Michael Hendryx1, Wanda Nicholson2,3, JoAnn E Manson4, Candyce H Kroenke5, Jennifer Lee6, Julie C Weitlauf7, Lorena Garcia8, Junmei M Jonasson9, Jean Wactawski-Wende10, Juhua Luo11. 1. Department of Environmental and Occupational Health, School of Public Health, Indiana University Bloomington. 2. Department of Obstetrics and Gynecology, Diabetes and Obesity Core, Center for Women's Health Research, University of North Carolina, Durham. 3. Center for Health Promotion and Disease Prevention, University of North Carolina, Durham. 4. Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 5. Division of Research, Kaiser Permanente, Oakland, California. 6. Division of Endocrinology, Gerontology, and Metabolism, Department of Medicine, Stanford University, Palo Alto, California. 7. Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California. 8. Department of Public Health Sciences, School of Medicine University of California-Davis. 9. Department of Public Health and Community Medicine at Institute of Medicine Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden. 10. Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, Buffalo, New York. 11. Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington.
Abstract
OBJECTIVES: We examined whether social relationship variables (social support, social strain, social network size, and stressful life events) were associated with risk of developing type 2 diabetes among postmenopausal women. METHOD: 139,924 postmenopausal women aged 50-79 years without prevalent diabetes at baseline were followed for a mean of 14 years. 19,240 women developed diabetes. Multivariable Cox proportional hazard models tested associations between social relationship variables and diabetes incidence after consideration of demographics, depressive symptoms, and lifestyle behaviors. We also examined moderating effects of obesity and race/ethnicity, and we tested whether social variable associations were mediated by lifestyle or depressive symptoms. RESULTS: Compared with the lowest quartile, women in the highest social support quartile had lower risk of diabetes after adjusting for demographic factors, health behaviors, and depressive symptoms (hazard ratio [HR] = 0.93, 95% confidence interval [CI] = 0.89-0.97). Social strain (HR = 1.09, 95% CI = 1.04-1.13) and stressful life events (HR = 1.10, 95% CI = 1.05-1.15) were associated with higher diabetes risks. The association between diabetes and social strain was stronger among African American women. Social relationship variables had direct relationships to diabetes, as well as indirect effects partially mediated by lifestyle and depressive symptoms. DISCUSSION: Social support, social strain, and stressful life events were associated with diabetes risk among postmenopausal women independently of demographic factors and health behaviors. In addition to healthy behaviors such as diet and physical activity, healthy social relationships among older women may be important in the prevention of diabetes.
OBJECTIVES: We examined whether social relationship variables (social support, social strain, social network size, and stressful life events) were associated with risk of developing type 2 diabetes among postmenopausal women. METHOD: 139,924 postmenopausal women aged 50-79 years without prevalent diabetes at baseline were followed for a mean of 14 years. 19,240 women developed diabetes. Multivariable Cox proportional hazard models tested associations between social relationship variables and diabetes incidence after consideration of demographics, depressive symptoms, and lifestyle behaviors. We also examined moderating effects of obesity and race/ethnicity, and we tested whether social variable associations were mediated by lifestyle or depressive symptoms. RESULTS: Compared with the lowest quartile, women in the highest social support quartile had lower risk of diabetes after adjusting for demographic factors, health behaviors, and depressive symptoms (hazard ratio [HR] = 0.93, 95% confidence interval [CI] = 0.89-0.97). Social strain (HR = 1.09, 95% CI = 1.04-1.13) and stressful life events (HR = 1.10, 95% CI = 1.05-1.15) were associated with higher diabetes risks. The association between diabetes and social strain was stronger among African American women. Social relationship variables had direct relationships to diabetes, as well as indirect effects partially mediated by lifestyle and depressive symptoms. DISCUSSION: Social support, social strain, and stressful life events were associated with diabetes risk among postmenopausal women independently of demographic factors and health behaviors. In addition to healthy behaviors such as diet and physical activity, healthy social relationships among older women may be important in the prevention of diabetes.
Authors: Yang Claire Yang; Courtney Boen; Karen Gerken; Ting Li; Kristen Schorpp; Kathleen Mullan Harris Journal: Proc Natl Acad Sci U S A Date: 2016-01-04 Impact factor: 11.205
Authors: Miranda T Schram; Willem J J Assendelft; Theo G van Tilburg; Nicole H T M Dukers-Muijrers Journal: Diabetologia Date: 2021-06-29 Impact factor: 10.122