Racial differences in psychological stress and insulin sensitivity in non-Hispanic Black and White adolescents with overweight/obesity

Abstract

Introduction: Racial differences in type 2 diabetes risk persist among non-Hispanic Black and non-Hispanic White adolescents with overweight/obesity; however, the role of psychological stress in this disparity is less clear. Purpose: To examine racial differences in the association between psychological stress, insulin sensitivity (Si), acute insulin response to glucose (AIRg), and disposition index (DI) among non-Hispanic Black and non-Hispanic White adolescents with overweight/obesity. Methods: Ninety-six adolescents (60% female; 51% non-Hispanic Black; 16.6 ± 1.8 years of age) with overweight/obesity (BMI percentile ≥ 85th percentile) were included in this analysis. Psychological stress was assessed using the 14-item Perceived Stress Scale. Glucose and insulin data from an intravenous glucose tolerance test was modeled to obtain Si, AIRg, and DI. Multivariable linear regression models were used to examine the association between race, psychological stress and metabolic outcomes (Si, AIRg, and DI). Results: Race was a significant predictor of log-AIRg and log-DI (ps < 0.05) independent of all covariates in the main effect models. Lower Si (pinteraction = 0.014) and DI (pinteraction = 0.012) was also observed among Black adolescents who reported higher stress levels, whereas higher Si and DI was observed among non-Hispanic White adolescents reporting higher stress in the race interaction models. Race however, did not moderate the association between psychological stress and AIRg (p > 0.05), nor was stress associated with Si, AIRg, or DI ("p" "s" > 0.05) across all other models. Conclusions: Psychological stress may play an important and distinct role in shaping racial differences in type 2 diabetes risk among adolescents with overweight/obesity. Additional research is needed to understand the long-term effects of psychological stress on metabolic health among non-Hispanic Black and non-Hispanic White adolescents with overweight/obesity.