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    Physiological and Psychological Stressors Associated with Glucose Metabolism in the Boston Puerto Rican Health Study

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    Authors
    Lopez-Cepero, Andrea A.
    Faculty Advisor
    Milagros C. Rosal
    Academic Program
    Clinical and Population Health Research
    UMass Chan Affiliations
    Quantitative Health Sciences
    Document Type
    Doctoral Dissertation
    Publication Date
    2019-03-29
    Keywords
    Allostatic load
    glycemic load
    perceived stress
    type 2 diabetes
    Puerto Rican
    Endocrinology, Diabetes, and Metabolism
    Health Psychology
    Psychiatry and Psychology
    Public Health
    Social and Behavioral Sciences
    
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    Abstract
    Background: Puerto Ricans experience high prevalence of type 2 diabetes (diabetes). Stress is a risk factor for diabetes. The allostatic load (AL) model explains how stress influences disease through a chain of physiological changes. Puerto Ricans experience psychological and physiological (obesity and high glycemic load (GL)) stressors linked with diabetes, yet how these stressors impact the AL chain and how their interplay affects glucose metabolism remains unknown. Methods: Using data from the Boston Puerto Rican Health Study, this thesis sought to examine: 1) the relationship between GL and primary AL markers, 2) the interaction between perceived stress and GL on HbA1c, and if primary AL markers mediate this interaction, and 3) the interaction between change in weight and in perceived stress on HbA1c. Results: 1) GL change over 2 years was associated with increases in primary AL markers in women. 2) Women with high perceived stress and high GL had higher HbA1c and primary AL markers did not mediate this interaction. 3) In women, there was an interaction between change in weight and perceived stress on HbA1c over 2 years, with the effect of weight change on HbA1c being greater with increases in perceived stress. None of these associations were observed in men. Conclusion: This study partially confirms the AL model in Puerto Rican women but not in men. It provides data to inform intervention targets to prevent and manage diabetes in Puerto Rican women and identifies women at high risk of diabetes in this minority group.
    DOI
    10.13028/6y2r-6f43
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/31230
    Rights
    Copyright is held by the author, with all rights reserved.
    ae974a485f413a2113503eed53cd6c53
    10.13028/6y2r-6f43
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