Cortisol-Based Measures of Stress Are Associated with Fasting Blood Glucose but Not Perceived Stress in Adolescents

Objective: We previously showed that mind/body practices improve glycemic control in people with type 2 diabetes presumably by reducing stress and lowering stress biomarkers thereby reducing glycemia. The relationship between subjectively experienced stress and stress biomarkers and subsequent glycemic effects is not understood. Our objective was to determine if subjective stress predicts cortisol levels. Methods: We examined 232 healthy, primarily Latino, adolescents (mean age=15.8 years, 70 males, all BMI categories). Stress was assessed using the 14-item questionnaire of perceived stress scale (PSS). Serum cortisol (sCOR) was measured at fasting. Salivary cortisol was measured 3 times daily (awakening, 30-min post-awakening, and evening) to assess Cortisol Awakening Response (CAR= 30-minute post-awakening - awakening) and Diurnal Cortisol Slope (DCS= evening-awakening). We performed multivariate regression to test association between PSS and sCOR and mixed effects regression to test association between PSS and CAR and DCS. Analyses were adjusted for age, sex, and BMI. Additional covariates (e.g. SES, ethnicity, etc.) gave similar results. Multivariate regression was used to assess association between PSS and fasting blood glucose (FBG), biomarkers of stress and FBG, a biologic outcome affected by stress. Results: There was no association between PSS and sCOR (p= 0.40), CAR (p =0.26), DCS (p =0.38), or FBG (p = 0.47). There was a significant association between sCOR and FBG (β=0.02, p <0.001). Conclusion: We found no evidence of association between PSS and biomarkers of stress. We further show an association between sCOR and FBG, but no association between PSS and FBG, suggesting PSS may measure a different aspect of stress than reflected in sCOR and diurnal cortisol patterns. Disclosure F.Sanogo: None. R.M.Watanabe: None. M.Weigensberg: None. A.Ruth: None.