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Consistent with other reports in adults, the current study found a significant correlation between hostility measured with the Cook Medley Hostility scale (CMHOST) and waist circumference. In a recent three-year follow-up study of 134 children and adolescents, Raikkonen et al. reported that high CMHOST scores at baseline were associated with an increased likelihood of the presence of the metabolic syndrome at follow-up. It has been argued that psychological states, like hostility, might influence the accumulation of abdominal fat and metabolic abnormalities by contributing to perturbations of the HPA axis. However, it is also possible that hostility might influence metabolic risk by influencing behaviors, like caloric intake and physical activity, which lead to obesity and insulin resistance. Serwitt et al. recently showed that adjustment for BMI attenuated the significant correlation of CMHOST to HOMA in European Americans but not African Americans. This suggests that the lifestyle behaviors pathway linking hostility to greater BMI and metabolic risk may be more relevant for European Americans than African Americans. The finding in the current study of a stronger correlation of hostility to waist circumference than to BMI is consistent with the possibility that among blacks hostility might exert its influence to a greater degree through HPA-axis-medi-ated effects than through lifestyle behaviors.

As was observed in adult Caribbean women in an earlier study, a high level of INR was associated with increased metabolic health risk independent of hostility among adolescent girls in the current study. The confounding effect of INR on the relationship of hostility, anxiety and depression to waist circumference, glucose intolerance in other reports and high insulin resistance (HOMA) score in the current study is consistent with its hypothesized role as a marker of a mental state that predisposes to psychological distress in some. generic cialis soft tabs

In the current study, there was a differential associa tion of INR to insulin resistance by gender. It is unclear why the association of INR on HOMA was stronger among adolescent girls compared to boys in the current study. Hormonal activity is heightened and changes during the different stages of pubertal development. Insulin sensitivity is quite variable during puberty between boys and girls and may explain to some degree why in this study boys appear to respond differently with respect to the effects of psychosocial stress on metabolism. However, there is some suggestion that the effects of psychosocial stress on metabolic risk may also be more pronounced in women than in men. This raises the question as to whether the effects of INR on metabolic health risk may be generational passing from mothers to daughters within families.

It is important to note that this study was the first time that the RASS scale has been used in a research setting. However, the adult version of the scale (NAD) has been used in a number of studies in populations of African descent living in Caribbean countries as well as the U.S. Virgin Islands. The results of the current study are consistent with the data presented in these adult studies suggesting that INR has an effect on metabolic characteristics as early as adolescence. canadian pharmacy viagra

In summary, this study provides further evidence of a significant association of high levels INR to increased metabolic health risk in Caribbean blacks. INR may be indicative of a detrimental coping strategy that impairs an individual’s ability to manage stressful life situations. Prevention campaigns designed to address these psychosocial issues among individuals with high levels of INR may be a step towards closing the disparities gap in diabetes risk among peoples of African descent. Additional studies are needed to confirm these results among U.S. blacks and among blacks on the African continent, particularly those who were exposed to apartheid as in Zimbabwe and South Africa.