Anger, adiposity, and glucose control in nondiabetic adults: findings from MIDUS II

Abstract Anger has been linked to cardiovascular dis-ease, but few studies have examined the relationship between anger and type 2 diabetes. The aim was to investigate associations among different indicators of anger expression, adiposity, and nondiabetic glucose metabolism in a national survey of adults. Participants were 939 adults without diabetes in the Midlife in the US study (MIDUS II). Glucose metabolism was characterized by fasting glu-cose, insulin, insulin resistance, and glycosylated hemo-globin (HbA1c). Spielberger’s Anger Expression inventory was used to measure suppressed anger (anger-in), expres-sed anger (anger-out), and controlled anger (anger-control). We investigated the relationship between anger and glu-cose metabolism, and whether anger amplified the adverse relationship between body weight distribution (body mass index = BMI and waist-to-hip ratio = WHR) and glucose metabolism. Multivariate-adjusted analyses revealed an association between anger-out and both insulin and insulin resistance. As predicted, anger-in amplified the relation-ships between BMI and insulin and insulin resistance, while anger-out amplified the association between WHR and insulin and insulin resistance. Low anger-control was associated with higher glucose. None of the three anger measures was significantly associated with HbA1c. Our findings extend previous research on anger as a potential risk factor for type 2 diabetes by demonstrating that anger expression is associated with clinical indicators of glyce-mic control, especially among those with pre-existing risk due to obesity and high central adiposity