Sex differences in the prediction of metabolic burden from physiological responses to stress.

Background: Heightened or prolonged physiological responses to stress may contribute to the development or progression of metabolic abnormalities.

Purpose: This study aims to examine the prospective relationships between stress responses and metabolic burden, and to determine whether age and/or sex moderate these relationships.

Methods: One hundred ninety-nine healthy men and women (M(age) = 41 ± 11.5) were exposed to four stressors while blood pressure, heart rate, and heart rate variability were obtained. Residual change scores for reactivity (stress - baseline) and recovery (post-stress - baseline) scores were computed. Metabolic burden refers to the number of metabolic parameters for which participants were in the highest quartile (lowest for high-density lipoprotein cholesterol) for their sex. Metabolic burden was reassessed in 136 participants 3 years later.

Results: Greater parasympathetic withdrawal in response to stress was associated with increased metabolic burden, though this was evident mostly in men. In women, dampened autonomic responses to stress were associated with higher metabolic burden.

Conclusions: Cardiac autonomic responses to stress predict future metabolic abnormalities, though the direction of effect differs according to sex.