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.


K.Felix: None. M.Weigensberg: None. C.M.Toledo-corral: None.


National Institutes of Health (P60 MD00254) National Institutes of Health (UL1GM118976) National Institutes of Health (RLGM118975) National Institutes of Health (TL4GM118977)

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