Change in Perceived Stress Moderates the Association Between Weight Change and HbA1c Change in Puerto Rican Women (P21-035-19)

Abstract

ObjectivesTo assess the association between weight change and change in HbA1c in Puerto Rican men and women, and to evaluate the moderating role of perceived stress in this association MethodsBaseline and 2-year data from the Boston Puerto Rican Health Study were used. Individuals on diabetes medications were excluded. The sample included 218 men and 549 women with complete measures at baseline and 2-year follow up. Stress was assessed with the Perceived Stress Scale-14 and HbA1c from fasting blood samples. Changes in weight, perceived stress, and HbA1c from baseline to year 2 were calculated (i.e., year 2 – baseline). Analyses included linear regression models stratified by sex and adjusted for baseline age, education, smoking status, diet quality, physical activity, body mass index (BMI), baseline HbA1c, diabetes status, menopause status and use of medications for hypertension, hyperlipidemia, depression and thyroid disease. Likelihood ratio (LR) tests were used to evaluate the interaction between weight change and change in perceived stress. ResultsMean baseline to year 2 change in weight was −0.3 kg + 6.1 for women and 0.3 kg + 4.7 for men. Mean change in HbA1c was 0.03% + 0.87 for women and −0.07% + 1.16 for men. Weight change was associated with HbA1c change in women (= 0.037; P < 0.001) but not in men. In women, there was an interaction between weight change and change in perceived stress (p value LR test = 0.005) on change in HbA1c. The coefficient for the interaction was positive and statistically significant (= 0.002; p value = 0.006), indicating that the positive association between weight change on HbA1c change was greater with increasing changes in perceived stress. ConclusionsIn this sample of Puerto Rican men and women, weight change was positively associated with change in HbA1c in women but not in men. Change in perceived stress increased HbA1c sensitivity to weight change. Future studies are needed to replicate our findings and examine pathways that explain this interaction. Funding SourcesResearch was supported by NIH P50 HL105185, P01 AG023394, R01 AG055948, and the University of Massachusetts CCTS (TL1, UL1TR001453). Supporting Tables, Images and/or Graphs▪