Optimism, pessimism, cynical hostility, and biomarkers of metabolic function in the Women's Health Initiative

Hilary A. Tindle, Meredith S. Duncan, Simin Liu, Lewis H. Kuller, Nancy Fugate Woods, Steve R. Rapp, Candyce H. Kroenke, Mace Coday, Eric B. Loucks, Michael J. Lamonte, Ana M. Progovac, Elena Salmoirago-Blotcher, Brian T. Walitt, Nai Chieh Y. Yuo, Matthew S. Freiberg

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Background: Psychological attitudes reflecting expectations about the future (optimism, pessimism) and people (cynical hostility) independently predict incident cardiovascular disease and possibly diabetes, but underlying biologic pathways are incompletely understood. Herein we examined the cross-sectional relationship between optimism, pessimism, and cynicism and biomarkers of metabolic function in the Women's Health Initiative. Methods: Among 3443 postmenopausal women, biomarkers of metabolic function (fasting insulin [FINS] and glucose) were measured at baseline and used to calculate insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR]) and pancreatic β-cell activity (homeostasis model assessment of β-cell function [HOMA-B]). Psychological attitudes were assessed by the Life Orientation Test, Revised (full scale, and optimism and pessimism subscales) and the Cook–Medley cynicism subscale. Multivariable linear regression modeled the association of psychological attitudes with biomarker levels, adjusting for sociodemographics, health conditions, and health behaviors. Because obesity promotes insulin resistance and obese individuals tend to report higher levels of pessimism and cynical hostility, an interaction with body mass index (BMI) was explored. Results: In fully adjusted models, only pessimism remained independently associated with higher FINS and insulin resistance (HOMA-IR). Scoring 1 point higher on the pessimism subscale was associated with a 1.2% higher FINS, whereas scoring 1 SD higher was associated with a 2.7% higher FINS (P = 0.03); results were similar for HOMA-IR. An interaction term with BMI was not significant. Conclusions: In multivariable models, higher dispositional pessimism was associated with worse metabolic function; these findings were not modified by obesity status. Results extend prior work by linking pessimism to an objective biomarker of insulin resistance in elderly women.

Original languageEnglish
Pages (from-to)512-523
Number of pages12
JournalJournal of Diabetes
Volume10
Issue number6
DOIs
StatePublished - Jun 2018

Bibliographical note

Funding Information:
HAT thanks the University of Pittsburgh, where she was on faculty, for support during the initial phases of this study. The authors acknowledge Stephen M. KING and Vanessa C. GATSKIE (Vanderbilt University Medical Center, Nashville, TN, USA) for help with the preparation of this manuscript. The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), and US Department of Health and Human Services through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C. The research reported in this paper was supported by the National Institute of Mental Health of the NIH under Award no. T32MH019733. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This manuscript was prepared in collaboration with investigators of the WHI, and has been reviewed and approved by the Women's Health Initiative (WHI). The short list of WHI investigators can be found at: https://www.whi.org/researchers/Documents%20%20Write%20a%20Paper/WHI%20Investigator%20Short%20List.pdf (accessed 18 July 2017).

Funding Information:
HAT thanks the University of Pittsburgh, where she was on faculty, for support during the initial phases of this study. The authors acknowledge Stephen M. KING and Vanessa C. GATSKIE (Vanderbilt University Medical Center, Nashville, TN, USA) for help with the preparation of this manuscript. The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), and US Department of Health and Human Services through contracts HHSN268201100046C, HHSN268201100001C, HHSN 268201100002C, HHSN268201100003C, HHSN26820 1100004C, and HHSN271201100004C. The research reported in this paper was supported by the National Institute of Mental Health of the NIH under Award no. T32MH019733. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This manuscript was prepared in collaboration with investigators of the WHI, and has been reviewed and approved by the Women’s Health Initiative (WHI). The short list of WHI

Publisher Copyright:
© 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd

Keywords

  • cynical hostility
  • diabetes
  • insulin resistance
  • optimism
  • pessimism

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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