999-P: Associations between Perceived Stress and Morning Serum Cortisol with Glycemic Measures in Minority Youth with Overweight or Obesity

• Published in: Diabetes (New York, N.Y.) Vol. 71; no. Supplement_1
• Main Authors: FELIX, KIMBERLY, WEIGENSBERG, MARC, TOLEDO-CORRAL, CLAUDIA M.
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 01-06-2022
• Subjects: Body weight; Children; Children & youth; Cortisol; Diabetes; Diabetes mellitus (non-insulin dependent); Fasting; Glucose; Glucose tolerance; Hemoglobin; Hormones; Obesity; Overweight; Regression analysis; Risk factors; Social interactions
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db22-999-P

Background: In youth, higher morning serum cortisol has been associated with fasting glucose, however the direct role of psychosocial stress as risk factor type 2 diabetes has not been well established; therefore, in this study, we examined the associations between perceived stress and fasting serum cortisol with fasting and 2-hour post glucose challenge and hemoglobin A1c.
Methods: In this cross-sectional study among Latino and African American youth with overweight or obesity (n=195, age=14.6±2.8yrs) we measured psychosocial stress with the 14-item Perceived Stress Scale for children and glucose concentrations at fasting and 2-hour post glucose challenge (1.75g oral glucose solution/kg body weight to a maximum 75g) . Hemoglobin A1c (HbA1c) and morning serum cortisol were measured from the fasting blood draw. Linear regression models assessed the relationships between perceived stress and morning cortisol with fasting glucose, 2-hour glucose, and HbA1c. With logistic regression models, we tested if perceived stress and morning serum cortisol associated with impaired fasting glucose, impaired glucose tolerance, or impaired HbA1c status. A priori covariates included age, sex, and ethnicity.
Results: Perceived stress scores were not associated with any glycemic measures (all p>0.05) . Morning serum cortisol was positively associated with HbA1c (β=0.016; 95%CI=0.002,0.030) and impaired HbA1c status (OR=1.090; 95%CI=1.006,1.181) in unadjusted models and results were largely unchanged in adjusted models.
Conclusion: Perceived stress, a common way to measure psychosocial stress, was not associated with any glycemic measures. Morning fasting cortisol was not associated with glucose levels, but was associated with HbA1c, a novel finding in this population of minority children. This finding adds to previous literature which showed that fasting serum cortisol associates with fasting glucose in children with overweight and obesity.