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.


T. Hormenu: None. A.F. Hobabagabo: None. E.M. Shoup: None. N.H. Osei-Tutu: None. C. DuBose: None. A.E. Sumner: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at