The Prospective Contribution of Hostility Characteristics to High Fasting Glucose Levels

OBJECTIVE To assess whether psychological constructs of hostility, anger, type A behavior pattern, and depressive symptom severity 1) were associated with concurrent and prospective fasting glucose levels and 2) whether this association was moderated by marital status. RESEARCH DESIGN AND METHODS Participants were 485 healthy men ([mean +/- SD] age 59 +/- 7 years) without a history of heart disease, diabetes, or taking related medications in the Veterans Affairs Normative Aging Study. Their fasting glucose levels between 1986 and 1995 were examined. Hierarchical linear regressions were conducted to investigate whether hostility, anger, type A behavior, and depressive symptoms were associated with concurrent fasting glucose levels as well as fasting glucose 9 years later, controlling for standard sociodemographic and biomedical covariates, including baseline fasting glucose, age, education, marital status, BMI, total cholesterol, and systolic blood pressure. RESULTS Although none of the psychological variables were associated with concurrent fasting glucose, Cook-Medley hostility (beta = 0.105), anger (beta = 0.091), and type A behavior (beta = 0.152) each were associated with prospective fasting glucose 9 years later, controlling for standard covariates. Depressive symptom severity was not associated with either concurrent or follow-up glucose levels. Further analysis showed that marital status moderated the effects of these characteristics on follow-up fasting glucose such that hostility, anger, and type A behavior were significant only among those who were not married (beta = 0.348, 0.444, 0.439, respectively; all P <0.001). CONCLUSIONS Hostility, anger, and type A behavior appear to be independent risk factors for impaired glucose metabolism among unmarried older men.