Allostatic load is associated with chronic conditions in the Boston Puerto Rican Health Study
Open accessAbstract
Puerto Ricans living in the United States mainland present multiple disparities in prevalence of chronic diseases, relative to other racial and ethnic groups. Allostatic load (AL), or the cumulative wear and tear of physiological responses to stressors such as major life events, social and environmental burden, has been proposed as a possible mechanism for the inequalities observed in minority groups, but has not been studied in Puerto Ricans. The aim of this study was to determine the association of AL to six chronic diseases (abdominal obesity, hypertension, diabetes, and self-reported cardiovascular disease (CVD), arthritis and cancer) in Puerto Ricans, and to contrast AL to metabolic syndrome (MetS). Participants of the Boston Puerto Rican Health Study (n=1,116, ages 45–75 years) underwent a home-based interview, where questionnaires were completed and biological samples collected. A summary definition of AL was constructed using clinically-defined cutoffs and medication use for 10 physiological parameters in different body systems. Logistic regression models were run to determine associations between AL score and disease status, controlling for age, sex, smoking, alcohol use, physical activity, total fat intake and energy intake. Parallel models were also run with MetS score replacing AL. We found that increasing categories of AL score were significantly associated with abdominal obesity, hypertension, diabetes and self-reported cardiovascular disease (CVD) and arthritis, but not with self-reported cancer. The strength of associations of AL with all conditions, except diabetes and cancer, was similar to or larger than those of MetS score. In conclusion, Puerto Rican older adults experienced physiological dysregulation that was associated with increased odds of chronic conditions. AL was more strongly associated with most conditions, compared to MetS, suggesting that this cumulative measure may be a better predictor of disease. These results have prospective research implications for Puerto Ricans and other ethnic groups.
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One study of 1,000 individuals reported that high allostatic load was associated with increased T2DM risk.
“One study of 1,000 individuals reported that high allostatic load was associated with increased T2DM risk 57”
From Type 2 diabetes mellitus and psychological stress — a modifiable risk factor (2017) · cites this paper as [57]
The Results report higher odds of diabetes with increasing allostatic load, and Methods (Study Population; page unavailable) states that 1,116 participants were analyzed—approximately 1,000. However, the Discussion describes the data as cross-sectional and says they cannot establish causal direction, so the study supports an association with existing diabetes, not increased future T2DM risk. (LLM, conf=0.88)
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- Authors
- Mattei, J., Demissie, S., Falcon, L. M., Ordovas, J. M., & Tucker, K.
- Affiliations
- Tufts University (US)
- Boston University (US)
- Corresponding author
- Tucker, Katherine
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2010-06
- Volume
- 70
- Issue
- 12
- Pages
- 1988-1996
- ISSN
- 0277-9536 (ISSN-L)
- PMC
- PMC2907654
- OpenAlex
- W2049044751
- Semantic Scholar
- 6e79e891057cde928ee3c2bbe631f267067b4e1c
- Cited by
- 203
- References
- 83
- Citations by year
- 2026: 6 · 2025: 17 · 2024: 12 · 2023: 16 · 2022: 11 · 2021: 27 · 2020: 18 · 2019: 16 · 2018: 11 · 2017: 11 · 2016: 14 · 2015: 5 · 2014: 13 · 2013: 9 · 2012: 7
- FWCI
- 8.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- University Libraries (University of Maryland) (submittedVersion)
- Digital Repository at the University of Maryland (University of Maryland College Park)
- Funders
- National Institutes of Health-National Institute on Aging (P01-AG023394, P01-AG023394-S1)
- United States Department of Agriculture, Agricultural Research Service (58-1950-7-707)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- allostatic load, chronic disease, Puerto Ricans, metabolic syndrome, abdominal obesity, hypertension, diabetes mellitus, cardiovascular disease, arthritis, cancer, health disparities, physiological dysregulation, older adults, Boston Puerto Rican Health Study
- MeSH terms
- Aged, Arthritis, Boston, Cardiovascular Diseases, Chronic Disease, Diabetes Mellitus, Female, Health Surveys, Hispanic or Latino, Humans, Interviews as Topic, Male, Middle Aged, Neoplasms, Puerto Rico, Risk Factors, Logistic Models, Metabolic Syndrome, Allostasis, Health Status Disparities, Obesity, Abdominal
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