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Original Article
- Prospective associations between psychosocial stress and the risk of type 2 diabetes in middle-aged adults: findings from the KoGES_CAVAS
- Ji Eun Kim, Hye Won Woo, Yu-Mi Kim, Min-Ho Shin, Sang Baek Koh, Mi Kyung Kim
- Epidemiol Health. 2025;47:e2025061. Published online October 31, 2025
- DOI: https://doi.org/10.4178/epih.e2025061
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AbstractOBJECTIVES
Psychosocial stress is a potential risk factor for type 2 diabetes (T2D); however, the influence of the timing of stress exposure remains uncertain. We examined the prospective associations of baseline, cumulative average, and recent psychosocial stress with the risk of incident T2D in middle-aged adults.METHODSWe analyzed data from 7,880 participants aged 40-64 years without T2D at baseline. Psychosocial stress was assessed repeatedly using the Psychosocial Well-Being Index-Short Form. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated using modified Poisson regression models with robust error estimators.RESULTSA total of 437 T2D cases occurred over 47,621 person-years. While baseline stress showed a non-significant association, both cumulative and recent stress demonstrated positive associations with T2D risk. Recent stress exhibited the strongest association in both male (stress vs. healthy group: IRR, 2.23; 95% CI, 1.41 to 3.52; highest [T3] vs. lowest tertile [T1]: IRR, 1.50; 95% CI, 1.07 to 2.10) and female (stress vs. healthy group: IRR, 1.72; 95% CI, 1.11 to 2.66; T3 vs. T1: IRR, 1.73; 95% CI, 1.26 to 2.37). These associations were more pronounced among participants with abdominal obesity, showing a significant positive linear trend (Bonferroni-corrected threshold, p=0.003).CONCLUSIONSRecent psychosocial stress was associated with an increased incidence of T2D, underscoring the importance of integrating psychosocial factors into diabetes prevention strategies, particularly for individuals with abdominal obesity. -
SummaryKorean summary
최근(진단 전 방문)의 심리사회적 스트레스는 T2D의 위험인자로 확인되었으며, 기저 스트레스와는 유의미하지 않은 관계를 보였고 누적 스트레스와는 보다 약한 연관성을 보였다. 특히, 복부 비만이 있는 대상자에서 이러한 양상이 두드러져, 이 고위험군을 중심으로 한 스트레스 관리의 필요성이 제기된다.Key Message
Recent psychosocial stress was identified as the strongest risk factor for type 2 diabetes (T2D), showing non-significant relationship with baseline stress and weaker link for cumulative stress. Particularly, it was more pronounced among those with abdominal obesity, highlighting the importance of stress management in T2D prevention focusing on this high-risk subgroup.
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