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应激激素负荷:少数民族和差异人群中的重要性、标志物和评分确定。

Allostatic Load: Importance, Markers, and Score Determination in Minority and Disparity Populations.

机构信息

Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 3 Center Drive, Room 5W21, Bethesda, MD, 20892-0311, USA.

Section of Ethnicity and Health, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.

出版信息

J Urban Health. 2019 Mar;96(Suppl 1):3-11. doi: 10.1007/s11524-019-00345-5.

Abstract

Allostatic load is a physiological measure of the cumulative burden of stress on the body assessed by markers of physiological dysregulation. It is a multisystem construct that quantifies biological risk which leads to poor health and maladaptive trajectories. In this overview, which is based on a presentation made at the Flip the Script: Understanding African American Women's Resilience in the Face of Allostatic Load meeting at Ohio State University in August 2018, we build upon previous reviews by discussing four key aspects of allostatic load, specifically its: (1) importance, (2) operationalization, (3) use in minority health and health disparities research, and (4) value in such research. Operationalized in various ways, allostatic load is composed of 10 original markers and additional markers deriving from research among minority and disparity populations. The markers represent four biological systems: (1) cardiovascular, (2) metabolic, (3) inflammatory, and (4) neuroendocrine. System-specific racial/ethnic and sex-based differences have been observed. An overall score can be determined using sample-generated or empirically derived clinically relevant cut points. In summary, allostatic load provides an overall and a body system-specific mechanistic link between exposures to stressors and health outcomes that may help explain health disparities among minority populations.

摘要

应激反应负荷是一种生理测量方法,用于评估生理失调标志物所反映的压力对身体的累积负担。它是一种多系统结构,可量化导致健康状况不佳和适应不良轨迹的生物风险。在本次概述中,我们基于 2018 年 8 月在俄亥俄州立大学举行的“翻转脚本:了解非裔美国女性在应对应激反应负荷方面的韧性”会议上的演讲,在先前的综述基础上进行讨论,内容涉及应激反应负荷的四个关键方面,具体包括:(1)重要性,(2)操作化,(3)在少数族裔健康和健康差异研究中的应用,以及(4)此类研究的价值。应激反应负荷通过各种方式进行操作化,由 10 个原始标志物和源自少数族裔和差异人群研究的其他标志物组成。这些标志物代表四个生物系统:(1)心血管,(2)代谢,(3)炎症,和(4)神经内分泌。已经观察到特定种族/民族和性别差异的系统。可以使用样本生成或经验衍生的临床相关切点来确定总体评分。总之,应激反应负荷提供了一种总体和特定于身体系统的机制联系,将压力源暴露与健康结果联系起来,这可能有助于解释少数族裔人群中的健康差异。

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