Association between allostatic load and mortality among Chinese older adults: the Chinese Longitudinal Health and Longevity Study

Epigenomic Links Between Social Determinants of Health and Symptoms: A Scoping Review

Social determinants of health (SDoH) impact health and wellness. The link between SDoH and adverse health outcomes, including symptom occurrence and severity, may be explained by an individual's physiologic response to one or more SDoH. One potential mechanism underlying this physiologic response linking SDoH and symptoms is the dynamic epigenome. The purpose of this scoping review of the literature was to examine differential susceptibility for symptoms by identifying and summarizing research linking SDoH and symptoms through epigenomic mechanisms. PubMed was searched to identify empirical research where at least one SDoH was an independent or dependent variable, at least one symptom was investigated, and the investigation included an epigenomic measure. Of the 484 articles initially retrieved, after thorough vetting, 41 articles met eligibility. The most studied symptom was depressive symptoms followed by anxiety, cognitive function, sleep dysfunction, and pain. The most frequently studied SDoH were: 1) stress, particularly early life stress and acculturative stress; and 2) trauma, predominantly childhood trauma. DNA methylation and telomere length were the most studied epigenomic measures. Four genes (SLC6A4, BDNF, NR3C1, OXTR) had evidence from multiple studies and across methodological approaches linking SDoH to symptoms. This review supports the inclusion of epigenomic approaches to better understand the link between SDoH and symptoms and provides evidence that SDoH impact telomere length and the methylation of genes involved in neurotransmitter signaling, neuronal survival, behavior, inflammation and stress response.

Physical activity is associated with allostatic load: Evidence from the National Health and Nutrition Examination Survey

We determined the associations between physical activity and allostatic load, and whether it is a modifiable factor related to allostatic load. We obtained data from the National Health and Nutrition Examination Survey (NHANES) database collected between 2017 and March 2020. The relationship between physical activity and allostatic load was examined using a logistic regression model. In the unadjusted model, physical activity level was associated with allostatic load index (odds ratio [OR] = 0.664, 95% confidence interval [CI]: 0.550, 0.802, P＜0.001), with this relationship being retained in the adjusted model (OR = 0.739, 95%CI: 0.603, 0.907; P = 0.004). Sedentary behaviour was also related to allostatic load index (OR = 1.236, 95%CI: 1.005, 1.520; P = 0.044). Our findings indicated that sufficient physical activity is associated with a lower allostatic load index, and sedentary behaviour is associated with a higher allostatic load index. Physical activity is a modifiable factor related to allostatic load.

Allostatic load as predictor of mortality: a cohort study from Lolland-Falster, Denmark

OBJECTIVES

The purposes of the present study were to determine the association between (1) 10 individual biomarkers and all-cause mortality; and between (2) allostatic load (AL), across three physiological systems (cardiovascular, inflammatory, metabolic) and all-cause mortality.

DESIGN

Prospective cohort study.

SETTING

We used data from the Lolland-Falster Health Study undertaken in Denmark in 2016-2020 and used data on systolic blood pressure (SBP) and diastolic blood pressure (DBP), pulse rate (PR), waist-hip ratio (WHR) and levels of low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglycerides, glycated haemoglobin A1c (HbA1c), C-reactive protein (CRP) and serum albumin. All biomarkers were divided into quartiles with high-risk values defined as those in the highest (PR, WHR, triglycerides, HbA1c, CRP) or lowest (HDL-c, albumin) quartile, or a combination hereof (LDL-c, SBP, DBP). The 10 biomarkers were combined into a summary measure of AL index. Participants were followed-up for death for an average of 2.6 years.

PARTICIPANTS

We examined a total of 13 725 individuals aged 18+ years.

PRIMARY OUTCOME MEASURE

Cox proportional hazard regression (HR) analysis were performed to examine the association between AL index and mortality in men and women.

RESULTS

All-cause mortality increased with increasing AL index. With low AL index as reference, the HR was 1.33 (95% CI: 0.89 to 1.98) for mid AL, and HR 2.37 (95% CI: 1.58 to 3.54) for high AL.

CONCLUSIONS

Elevated physiological burden measured by mid and high AL index was associated with a steeper increase of mortality than individual biomarkers.

Quo Vadis Anesthesiologist? The Value Proposition of Future Anesthesiologists Lies in Preserving or Restoring Presurgical Health after Surgical Insult

This Special Issue of the Journal of Clinical Medicine is devoted to anesthesia and perioperative care [...].