DURHAM, N.C. – The economic crisis, depressed home values, job losses – such stresses are enough to make a person sick.

And for many, that’s exactly what’s happening.

Studies by two Duke University research teams have found that certain inherited traits make some people more susceptible to disease when stress hormones hit the system.

One study reports this week that stress triggers spikes in blood sugar among African-American women who carry extra weight around their middles. Another, also reported this week, found that some men have a genetic predisposition to produce extra stress hormones when they’re angry, causing not only blood sugar to rise, but also blood pressure.

“Stress will bring out an underlying disease process in people who are predisposed for some other reason,” said Richard Surwit, chief of Duke’s division of medical psychology and co-author of the study about black women and diabetes. Surwit’s team presented their findings to the American Psychosomatic Society annual meeting in Chicago.

For years, doctors and patients alike figured stress eroded everyone’s health, but studies now are looking deeper to explore what underlying mechanisms cause some to get sick, while others remain healthy.

Surwit’s study included 62 healthy, non-diabetic black women who underwent scans and participated in emotional stress tests. They found blood sugar spikes occurred in participants only when two key factors were present: A lot of belly fat, plus a predisposition to secrete higher-than-normal levels of a stress hormone called epinephrine, which is secreted by the adrenal gland as part of the flight-or-fight response to dangers and hardships.

“As everyone knows, patients with higher belly fat do have higher blood glucose levels,” Surwit said. “But the real impact of belly fat was the interaction of epinephrine. High levels of epinephrine and high levels of belly fat are what seems to be toxic in this population. It’s a one-two punch.”

He said it’s unknown why some women secrete more stress hormone, and why some store fat around their midsections – topics for more research.

A second study reported at the Chicago meeting by another team at Duke looked at how stress affects men. Some men, the researchers found, have a genetic variant that causes them to release twice as much of the stress hormone cortisol when they are angered. Cortisol is also released by the adrenal gland and is known to trigger elevated blood sugars and blood pressure.

Dr. Redford Williams, a behavioral psychiatrist, said men who have this inherited trait go through daily life with elevated stress hormones. He said the next phase of research will be to test men for the genetic trait, then determine whether they actually have higher rates of heart disease, diabetes and other illnesses as a result of their elevated stress hormones.

Those findings, he said, will enable doctors to tailor treatments based on their patients’ genetic makeup.

“We could think about therapies of a pharmaceutical sort that would block this receptor,” he said. “We can also think of behavioral stress therapies, and teach men of this variant to learn how to cope with stress and anger to reduce cortisol responses.”


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