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

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 (S-i), acute insulin response to glucose (AIR(g)), 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 S-i, AIR(g), and DI. Multivariable linear regression models were used to examine the association between race, psychological stress and metabolic outcomes (S-i, AIR(g), and DI). Results: : Race was a significant predictor of log-AIR(g) and log-DI (ps < 0.05) independent of all covariates in the main effect models. Lower S-i (p(interaction) = 0.014) and DI (p(interaction) = 0.012) was also observed among Black adolescents who reported higher stress levels, whereas higher S-i 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 S-i, AIR(g), 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 longterm effects of psychological stress on metabolic health among non-Hispanic Black and non-Hispanic White adolescents with overweight/obesity.