TY - JOUR
T1 - Latent profiles of biological dysregulation and risk of mortality
T2 - Time-to-event analysis using the Midlife in the US longitudinal study
AU - Carbone, Jason T.
AU - Holzer, Katherine J.
AU - Clift, Jennifer
AU - Fu, Qiang
N1 - Funding Information:
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).
Publisher Copyright:
© 2023 Author(s).
PY - 2023/3
Y1 - 2023/3
N2 - 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.
AB - 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.
KW - BIOSTATISTICS
KW - MORTALITY
KW - PUBLIC HEALTH
UR - http://www.scopus.com/inward/record.url?scp=85147834619&partnerID=8YFLogxK
U2 - 10.1136/jech-2021-218073
DO - 10.1136/jech-2021-218073
M3 - Article
C2 - 36627117
AN - SCOPUS:85147834619
SN - 0143-005X
VL - 77
SP - 182
EP - 188
JO - Journal of Epidemiology and Community Health
JF - Journal of Epidemiology and Community Health
IS - 3
ER -