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.
- PUBLIC HEALTH
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/
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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.
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