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Training Grant-
Biology of Aging

Vera Tsenkova

Vera Tsenkova

PhD, UW-Madison
Associate Scientist, Institute on Aging

Biopsychosocial Pathways to Prediabetes and Diabetes

Type 2 diabetes is a multifactorial disease affected by the interplay of influences from different domains: established risk factors include obesity, physical inactivity, familial predisposition, and aging. While the role of these risk influences is well-established and generally uncontested, significant heterogeneity in diabetes risk remains unexplained. Understanding why some people remain healthy while others progress to insulin resistance and diabetes requires a comprehensive integrative approach that draws on advances in multiple fields. Biomedical and public health models of diabetes have traditionally focused on excess weight and physical inactivity as the key targets for reducing diabetes risk. The value of interventions aimed at weight loss and increased exercise is undeniable, but it only partly explains the progression from preclinical stages to overt diabetes. It is well-documented that risk for type 2 diabetes is increased among people with depression, ethnic/racial minorities, and low socioeconomic status (SES) groups. We have capitalized on the richness of multi-domain assessments in the MIDUS (Midlife in the United States) study and leveraged its ongoing longitudinal sample (MIDUS 1 and 2; ~10 years between assessments) to integrate these separate strands of biomedical, health disparities, and psychosocial research. Our work has been supported by grants from the NIH and Robert Wood Johnson Foundation.

We have provided initial evidence for the importance of assessing mental health in adults at risk for diabetes. We have documented that psychosocial vulnerabilities such as depression, anger, perceived weight discrimination, and neuroticism amplify the pernicious influence of obesity on dysregulated glucose metabolism. Patients and providers will benefit from recognizing that a range of psychosocial vulnerabilities are associated with increased diabetes risk, and that their impact is accentuated in people already at high risk due to obesity. Conversely, emerging evidence shows that the impact of a powerful, non-modifiable risk factor such as having a parental history of diabetes could be offset by positive affect, underscoring the importance of better understanding resilience among people with pre-existing risk factors. While the significance of targeting physical activity and weight loss in people at risk for diabetes is undisputed, integrative approaches that identify and address psychosocial vulnerabilities and promote psychological well-being could complement existing approaches and prove to be an equally powerful route to preventing diabetes. Ultimately, elucidating the interplay among risk and protective factors from different domains will be key to understanding multifactorial diseases such as diabetes and informing theory-based, person-centered interventions aimed at reducing risk.

Representative Publications
Lee, C., Tsenkova, V. K., Boylan, J. M., & Ryff, C. D. (2018). Gender differences in the pathways from childhood disadvantage to metabolic syndrome in adulthood: An examination of health lifestyles. SSM - Population Health, 4, 216-224.
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View publication via DOI: DOI:10.1016/j.ssmph.2018.01.003

Morozink Boylan, J., Tsenkova, V. K., Miyamoto, Y., & Ryff, C. D. (2017). Psychological resources and glucoregulation in Japanese adults: Findings from MIDJA. Health Psychology, 36(5), 449-457.
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View publication via DOI: DOI:10.1037/hea0000455

Tsenkova, V. K. (2017). Leisure-time, occupational, household physical activity and insulin resistance (HOMAIR) in the Midlife in the United States (MIDUS) national study of adults. Preventive Medicine Reports, 5, 224-227.
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View publication via DOI: DOI:10.1016/j.pmedr.2016.12.025

Tsenkova, V. K., Lee, C., & Boylan, J. M. (2017). Childhood socioeconomic disadvantage, occupational, leisure-time, and household physical activity, and diabetes in adulthood. Journal of Physical Activity and Health, 14(10), 766-772.
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View publication via DOI: DOI:10.1123/jpah.2016-0438

Tsenkova, V. K., Karlamangla, A. S., & Ryff, C. D. (2016). Parental history of diabetes, positive affect, and diabetes risk in adults: Findings from MIDUS. Annals of Behavioral Medicine, 50(6), 836-843.
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View publication via DOI: DOI:10.1007/s12160-016-9810-z

Tsenkova, V.K. & Karlamangla, A. (2016). Depression amplifies the influence of central obesity on 10-year incidence of diabetes: Findings from MIDUS PLoS ONE, 11(10), e0164802.
View publication via DOI: DOI:10.1371/journal.pone.0164802

Tsenkova, V. K., Carr, D., Coe, C. L., & Ryff, C. D. (2014). Anger, adiposity, and glucose control in nonidabetic adults: Findings from MIDUS II. Journal of Behavioral Medicine, 37(1), 37-46.
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View publication via DOI: DOI:10.1007/s10865-012-9460-y

Lee, C., Tsenkova, V., & Carr, D. (2014). Childhood trauma and metabolic syndrome in men and women. Social Science & Medicine, 105, 122-130.
View publication via DOI: DOI:10.1016/j.socscimed.2014.01.017

Tsenkova, V., Pudrovska, T., & Karlamangla, A. (2014). Childhood socioeconomic disadvantage and prediabetes and diabetes in later life: A study of biopsychosocial pathways. Psychosomatic Medicine, 76(8), 622-628.
View publication via DOI: DOI:10.1097/psy.0000000000000106

Tsenkova, V., Boylan, J. M., & Ryff, C. (2013). Stress eating and health: Findings from MIDUS, a national Study of U.S. Adults. Appetite, 69, 151-155.
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View publication via DOI: DOI:10.1016/j.appet.2013.05.020

Tsenkova, V. K., Albert, M. A., Georgiades, A., & Ryff, C. D. (2012). Trait anxiety and glucose metabolism in people without diabetes: Vulnerabilities among Black women. Diabetic Medicine, 29(6), 803-806.
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View publication via DOI: DOI:10.1111/j.1464-5491.2011.03534.x

Ryff, C. D., Friedman, E., Fuller-Rowell, T., Love, G., Morozink, J., Radler, B., Tsenkova, V., Miyamoto, Y. (2012). Varieties of resilience in MIDUS. Social and Personality Psychology Compass, 6(11), 792-806.
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View publication via DOI: DOI:10.1111/j.1751-9004.2012.00462.x

Tsenkova, V. K., Carr, D., Coe, C. L., & Ryff, C. D. (2012). Synergistic effect of neuroticism and body mass index on glucose metabolism in nondiabetic adults. Psychotherapy and Psychosomatics, 81(5), 327-328.
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View publication via DOI: DOI:10.1159/000337413

Ryff, C. D., Friedman, E. M., Morozink, J. A., & Tsenkova, V. (2012). Chapter 4: Psychological resilience in adulthood and later life: Implications for health. In J. Hayslip, Bert & G. Smith (Eds.), Annual review of gerontology and geriatrics: Emerging perspectives on resilience in adulthood and later life (Vol. 32, pp. 73-92).
View publication via DOI: DOI:10.1891/0198-8794.32.73

Tsenkova, V. K., Carr, D., Schoeller, D. A., & Ryff, C. D. (2010). Perceived weight discrimination amplifies the link between central adiposity and nondiabetic glycemic control (HbA(1c)). Annals of Behavioral Medicine, 41(2), 243-251.
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View publication via DOI: DOI:10.1007/s12160-010-9238-9

Tsenkova, V.K., Love, G.D., Singer, B.H., & Ryff, C.D. (2008). Coping and positive affect predict longitudinal change in glycosylated hemoglobin. Health Psychology, 27(2, Suppl), S163-S171.
View publication via DOI: DOI:10.1037/0278-6133.27.2(Suppl.).S163

Wagner, J. T., Camparo, L. B., Tsenkova, V., & Camparo, J. C. (2008). Do anti-immigrant sentiments track into Danish classrooms? Ethnicity, ethnicity salience, and bias in children's peer preferences. International Journal of Educational Research, 47(5), 312-322.
View publication via DOI: DOI:10.1016/j.ijer.2008.12.003

Tsenkova, V.K., Love, G.D., Singer, B.H., & Ryff, C.D. (2007). Socioeconomic status and psychological well-being predict cross-time change in glycosylated hemoglobin in older women without diabetes. Psychosomatic Medicine, 69(8), 777-784.
View publication via DOI: DOI:10.1097/PSY.0b013e318157466f

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