BACKGROUND Psychological resilience is considered to protect against detrimental effects of perceived stress on cardiovascular and metabolic health, but few studies have tested biological mechanisms underlying these relationships. PURPOSE This study examined whether psychological resilience moderated the indirect association of perceived stress with Metabolic Syndrome (MetS) severity via hair cortisol concentration (HCC), a retrospective index of hypothalamic pituitary adrenal (HPA) axis activity. METHOD Participants included 228 adults (73 White, 86 Hispanic, 69 African American; mean age 45.29 years; 68% females). Participants completed questionnaires assessing perceived stress (Perceived Stress Scale) and resilience (Brief Resilience Scale). The first 3 cm of scalp-near hair were analyzed for cortisol concentration using enzyme-linked immunoassay analysis. Cardiometabolic risk factors including blood glucose, lipids, blood pressure, and waist circumference were assessed, from which a sex- and race/ethnicity-specific continuous MetS severity score was calculated. A moderated mediation model was tested using path analysis. RESULTS Psychological resilience moderated the association of perceived stress with HCC (R2 change for interaction = 0.014, p = 0.043), such that the association of perceived stress and HCC decreased as resilience scores increased. Resilience also moderated the indirect association of perceived stress with MetS severity via HCC (b = -0.039, 95% CI [-0.001; -0.100]), such that HCC mediated the association of greater perceived stress with greater MetS severity only for individuals reporting Brief Resilience Scale scores 3 or below (range: 1.17-5.00). Psychological resilience was also associated with lower MetS severity (β = -0.227, p = 0.014) independent of perceived stress and HCC. CONCLUSION Findings suggest that psychological resilience may serve as both a stress buffer and as a direct determinant of cardiometabolic health. These results extend literature on psychological resilience to measures of retrospective HPA axis function and MetS severity in a diverse sample.

中文翻译：

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感知压力、心理弹性、头发皮质醇浓度和代谢综合征严重程度：一个有调节的中介模型

背景心理弹性被认为可以防止感知压力对心血管和代谢健康的不利影响，但很少有研究测试这些关系背后的生物学机制。目的 本研究检查心理弹性是否通过毛发皮质醇浓度 (HCC)（下丘脑垂体肾上腺 (HPA) 轴活动的回顾性指标）调节感知压力与代谢综合征 (MetS) 严重程度的间接关联。方法 参与者包括 228 名成人（73 名白人、86 名西班牙裔、69 名非裔美国人；平均年龄 45.29 岁；68% 为女性）。参与者完成了评估感知压力（感知压力量表）和弹性（简要弹性量表）的问卷。使用酶联免疫分析法分析头皮附近头发的前 3 厘米的皮质醇浓度。评估了包括血糖、血脂、血压和腰围在内的心脏代谢风险因素，从中计算出性别和种族/民族特定的连续 MetS 严重程度评分。使用路径分析测试了一个有调节的中介模型。结果 心理弹性调节感知压力与 HCC 的关联（交互作用的 R2 变化 = 0.014，p = 0.043），因此感知压力和 HCC 的关联随着弹性分数的增加而降低。韧性还通过 HCC 调节了感知压力与 MetS 严重程度的间接关联（b = -0.039，95% CI [-0.001; -0.100]），因此，HCC 介导了更大的感知压力与更大的 MetS 严重程度之间的关联，仅适用于报告简短复原量表分数 3 或以下（范围：1.17-5.00）的个人。心理弹性还与较低的 MetS 严重程度（β = -0.227，p = 0.014）相关，而与感知压力和 HCC 无关。结论 研究结果表明，心理弹性既可以作为压力缓冲，也可以作为心脏代谢健康的直接决定因素。这些结果将有关心理弹性的文献扩展到不同样本中回顾性 HPA 轴功能和 MetS 严重程度的测量。结论 研究结果表明，心理弹性既可以作为压力缓冲，也可以作为心脏代谢健康的直接决定因素。这些结果将有关心理弹性的文献扩展到不同样本中回顾性 HPA 轴功能和 MetS 严重程度的测量。结论 研究结果表明，心理弹性既可以作为压力缓冲，也可以作为心脏代谢健康的直接决定因素。这些结果将有关心理弹性的文献扩展到不同样本中回顾性 HPA 轴功能和 MetS 严重程度的测量。