a Institute for Occupational Social and Environmental Medicine , RWTH Aachen University , Aachen , Germany.
b Corporate Health Management Germany , Deutsche Post DHL Group, Headquarters , Bonn , Germany.
Stress. 2019 Jan;22(1):9-16. doi: 10.1080/10253890.2018.1492537. Epub 2018 Oct 23.
The allostatic load index (ALI) assesses the physiological adaption to chronic stress by cumulative changes in the circulation, respiration, inflammation, metabolic and anthropometric systems. The ALI thus can function as a risk marker for secondary prevention in occupational medicine. The aim of this study was to investigate the feasibility of creating a predictive marker by using data from an executive checkup program of an international company and to examine its relationship to work-related surrogate health parameters. Datasets from 307 examinations of 151 executives (19 males and 132 females) were available. Each participant attended at least one checkup examination between 2003 and 2015. The mean age was 43.6 (SD ±6.6, 31-64y). We developed four different ALIs with different biomarkers of the cardio-vascular, immune, metabolic and anthropometric systems. As a primary mediator, the thyroid-stimulating hormone was used as a proxy. For each ALI, the associations with the work ability index (WAI) and categories of sick leave days (SLD) were examined. Zero inflation was considered for SLD. One ALI showed a significant negative association with the WAI (B = -0.680, SE =0.266, p = .049). The results of a second ALI had a similar trend (B= -0.355, SE =0.201, p = .081). After adjustment for zero inflation two other ALIs showed a positive association with SLD. This study provides the first hints that biomarkers form a secondary prevention program are useful in calculating a meaningful ALI. Thus, the concept of allostatic load could be used in workplace health-promotion.
应激适应负荷指数（ALI）通过循环、呼吸、炎症、代谢和人体测量系统的累积变化来评估对慢性应激的生理适应。因此，ALI 可以作为职业医学二级预防的风险标志物。本研究旨在探讨使用国际公司执行体检计划的数据创建预测标志物的可行性，并研究其与与工作相关的替代健康参数的关系。共有 151 名高管（19 名男性和 132 名女性）的 307 次检查的数据集可用。每位参与者在 2003 年至 2015 年间至少参加了一次体检。参与者的平均年龄为 43.6（SD ±6.6，31-64 岁）。我们开发了四个不同的 ALI，它们具有不同的心血管、免疫、代谢和人体测量系统的生物标志物。甲状腺刺激激素作为主要介质，被用作替代物。对于每个 ALI，都检查了与工作能力指数（WAI）和病假天数（SLD）类别的关系。考虑到 SLD 的零膨胀。一个 ALI 与 WAI 呈显著负相关（B =-0.680，SE =0.266，p =0.049）。第二个 ALI 的结果也有类似的趋势（B =-0.355，SE =0.201，p =0.081）。在调整零膨胀后，另外两个 ALI 与 SLD 呈正相关。本研究首次提示，二级预防计划中的生物标志物在计算有意义的 ALI 方面是有用的。因此，应激适应负荷的概念可用于工作场所健康促进。
