Appetite Regulation and Allostatic Load Across Prediabetes Phenotypes

Area of Science:

• Endocrinology
• Metabolic Health
• Stress Physiology

Background:

• Allostatic load quantifies chronic stress, a factor implicated in appetite dysregulation.
• Individuals with obesity and type 2 diabetes show elevated allostatic load.
• The relationship between allostatic load, prediabetes phenotypes, and appetite remains unclear.

Purpose of the Study:

• To investigate differences in allostatic load across prediabetes phenotypes.
• To examine the association between allostatic load and appetite regulation in prediabetes.

Main Methods:

• A cross-sectional study involving individuals with obesity.
• Prediabetes classification using American Diabetes Association (ADA) criteria (75 g OGTT).
• Measurement of appetite hormones (ghrelin, PYY), glucose, insulin, and subjective appetite ratings during OGTT.
• Calculation of allostatic load from physiological markers; assessment of aerobic fitness, body composition, and clinical labs.

Main Results:

• Individuals with combined impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) presented higher allostatic load, obesity, and insulin resistance compared to IFG or IGT alone (p < 0.05).
• The IFG + IGT group exhibited lower fasting ghrelin levels but similar fasting PYY levels compared to other groups.
• While hunger and fullness perceptions were comparable, ratings for fatty foods tended to be higher in the IFG + IGT group.

Conclusions:

• Higher allostatic load in the IFG + IGT group was linked to altered fasting ghrelin, increased body weight, and insulin resistance.
• These findings suggest that chronic stress may be a contributing factor to appetite dysregulation in various forms of prediabetes.