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Original Research
Social Support, Social Network Size, Social Strain, Stressful Life Events, and Coronary Heart Disease in Women With Type 2 Diabetes: A Cohort Study Based on the Women’s Health Initiative
Junmei Miao Jonasson, Michael Hendryx, Aladdin H. Shadyab, Erika Kelley, Karen C. Johnson, Candyce H. Kroenke, Lorena Garcia, Sofia Lawesson, Ailiana Santosa, Shawnita Sealy-Jefferson, Xiaochen Lin, Crystal W. Cene, Simin Liu, Carolina Valdiviezo, Juhua Luo
Diabetes Care 2020 Jun; dc192065. https://doi.org/10.2337/dc19-2065
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Abstract

OBJECTIVE We studied associations between social support, social network size, social strain, or stressful life events and risk of coronary heart disease (CHD) in postmenopausal women with type 2 diabetes.

RESEARCH DESIGN AND METHODS From the Women’s Health Initiative, 5,262 postmenopausal women with type 2 diabetes at baseline were included. Cox proportional hazards regression models adjusted for demographics, depressive symptoms, anthropometric variables, and lifestyle factors were used to examine associations between social factors and CHD.

RESULTS A total of 672 case subjects with CHD were observed during an average 12.79 (SD 6.29) years of follow-up. There was a significant linear trend toward higher risk of CHD as the number of stressful life events increased (P for trend = 0.01; hazard ratio [HR] [95% CI] for the third and fourth quartiles compared with first quartile, 1.27 [1.03–1.56] and 1.30 [1.04–1.64]). Being married or in an intimate relationship was related to decreased risk of CHD (HR 0.82 [95% CI 0.69–0.97]).

CONCLUSIONS Among postmenopausal women with type 2 diabetes, higher levels of stressful life events were associated with higher risk of CHD. Experience of stressful life events might be considered as a risk factor for CHD among women with type 2 diabetes.

Footnotes

  • This article contains supplementary material online at https://doi.org/10.2337/figshare.12200195.

  • Received October 16, 2019.
  • Accepted April 26, 2020.
  • © 2020 by the American Diabetes Association
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Social Support, Social Network Size, Social Strain, Stressful Life Events, and Coronary Heart Disease in Women With Type 2 Diabetes: A Cohort Study Based on the Women’s Health Initiative
Junmei Miao Jonasson, Michael Hendryx, Aladdin H. Shadyab, Erika Kelley, Karen C. Johnson, Candyce H. Kroenke, Lorena Garcia, Sofia Lawesson, Ailiana Santosa, Shawnita Sealy-Jefferson, Xiaochen Lin, Crystal W. Cene, Simin Liu, Carolina Valdiviezo, Juhua Luo
Diabetes Care Jun 2020, dc192065; DOI: 10.2337/dc19-2065

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Social Support, Social Network Size, Social Strain, Stressful Life Events, and Coronary Heart Disease in Women With Type 2 Diabetes: A Cohort Study Based on the Women’s Health Initiative
Junmei Miao Jonasson, Michael Hendryx, Aladdin H. Shadyab, Erika Kelley, Karen C. Johnson, Candyce H. Kroenke, Lorena Garcia, Sofia Lawesson, Ailiana Santosa, Shawnita Sealy-Jefferson, Xiaochen Lin, Crystal W. Cene, Simin Liu, Carolina Valdiviezo, Juhua Luo
Diabetes Care Jun 2020, dc192065; DOI: 10.2337/dc19-2065
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