1555-P: Physiologic Stress Measured by Allostatic Load Score Is Associated with Abnormal Glucose Tolerance in African Immigrants

The extent to which abnormal glucose tolerance (Abnl-GT) is associated with either physiologic stress measured by allostatic load score (ALS) or inflammation in African immigrants is unknown. Our goals were to determine in African-born blacks living in Washington, DC: a) the prevalence of physiologic stress measured by ALS and b) the association of ALS with Abnl-GT and key inflammatory markers. Enrollees were 324 African-born blacks who immigrated to the United States as adults (age of immigration ≥18years, current age 40±10y (mean±SD), range 21-65y, duration of stay in the United States 11±9y, range 0.2-43y, BMI 27.9±4.4 kg/m2, range 18.4-42.4 kg/m², 70% male). ALS was calculated with 10 variables: cardiovascular (SBP, DBP, pulse, CHOL, HDL, homocysteine), metabolic (BMI, A1C, albumin), and immunological (hsCRP). Variables were divided into sex-specific quartiles with high-risk defined by the highest quartile for each variable except for albumin and HDL, which used the lowest quartile. One point was assigned if the variable was in the high-risk range and 0 if not. Physiologic stress was defined by ALS≥4 (upper quartile). Glucose tolerance was determined by the OGTT. The markers of inflammation were: TNF-alpha, IL-6 and MCP-1. Visceral adipose tissue (VAT) was measured by CT scan. High ALS occurred in 31% (102/324) of enrollees. The high ALS group were older than the low ALS group (45±9 vs. 39±9, P<0.01). BMI, WC and VAT were higher in the high ALS group even after adjusting for age (all P<0.01). Abnl-GT occurred in 41% (132/324). But the odds of Abnl-GT was higher in the high ALS than the low ALS group (OR= 2.6, CI: 1.63-4.67, P<0.01). The three inflammatory markers were higher in the high ALS group but after adjustment for age, the difference only approached significance. Overall, nearly one-third of African immigrants experience physiologic stress measured by ALS and this may represent a predisposition to abnormal glucose tolerance.