부산대학교 도서관

Background: Metabolic syndrome is associated with a two-fold increase in cardiovascular disease (CVD) outcomes. Chronic stress is related to poor diet and development of metabolic syndrome. Inflammation plays an essential role in metabolic syndrome and can be moderated by diet. Hypothesis: Diet quality mediates the relationship between chronic stress and inflammation in patients with metabolic syndrome.Methods: Participants with metabolic syndrome (n=73, 62±12 years old, 71% female) completed questionnaires on chronic stress (Perceived Stress Scale [PSS-10]) and diet quality (Healthy Eating Index [HEI-2015]). The PSS-10 was dichotomized (highest quartile -Higher stress group- vs. lower quartiles -Lower stress group-). The HEI-2015 is comprised of 13 dietary components. Higher HEI-2015 scores indicate better diet quality. Inflammation was assessed by plasma high-sensitivity C-Reactive protein (hs-CRP). We used the PROCESS macro to test mediating roles of HEI-2015 between chronic stress and hs-CRP (log-transformed).Results: Higher stress group had worse mean HEI-2015 scores (64 ± 10 vs. 57 ± 13, P = .02). Among the 13 dietary components, the greatest differences between higher and lower stress groups were fruits and vegetable component scores (P < .05). As shown in Figure, diet quality mediated the relationship between chronic stress and inflammation (indirect effect = a*b = .211, 95% Confidence Interval [CI] = .006 to .496). Higher chronic stress group was associated with lower diet quality (a = - 7.152, 95% CI = - 13.168 to - 1.137), and, in turn, increased inflammation (b = - .030, 95% CI = - .052 to - .007).Conclusions: Our findings show the important role of diet quality in the relationship of chronic stress with inflammation in patients with metabolic syndrome. Increased intake of fruits and vegetables may be one of the most important recommendations for lowering inflammation and reducing CVD risks in highly stressed patients with metabolic syndrome.