Heart rate variability and HbA1c predict plasma interleukin-6 response to psychosocial stress challenge in trauma-exposed women with type 2 diabetes

Abstract

Background Type 2 diabetes mellitus (T2DM) is a major public health problem in the United States. Although cardiovascular autonomic functioning, blood glucose control, and inflammation are known to play a role in T2DM, the interaction between these variables remains largely unexplored, particularly in the context of stress. To address this gap, we examined the relationship between these variables in a sample that is uniquely vulnerable to the health consequences of T2DM. Methods Participants were 37 trauma-exposed Black women with a diagnosis of T2DM. High frequency heart rate variability (HF-HRV), blood glucose control (HbA1c), and a stressor-evoked biomarker of inflammation (interleukin 6; IL-6) were obtained as part of a larger study of the genetic risk factors for and consequences of trauma exposure. Results The interaction of HbA1c and HF-HRV was significantly associated with IL-6 response calculated as area under the curve with respect to ground. Post-hoc simple slopes analyses revealed HbA1c, rather than HF-HRV, as the moderator in this association such that higher HF-HRV conferred higher circulating levels of IL-6 only in the presence of lower HbA1c, ( β ​= ​0.60, t ​= ​3.51, p ​= ​.001). Conclusions Cardiovascular autonomic functioning and blood glucose control were significantly associated with stressor-evoked IL-6 responses when controlling for BMI and age. Moreover, the association between cardiovascular autonomic functioning and inflammation varied at different levels of HbA1c. This highlights the possibility that individuals with trauma exposure and T2DM may benefit from stratification by HbA1c levels for research analysis and treatment decision making.

Work-family enrichment: A potential buffer of inflammation among black adults?

“…From 1999 to 2017, CVD death rates have dropped significantly for all age, race, and gender groups; however, the Black population still faces the highest rates of CVD mortality and morbidity ( Curtin, 2019 ). The increased burden of psychosocial stressors such as low income and family strain faced by Blacks has been linked to earlier progression of CVD and other chronic illnesses such as obesity and diabetes ( Friedman and Herd, 2010 ; Gebreab et al, 2017 ; Merker et al, 2022 ; Rohleder, 2014 ; Suglia et al, 2020 ).…”