Psychosocial factors and XXXX in 17 high-, middle- and low-income countries: the Prospective Urban Rural Epidemiologic study.

@entity286 @entity308 @entity101 @entity6 @entity28 @entity1144 @entity285
BACKGROUND/OBJECTIVES: Psychosocial stress has been proposed to contribute to @entity28 , particularly abdominal, or @entity1144 , through chronic activation of the neuroendocrine systems. However, these putative relationships are complex and dependent on country and cultural context. We investigated the association between psychosocial factors and general and @entity1144 in the Prospective Urban Rural Epidemiologic study. SUBJECTS/METHODS: This observational, cross-sectional study enrolled 151   966 individuals aged 35-70 years from 628 urban and rural communities in 17 high-, middle- and low-income countries. Data were collected for 125   290 individuals regarding education, anthropometrics, @entity101 / @entity6 , @entity286 / @entity285 use, diet and psychosocial factors (self-perceived stress and @entity308 ). RESULTS: After standardization for age, sex, country income and urban/rural location, the proportion with @entity28 (body mass index    30   kg   m(-)(2)) increased from 15.7% in 40   831 individuals with no stress to 20.5% in 7720 individuals with permanent stress, with corresponding proportions for ethnicity- and sex-specific @entity1144 of 48.6% and 53.5%, respectively (P<0.0001 for both). Associations between stress and @entity101 / @entity6 tended to be inverse. Estimating the total effect of permanent stress with age, sex, physical activity, education and region as confounders, no relationship between stress and @entity28 persisted (adjusted prevalence ratio (PR) for @entity28 1.04 (95% confidence interval: 0.99-1.10)). There was no relationship between ethnicity- and sex-specific @entity1144 (adjusted PR 1.00 (0.97-1.02)). Stratification by region yielded inconsistent associations. @entity308 was weakly but independently linked to @entity28 (PR 1.08 (1.04-1.12)), and very marginally to @entity1144 (PR 1.01 (1.00-1.03)). CONCLUSIONS: Although individuals with permanent stress tended to be slightly more @entity28 , there was no overall independent effect and no evidence that @entity1144 or its consequences ( @entity101 , @entity6 ) increased with higher levels of stress or @entity308 . This study does not support a causal link between psychosocial factors and @entity1144 .
