Allostatic load as a stress marker in MONICA/KORA

Allostatic load (AL) is the burden that is imposed on the body by either chronic or repeated stress or inadequate regulation of stress responses. High AL has been found to be associated with adverse health outcomes such as cardiovascular disease and all-cause mortality. Here we aimed to develop an AL index as an indicator for repeated or chronic stress to be applied to the population of the KORA S3 survey data. The objective was to assess whether this index was predictive of mortality caused by CHD, CVD or stroke, as well as all-cause mortality. Furthermore we investigated potential interactions of the index with psychosocial factors, for instance job strain or depression. The study population consisted of 4486 subjects from the population-based KORA study. Using logistic regression, we found that AL was a significant predictor of mortality from cardiovascular disease (OR 1.152, 95% CI 1.052–1.263) and all-cause mortality (OR 1.708, 95% CI 1.084–1.222) in our dataset. Of the psychosocial factors included, only the Social Network Index (SNI) showed to be a significant predictor of mortality from stroke (OR 0.496, 95% CI 0.280–0.878) and all-cause mortality (OR 0.770, 95% CI 0.663–0.893). Our findings confirm the predictive power of AL for cardiovascular-related disease and mortality. Psychosocial factors do not significantly impact the predictive risk of allostatic load on mortality.