar 

  • Kawakami, N., Araki, S., Ohtsu, H., Hayashi, T., Masumoto, T., & Yokoyama, K. (1995). Effects of mood states, smoking and urinary catecholamine excretion on hemoglobin A1c in male Japanese workers. Industrial Health, 33, 153–162.

    Article  CAS  PubMed  Google Scholar 

  • Kiecolt-Glaser, J. K., Loving, T. J., Stowell, J. R., Malarkey, W. B., Lemeshow, S., Dickinson, S. L., et al. (2005). Hostile marital interactions, proinflammatory cytokine production, and wound healing. Archives of General Psychiatry, 62, 1377–1384.

    Article  PubMed  Google Scholar 

  • Kiecolt-Glaser, J. K., Malarkey, W. B., Chee, M., Newton, T., Cacioppo, J. T., Mao, H. Y., et al. (1993). Negative behavior during marital conflict is associated with immunological down-regulation. Psychosomatic Medicine, 55, 395–409.

    CAS  PubMed  Google Scholar 

  • Koh, K. B., Choe, K. O., & An, S. K. (2003). Anger and coronary calcification in individuals with and without risk factors of coronary artery disease. Yonsei Medical Journal, 44, 793–799.

    PubMed  Google Scholar 

  • Kumari, M., Chandola, T., Brunner, E., & Kivimaki, M. (2010). A nonlinear relationship of generalized and central obesity with diurnal cortisol secretion in the Whitehall II study. Journal of Clinical Endocrinology and Metabolism, 95, 4415–4423.

    Article  CAS  PubMed  Google Scholar 

  • Love, G. D., Seeman, T. E., Weinstein, M., & Ryff, C. D. (2010). Bioindicators in the MIDUS national study: Protocol, measures, sample, and comparative context. Journal of Aging and Health, 22(8), 1059–1080.

    Article  PubMed Central  Google Scholar 

  • Matthews, D. R., Hosker, J. P., Rudenski, A. S., Naylor, B. A., Treacher, D. F., & Turner, R. C. (1985). Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia, 28, 412–419.

    Article  CAS  PubMed  Google Scholar 

  • Mayne, T. J., & Ambrose, T. K. (1999). Research review on anger in psychotherapy. Journal of Clinical Psychology, 55, 353–363.

    Article  CAS  PubMed  Google Scholar 

  • McCrae, R. R., & Costa, P. T. (2003). Personality in adulthood: A five-factor theory perspective. New York: Guilford Press.

    Book  Google Scholar 

  • Merjonen, P., Pulkki-Raback, L., Puttonen, S., Keskivaara, P., Juonala, M., Telama, R., et al. (2008). Anger is associated with subclinical atherosclerosis in low SES but not in higher SES men and women. The cardiovascular risk in young Finns study. Journal of Behavioral Medicine, 31, 35–44.

    Article  PubMed  Google Scholar 

  • Midei, A. J., Matthews, K. A., & Bromberger, J. T. (2010). Childhood abuse is associated with adiposity in midlife women: possible pathways through trait anger and reproductive hormones. Psychosomatic Medicine, 72, 215–223.

    Article  PubMed Central  PubMed  Google Scholar 

  • Mittleman, M. A., Maclure, M., Sherwood, J. B., Mulry, R. P., Tofler, G. H., Jacobs, S. C., et al. (1995). Triggering of acute myocardial infarction onset by episodes of anger. Determinants of myocardial infarction onset study investigators. Circulation, 92, 1720–1725.

    Article  CAS  PubMed  Google Scholar 

  • Nelson, T. L., Palmer, R. F., & Pedersen, N. L. (2004). The metabolic syndrome mediates the relationship between cynical hostility and cardiovascular disease. Experimental Aging Research, 30, 163–177.

    Article  PubMed  Google Scholar 

  • Niaura, R., Banks, S. M., Ward, K. D., Stoney, C. M., Spiro, A., 3rd, Aldwin, C. M., et al. (2000). Hostility and the metabolic syndrome in older males: The normative aging study. Psychosomatic Medicine, 62, 7–16.

    CAS  PubMed  Google Scholar 

  • Peyrot, M., McMurry, J. F., Jr., & Kruger, D. F. (1999). A biopsychosocial model of glycemic control in diabetes: Stress, coping and regimen adherence. Journal of Health and Social Behavior, 40, 141–158.

    Article  CAS  PubMed  Google Scholar 

  • Raikkonen, K., Matthews, K. A., & Kuller, L. H. (2002). The relationship between psychological risk attributes and the metabolic syndrome in healthy women: Antecedent or consequence? Metabolism, 51, 1573–1577.

    Article  CAS  PubMed  Google Scholar 

  • Raikkonen, K., Matthews, K. A., Kuller, L. H., Reiber, C., & Bunker, C. H. (1999). Anger, hostility, and visceral adipose tissue in healthy postmenopausal women. Metabolism, 48, 1146–1151.

    Article  CAS  PubMed  Google Scholar 

  • Shen, B. J., Countryman, A. J., Spiro, A., I. I. I., & Niaura, R. (2008). The prospective contribution of hostility characteristics to high fasting glucose levels: The moderating role of marital status. Diabetes Care, 31, 1293–1298.

    Article  CAS  PubMed  Google Scholar 

  • Siegman, A. W., Malkin, A. R., Boyle, S., Vaitkus, M., Barko, W., & Franco, E. (2002). Anger, and plasma lipid, lipoprotein, and glucose levels in healthy women: the mediating role of physical fitness. Journal of Behavioral Medicine, 25, 1–16.

    Article  PubMed  Google Scholar 

  • Spielberger, C. D. (1983). Manual for the state–trait anxiety inventory (Form Y) (“Self-evaluation questionnaire”). Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Spielberger, C. D. (1996). State-trait anger expression inventory: Professional manual. FL: Odessa.

    Google Scholar 

  • Spielberger, C., & Reheiser, E. (2004). Measuring anxiety, anger, depression, and curiosity as emotional states and personality traits with the STAI, STAXI, and STPI. In M. Hersen (Ed.), Comprehensive handbook of psychological assessment: Personality assessment. Hoboken: Wiley.

  • Suarez, E. C. (2006). Sex differences in the relation of depressive symptoms, hostility, and anger expression to indices of glucose metabolism in nondiabetic adults. Health Psychology, 25, 484–492.

    Article  PubMed  Google Scholar 

  • Suls, J., & Bunde, J. (2005). Anger, anxiety, and depression as risk factors for cardiovascular disease: The problems and implications of overlapping affective dispositions. Psychological Bulletin, 131, 260–300.

    Article  PubMed  Google Scholar 

  • Surwit, R. S., Feinglos, M. N., Livingston, E. G., Kuhn, C. M., & McCubbin, J. A. (1984). Behavioral manipulation of the diabetic phenotype in ob/ob mice. Diabetes, 33, 616–618.

    Article  CAS  PubMed  Google Scholar 

  • Surwit, R. S., Lane, J. D., Millington, D. S., Zhang, H., Feinglos, M. N., Minda, S., et al. (2009). Hostility and minimal model of glucose kinetics in African American women. Psychosomatic Medicine, 71, 646–651.

    Article  PubMed Central  PubMed  Google Scholar 

  • Surwit, R. S., van Tilburg, M. A., Zucker, N., McCaskill, C. C., Parekh, P., Feinglos, M. N., et al. (2002a). Stress management improves long-term glycemic control in type 2 diabetes. Diabetes Care, 25, 30–34.

    Article  PubMed  Google Scholar 

  • Surwit, R. S., Williams, R. B., Lane, J. D., Feinglos, M. N., Kuhn, C. M., & Georgiades, A. (2010). Plasma epinephrine predicts fasting glucose in centrally obese African-American women. Obesity (Silver Spring), 18, 1683–1687.

    Article  CAS  Google Scholar 

  • Surwit, R. S., Williams, R. B., Siegler, I. C., Lane, J. D., Helms, M., Applegate, K. L., et al. (2002b). Hostility, race, and glucose metabolism in nondiabetic individuals. Diabetes Care, 25, 835–839.

    Article  PubMed  Google Scholar 

  • Tsenkova, V., Carr, D., Coe, C., & Ryff, C. D. (2012). Synergistic effect of neuroticism and BMI on glucose metabolism in nondiabetic adults. Psychotherapy and Psychosomatics, 81(5) 327–328.

    Article  PubMed Central  PubMed  Google Scholar 

  • Tsenkova, V. K., Carr, D., Schoeller, D. A., & Ryff, C. D. (2010). Perceived weight discrimination amplifies the link between central adiposity and nondiabetic glycemic control (HbA1c). Annals of Behavioral Medicine, 41, 243–251.

    Article  Google Scholar 

  • Vitaliano, P. P., Scanlan, J. M., Krenz, C., & Fujimoto, W. (1996). Insulin and glucose: Relationships with hassles, anger, and hostility in nondiabetic older adults. Psychosomatic Medicine, 58, 489–499.

    CAS  PubMed  Google Scholar 

  • Williams, J. E., Paton, C. C., Siegler, I. C., Eigenbrodt, M. L., Nieto, F. J., & Tyroler, H. A. (2000). Anger proneness predicts coronary heart disease risk: Prospective analysis from the atherosclerosis risk in communities (ARIC) study. Circulation, 101, 2034–2039.

    Article  CAS  PubMed  Google Scholar 

  • Wolf, H. U., Lang, W., & Zander, R. (1984). Alkaline haematin D-575, a new tool for the determination of haemoglobin as an alternative to the cyanhaemiglobin method. II. Standardisation of the method using pure chlorohaemin. Clinica Chimica Acta, 136, 95–104.

    Article  CAS  Google Scholar 

  • Yi, J. P., Yi, J. C., Vitaliano, P. P., & Weinger, K. (2008). How does anger coping style affect glycemic control in diabetes patients? International Journal of Behavioral Medicine, 15, 167–172.

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

This research was supported by a grant from the National Institute on Aging (P01-AG020166; Carol D. Ryff, Principal Investigator) to conduct a longitudinal follow-up of the MIDUS (Midlife in the US) investigation. The original study was supported by the John D. and Catherine T. MacArthur Foundation Research Network on Successful Midlife Development. We thank the staff of the Clinical Research Center at the University of Wisconsin-Madison, at the University of California—Los Angeles, and at Georgetown University for their support in conducting this study. Data collection was supported by the following Grants M01- RR023942 (Georgetown), M01-RR00865 (UCLA) from the General Clinical Research Centers Program, and 1UL1RR025011 (UW) from the Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources, National Institutes of Health. The first author of this study was supported by the National Institute on Aging (K01AG041179) and by the Eunice Kennedy Shriver National Institute of Child Health And Human Development (T32HD049302). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development or the National Institutes of Health.

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  1. Center for Women’s and Health Disparities Research, University of Wisconsin-Madison, 310N. Midvale Blvd, Madison, WI, 53706, USA

    Vera K. Tsenkova

  2. Department of Sociology and Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA

    Deborah Carr

  3. Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA

    Christopher L. Coe

  4. Institute on Aging and Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA

    Carol D. Ryff

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  1. Vera K. Tsenkova
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Correspondence to Vera K. Tsenkova.

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Tsenkova, V.K., Carr, D., Coe, C.L. et al. Anger, adiposity, and glucose control in nondiabetic adults: findings from MIDUS II. J Behav Med 37, 37–46 (2014). https://doi.org/10.1007/s10865-012-9460-y

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