Increases in Psychological Stress Are Associated With Higher Fasting Glucose in US Chinese Immigrants.

ABSTRACT

BACKGROUND: The majority of Chinese Americans is foreign-born, and it is well-documented that immigration to the United States (US) leads to increased risk for chronic diseases including type 2 diabetes. Increased disease risk has been attributed to changes in lifestyle behaviors following immigration, but few studies have considered the psychosocial impact of immigration upon biomarkers of disease risk. PURPOSE: To examine associations of psychological stress and social isolation with markers of type 2 diabetes risk over time among US Chinese immigrants. METHODS: In this longitudinal study of 614 Chinese immigrants, participants completed assessments of perceived stress, acculturative stress, negative life events, and social isolation annually at three time points. Fasting blood samples were obtained at each time point to measure blood glucose, glycated hemoglobin, and insulin resistance. Mean duration between baseline and follow-up assessments was approximately 2 years. RESULTS: Increases in migration-related stress, perceived stress and social isolation were associated with significant increases in fasting glucose at follow-up independent of age, body mass index, length of US residence, and other potential covariates. Moreover, increases in glucose varied depending on perceived stress levels at baseline, such that those with higher baseline stress had a steeper increase in glucose over time. CONCLUSIONS: Psychological stress and social isolation are associated with increases in fasting glucose in a sample of US Chinese immigrants. Findings suggest that the unique experiences of immigration may be involved in the risk of developing type 2 diabetes, a condition that is prevalent among US Chinese despite relatively low rates of obesity.

Many Chinese Americans are born outside the United States (US), and moving to the US can increase their risk of chronic diseases like type 2 diabetes. This increased risk is often linked to lifestyle changes after immigration, but not much research has looked at how stress and social isolation may affect disease risk. We conducted a longitudinal study that followed 614 Chinese immigrants over a 2-year period to see if stress and social isolation were linked to diabetes risk. Participants filled out surveys about their levels of stress, social isolation, and any negative life events that had occurred, and had their blood tested for markers that are associated with diabetes risk. The study showed that higher stress and social isolation were linked to higher fasting glucose (blood sugar) levels, regardless of other factors like age or how long they had lived in the US. People who started with higher stress levels also had a bigger increase in fasting blood sugar levels over time. In summary, among Chinese immigrants in the US, stress and social isolation leads to increases in fasting blood sugar levels over time, which can be indicative of type 2 diabetes.