Article Text

Download PDFPDF
Latent profiles of biological dysregulation and risk of mortality: time-to-event analysis using the Midlife in the US longitudinal study
  1. Jason T Carbone1,
  2. Katherine J Holzer2,
  3. Jennifer Clift1,
  4. Qiang Fu3
  1. 1School of Social Work, Wayne State University, Detroit, Michigan, USA
  2. 2St Louis School of Medicine, Washington University, St Louis, Missouri, USA
  3. 3Department of Community Health, Tufts University, Medford, Massachusetts, USA
  1. Correspondence to Dr Jason T Carbone, School of Social Work, Wayne State University, Detroit, Michigan 48202, USA; jason.carbone{at}wayne.edu

Abstract

Background There is a well-established relationship between high allostatic load (AL) and increased risk of mortality. This study expands on the literature by combined latent profile analysis (LPA) with survival data analysis techniques to assess the degree to which AL status is associated with time to death.

Methods LPA was employed to identify underlying classes of biological dysregulation among a sample of 815 participants from the Midlife in the US study. Sex-stratified Cox proportional hazards regression models were used to estimate the association between class of biological dysregulation and time to death while controlling for sociodemographic covariates.

Results The LPA resulted in three classes: low dysregulation, immunometabolic dysregulation and parasympathetic reactivity. Women in the immunometabolic dysregulation group had more than three times the risk of death as compared with women in the low dysregulation group (HR=3.25, 95% CI: 1.47 to 7.07), but that there was not a statistically significant difference between the parasympathetic reactivity group and the low dysregulation group (HR=1.80, 95% CI: 0.62 to 5.23). For men, the risk of death for those in the immunometabolic dysregulation (HR=1.79, 95% CI: 0.88 to 3.65) and parasympathetic reactivity (HR=0.90, 95% CI: 0.34 to 3.65) groups did not differ from the low dysregulation group.

Conclusion The findings are consistent with the previous research that demonstrates increased AL as a risk factor for mortality. Specifically, in women, that increased risk may be associated with immunometabolic dysregulation and not simply a generalised measure of cumulative risk as is typically employed in AL research.

  • MORTALITY
  • PUBLIC HEALTH
  • BIOSTATISTICS

Data availability statement

Data are available in a public, open access repository. Data from the MIdlife in the United States (MIDUS) study is freely available via https://www.icpsr.umich.edu/web/pages/

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data are available in a public, open access repository. Data from the MIdlife in the United States (MIDUS) study is freely available via https://www.icpsr.umich.edu/web/pages/

View Full Text

Footnotes

  • Contributors JTC designed and implemented the study, analysed the data, drafted the manuscript, and is the guarantor. KJH provided input on the analysis, assisted with results interpretation, aided in drafting the manuscript, reviewed and edited the manuscript. JC assisted with the literature review and reviewed and edited the manuscript. QF provided input on the analysis, assisted with results interpretation, reviewed and edited the manuscript.

  • Funding This research was supported by a 2021–2022 University Research Grant from the Wayne State University Office of the Provost Grant (internal funding, grant number not applicable).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.