Towards a consensus definition of allostatic load: a multi-cohort, multi-system, multi-biomarker individual participant data (IPD) meta-analysis

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dc.contributor.authorCathal McCrory
dc.contributor.authorSinead McLoughlin
dc.contributor.authorRichard Layte
dc.contributor.authorCliona NiCheallaigh
dc.contributor.authorAisling M. O’Halloran
dc.contributor.authorHenrique Barros
dc.contributor.authorLisa F. Berkman
dc.contributor.authorMurielle Bochud
dc.contributor.authorEileen M. Crimmins
dc.contributor.authorMeagan T. Farrell
dc.contributor.authorSilvia Fraga
dc.contributor.authorEmily Grundy
dc.contributor.authorMichelle Kelly-Irving
dc.contributor.authorDusan Petrovic
dc.contributor.authorTeresa Seeman
dc.contributor.authorSilvia Stringhini
dc.contributor.authorPeter Vollenveiderl
dc.contributor.authorRose Anne Kenny
dc.date.accessioned2024-02-28T11:38:55Z
dc.date.available2024-02-28T11:38:55Z
dc.date.issued2023-04-19
dc.description.abstractBackground: Allostatic load (AL) is a multi-system composite index for quantifying physiological dysregulation caused by life course stressors. For over 30 years, an extensive body of research has drawn on the AL framework but has been hampered by the lack of a consistent definition. Methods: This study analyses data for 67,126 individuals aged 40–111 years participating in 13 different cohort studies and 40 biomarkers across 12 physiological systems: hypothalamic-pituitary-adrenal (HPA) axis, sympathetic-adrenal-medullary (SAM) axis, parasympathetic nervous system functioning, oxidative stress, immunological/inflammatory, cardiovascular, respiratory, lipidemia, anthropometric, glucose metabolism, kidney, and liver. We use individual-participant-data meta-analysis and exploit natural heterogeneity in the number and type of biomarkers that have been used across studies, but a common set of health outcomes (grip strength, walking speed, and self-rated health), to determine the optimal configuration of parameters to define the concept. Results: There was at least one biomarker within 9/12 physiological systems that was reliably and consistently associated in the hypothesised direction with the three health outcomes in the meta-analysis of these cohorts: dehydroepiandrosterone sulfate (DHEAS), low frequency-heart rate variability (LF-HRV), C-reactive protein (CRP), resting heart rate (RHR), peak expiratory flow (PEF), high density lipoprotein cholesterol (HDL-C), waistto-height ratio (WtHR), HbA1c, and cystatin C. An index based on five biomarkers (CRP, RHR, HDL-C, WtHR and HbA1c) available in every study was found to predict an independent outcome – mortality – as well or better than more elaborate sets of biomarkers. Discussion: This study has identified a brief 5-item measure of AL that arguably represents a universal and efficient set of biomarkers for capturing physiological ‘wear and tear’ and a further biomarker (PEF) that could usefully be included in future data collection.
dc.description.librarianPM2023
dc.facultyFaculty of Health Sciences
dc.identifier.urihttps://hdl.handle.net/10539/37723
dc.language.isoen
dc.schoolPublic Health
dc.titleTowards a consensus definition of allostatic load: a multi-cohort, multi-system, multi-biomarker individual participant data (IPD) meta-analysis
dc.typeArticle
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