Association between low internal health locus of control, psychological distress and insulin resistance. An exploratory study

Maria C M Eriksson; Jesper Lundgren; Margareta Hellgren; Ying Li; Cecilia Björkelund; Ulf Lindblad; Bledar Daka

doi:10.1371/journal.pone.0285974

Association between low internal health locus of control, psychological distress and insulin resistance. An exploratory study

PLoS One. 2023 May 22;18(5):e0285974. doi: 10.1371/journal.pone.0285974. eCollection 2023.

Authors

Maria C M Eriksson¹, Jesper Lundgren², Margareta Hellgren^{1

3}, Ying Li⁴, Cecilia Björkelund¹, Ulf Lindblad¹, Bledar Daka¹

Affiliations

¹ Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
² Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
³ The Skaraborg Institute, Skövde, Sweden.
⁴ Biostatistics, School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.

Abstract

Aim: To assess the hypothesis that low internal health locus of control (IHLC) and psychological distress (PD) are associated with insulin resistance.

Materials and methods: In 2002-2005, a random population sample of 2,816 men and women aged 30-74 years participated (76%) in two municipalities in southwestern Sweden. This study included 2,439 participants without previously known diabetes or cardiovascular disease. IHLC was measured by a global scale and PD was measured by the 12-item General Health Questionnaire. Insulin resistance was estimated using HOMA-ir. General linear models were used to estimate differences in HOMA-ir between groups with low IHLC, PD, and both low IHLC and PD, respectively.

Results: Five per cent (n = 138) had both PD and low IHLC, 62 per cent of participants (n = 1509) had neither low IHLC nor PD, 18 per cent (n = 432) had PD, and 15 per cent (n = 360) low IHLC. Participants with both low IHLC and PD had significantly higher HOMA-ir than participants with neither low IHLC nor PD (Δ = 24.8%, 95%CI: 12.0-38.9), also in the fully adjusted model (Δ = 11.8%, 95%CI: 1.5-23.0). Participants with PD had significantly higher HOMA-ir (Δ = 12%, 95%CI: 5.7-18.7), but the significance was lost when BMI was included in the model (Δ = 5.3%, 95%CI:0.0-10.8). Similarly, participants with low IHLC had significantly higher HOMA-ir (Δ = 10.1%, 95%CI: 3.5-17.0) but the significance was lost in the fully adjusted model (Δ = 3.5%, 95%CI: -1.9-9.3).

Conclusions: Internal health locus of control (IHLC) and psychological distress (PD) were associated with insulin resistance. Especially individuals with both PD and low IHLC may need special attention.

Copyright: © 2023 Eriksson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Cardiovascular Diseases*
Diabetes Mellitus*
Female
Humans
Insulin
Insulin Resistance*
Internal-External Control
Male
Middle Aged
Psychological Distress*

Substances

Insulin

Grants and funding

This work was supported by a research grant from The Local Research and Development Council Gothenburg and Södra Bohuslän; The Healthcare Committee, Region Västra Götaland; and by grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (ALFGBG-938433 to U.L.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.