title: Sociodemographic, behavioral and genetic determinants of allostatic load in a Swiss population-based study.
abstract: Allostatic load (AL) is a marker of physiological dysregulation which reflects exposure to chronic stress. High AL has been related to poorer health outcomes including mortality. We examine here the association of socioeconomic and lifestyle factors with AL. Additionally, we investigate the extent to which AL is genetically determined. We included 803 participants (52% women, mean age 48±16years) from a population and family-based Swiss study. We computed an AL index aggregating 14 markers from cardiovascular, metabolic, lipidic, oxidative, hypothalamus-pituitary-adrenal and inflammatory homeostatic axes. Education and occupational position were used as indicators of socioeconomic status. Marital status, stress, alcohol intake, smoking, dietary patterns and physical activity were considered as lifestyle factors. Heritability of AL was estimated by maximum likelihood. Women with a low occupational position had higher AL (low vs. high OR=3.99, 95%CI [1.22;13.05]), while the opposite was observed for men (middle vs. high OR=0.48, 95%CI [0.23;0.99]). Education tended to be inversely associated with AL in both sexes(low vs. high OR=3.54, 95%CI [1.69;7.4]/OR=1.59, 95%CI [0.88;2.90] in women/men). Heavy drinking men as well as women abstaining from alcohol had higher AL than moderate drinkers. Physical activity was protective against AL while high salt intake was related to increased AL risk. The heritability of AL was estimated to be 29.5% ±7.9%. Our results suggest that generalized physiological dysregulation, as measured by AL, is determined by both environmental and genetic factors. The genetic contribution to AL remains modest when compared to the environmental component, which explains approximately 70% of the phenotypic variance.
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Route de la corniche 10, 1010 Lausanne, Switzerland.
authors.forename: Dusan
authors.initials: D
authors.lastname: Petrovic
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Route de la corniche 10, 1010 Lausanne, Switzerland.
authors.forename: Edward
authors.initials: E
authors.lastname: Pivin
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Route de la corniche 10, 1010 Lausanne, Switzerland; Department of Nephrology and Hypertension, University Hospital of Geneva (HUG), Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland.
authors.forename: Belen
authors.initials: B
authors.lastname: Ponte
authors.affiliation: University Clinic for Nephrology, Hypertension and Clinical Pharmacology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland.
authors.forename: Nasser
authors.initials: N
authors.lastname: Dhayat
authors.affiliation: Department of Nephrology and Hypertension, Lausanne University Hospital, Rue du Bugnon 17, 1011 Lausanne, Switzerland.
authors.forename: Menno
authors.initials: M
authors.lastname: Pruijm
authors.affiliation: Department of Cardiology, University Hospital of Geneva (HUG), Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland.
authors.forename: Georg
authors.initials: G
authors.lastname: Ehret
authors.affiliation: University Clinic for Nephrology, Hypertension and Clinical Pharmacology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ackermann
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Route de la corniche 10, 1010 Lausanne, Switzerland; Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Community Medicine and Primary Care and Emergency Medicine, University Hospital of Geneva (HUG), Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland.
authors.forename: Idris
authors.initials: I
authors.lastname: Guessous
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Route de la corniche 10, 1010 Lausanne, Switzerland.
authors.forename: Sandrine Estoppey
authors.initials: SE
authors.lastname: Younes
authors.affiliation: Department of Nephrology and Hypertension, University Hospital of Geneva (HUG), Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Pechère-Bertschi
authors.affiliation: University Clinic for Nephrology, Hypertension and Clinical Pharmacology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland.
authors.forename: Bruno
authors.initials: B
authors.lastname: Vogt
authors.affiliation: University Clinic for Nephrology, Hypertension and Clinical Pharmacology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: Mohaupt
authors.affiliation: Department of Nephrology and Hypertension, University Hospital of Geneva (HUG), Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Martin
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Route de la corniche 10, 1010 Lausanne, Switzerland.
authors.forename: Fred
authors.initials: F
authors.lastname: Paccaud
authors.affiliation: Department of Nephrology and Hypertension, Lausanne University Hospital, Rue du Bugnon 17, 1011 Lausanne, Switzerland.
authors.forename: Michel
authors.initials: M
authors.lastname: Burnier
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Route de la corniche 10, 1010 Lausanne, Switzerland.
authors.forename: Murielle
authors.initials: M
authors.lastname: Bochud
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Route de la corniche 10, 1010 Lausanne, Switzerland. Electronic address: silvia.stringhini@chuv.ch.
authors.forename: Silvia
authors.initials: S
authors.lastname: Stringhini
mesh_terms: D052636:Allostasis / Q000235:genetics* / Q000502:physiology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012923:Social Class
keywords: Allostatic load; heritability; physiological dysregulation; population-based; socioeconomic status