Association of Allostatic Load with All-Cause and Cancer Mortality by Race and Body Mass Index in the REGARDS Cohort
Among 29,701 Black and White participants aged 45 years and older in the Reasons for Geographic and Racial Difference in Stroke (REGARDS) study, allostatic load (AL) was defined as the sum score of established baseline risk-associated biomarkers for which participants exceeded a set cutoff point. Co...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-06-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/6/1695 |
| _version_ | 1797564118042935296 |
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| author | Tomi Akinyemiju Lauren E Wilson April Deveaux Stella Aslibekyan Mary Cushman Susan Gilchrist Monika Safford Suzanne Judd Virginia Howard |
| author_facet | Tomi Akinyemiju Lauren E Wilson April Deveaux Stella Aslibekyan Mary Cushman Susan Gilchrist Monika Safford Suzanne Judd Virginia Howard |
| author_sort | Tomi Akinyemiju |
| collection | DOAJ |
| description | Among 29,701 Black and White participants aged 45 years and older in the Reasons for Geographic and Racial Difference in Stroke (REGARDS) study, allostatic load (AL) was defined as the sum score of established baseline risk-associated biomarkers for which participants exceeded a set cutoff point. Cox proportional hazard regression was utilized to determine the association of AL score with all-cause and cancer-specific mortality, with analyses stratified by body-mass index, age group, and race. At baseline, Blacks had a higher AL score compared with Whites (Black mean AL score: 2.42, SD: 1.50; White mean AL score: 1.99, SD: 1.39; <i>p</i> < 0.001). Over the follow-up period, there were 4622 all-cause and 1237 cancer-specific deaths observed. Every unit increase in baseline AL score was associated with a 24% higher risk of all-cause (HR: 1.24, 95% CI: 1.22, 1.27) and a 7% higher risk of cancer-specific mortality (HR: 1.07, 95% CI: 1.03, 1.12). The association of AL with overall- and cancer-specific mortality was similar among Blacks and Whites and across age-groups, however the risk of cancer-specific mortality was higher among normal BMI than overweight or obese participants. In conclusion, a higher baseline AL score was associated with increased risk of all-cause and cancer-specific mortality among both Black and White participants. Targeted interventions to patient groups with higher AL scores, regardless of race, may be beneficial as a strategy to reduce all-cause and cancer-specific mortality. |
| first_indexed | 2024-03-10T18:52:54Z |
| format | Article |
| id | doaj.art-fa9504e15b434ed18feb27a05f92c9c7 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T18:52:54Z |
| publishDate | 2020-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-fa9504e15b434ed18feb27a05f92c9c72023-11-20T05:00:23ZengMDPI AGCancers2072-66942020-06-01126169510.3390/cancers12061695Association of Allostatic Load with All-Cause and Cancer Mortality by Race and Body Mass Index in the REGARDS CohortTomi Akinyemiju0Lauren E Wilson1April Deveaux2Stella Aslibekyan3Mary Cushman4Susan Gilchrist5Monika Safford6Suzanne Judd7Virginia Howard8Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27701, USADuke Cancer Institute, Duke University, Durham, NC 27710, USADuke Cancer Institute, Duke University, Durham, NC 27710, USADepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35233, USADepartment of Medicine and University of Vermont Cancer Center, Larner College of Medicine at the University of Vermont, Burlington, VT 05405, USADepartment of Clinical Cancer Prevention and Cardiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030; USAWeill Cornell Medical College, Weill Cornell, New York City, NY 10065, USADepartment of Biostatistics, University of Alabama at Birmingham, Birmingham, AL 35233, USADepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35233, USAAmong 29,701 Black and White participants aged 45 years and older in the Reasons for Geographic and Racial Difference in Stroke (REGARDS) study, allostatic load (AL) was defined as the sum score of established baseline risk-associated biomarkers for which participants exceeded a set cutoff point. Cox proportional hazard regression was utilized to determine the association of AL score with all-cause and cancer-specific mortality, with analyses stratified by body-mass index, age group, and race. At baseline, Blacks had a higher AL score compared with Whites (Black mean AL score: 2.42, SD: 1.50; White mean AL score: 1.99, SD: 1.39; <i>p</i> < 0.001). Over the follow-up period, there were 4622 all-cause and 1237 cancer-specific deaths observed. Every unit increase in baseline AL score was associated with a 24% higher risk of all-cause (HR: 1.24, 95% CI: 1.22, 1.27) and a 7% higher risk of cancer-specific mortality (HR: 1.07, 95% CI: 1.03, 1.12). The association of AL with overall- and cancer-specific mortality was similar among Blacks and Whites and across age-groups, however the risk of cancer-specific mortality was higher among normal BMI than overweight or obese participants. In conclusion, a higher baseline AL score was associated with increased risk of all-cause and cancer-specific mortality among both Black and White participants. Targeted interventions to patient groups with higher AL scores, regardless of race, may be beneficial as a strategy to reduce all-cause and cancer-specific mortality.https://www.mdpi.com/2072-6694/12/6/1695allostatic loadmortalityracial disparitiesobesitybiomarkers |
| spellingShingle | Tomi Akinyemiju Lauren E Wilson April Deveaux Stella Aslibekyan Mary Cushman Susan Gilchrist Monika Safford Suzanne Judd Virginia Howard Association of Allostatic Load with All-Cause and Cancer Mortality by Race and Body Mass Index in the REGARDS Cohort Cancers allostatic load mortality racial disparities obesity biomarkers |
| title | Association of Allostatic Load with All-Cause and Cancer Mortality by Race and Body Mass Index in the REGARDS Cohort |
| title_full | Association of Allostatic Load with All-Cause and Cancer Mortality by Race and Body Mass Index in the REGARDS Cohort |
| title_fullStr | Association of Allostatic Load with All-Cause and Cancer Mortality by Race and Body Mass Index in the REGARDS Cohort |
| title_full_unstemmed | Association of Allostatic Load with All-Cause and Cancer Mortality by Race and Body Mass Index in the REGARDS Cohort |
| title_short | Association of Allostatic Load with All-Cause and Cancer Mortality by Race and Body Mass Index in the REGARDS Cohort |
| title_sort | association of allostatic load with all cause and cancer mortality by race and body mass index in the regards cohort |
| topic | allostatic load mortality racial disparities obesity biomarkers |
| url | https://www.mdpi.com/2072-6694/12/6/1695 |
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