ORIGINAL RESEARCH article
Front. Stroke
Sec. Population Health and Risk Factors of Stroke
This article is part of the Research TopicSex and Gender Differences in Cerebrovascular Diseases and StrokeView all 4 articles
Sex as a Predictor and Moderator of Psychosocial Determinants of Cardiometabolic Risks for Métis People in Canada
Provisionally accepted
- 1University of Saskatchewan College of Kinesiology, Saskatoon, Canada
- 2University of Saskatchewan College of Engineering, Saskatoon, Canada
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Abstract Introduction: Métis People, one Indigenous group in Canada, have distinct culture, identity and experiences. The determinants of Métis People's health, including stroke risk, may differ from other groups. This study examined relationships between psychosocial and lifestyle factors with cardiometabolic risk, a stroke risk indicator, and the moderating role of sex among Métis adults living in Saskatchewan, Canada. Methods: A community-based cross-sectional observation study was conducted with 70 Métis adults (39± 16 years; 66% females). Hierarchical multiple regression, moderated by sex, assessed psychosocial and lifestyle predictors of cardiometabolic risks (blood cholesterol, fasting glucose, glycosylated haemoglobin, blood pressure, and waist circumference). Results: Psychosocial factors were significantly associated with cardiometabolic risk components. Average blood pressure was predicted by sex when psychological distress, discrimination experiences and age were covariates, F (4, 65) = 6.997, p = 0.01, R2 = 0.30, and when well-being, adverse childhood experiences and age were covariates, F (4, 65) = 5.896, p =0.039, R2 = 0.27. Sex moderated relationships of well-being with glycosylated haemoglobin, F (6, 63) = 7.374, p = 0.02, R2 = 0.414, with age (β = -0.497, p < 0.01), well-being (β = 0.593, p = 0.01), and well-being x sex (β = - 0.53, p = 0.01) being significant predictors. Psychological distress moderated by sex, also predicted total cholesterol. Lifestyle factors did not significantly predict cardiometabolic risk. Discussion: Psychosocial determinants, particularly well-being, play a central role in Métis People's cardiometabolic risk, with effects differing by sex. This emphasized the need for Métis-specific, trauma and gender-informed approaches to cardiovascular health promotion.
Keywords: cardiometabolic risks, cardiovascular disease, indigenous peoples, Psychosocial stressors, sex differences, Stroke
Received: 31 Oct 2025; Accepted: 12 Jan 2026.
Copyright: © 2026 Johnson, Moore, Fatima, McInnes and Foulds. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shara Johnson
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