title: Exploring the bio-behavioural link between stress, allostatic load & micronutrient status: A cross-sectional study among adolescent boys.
abstract: OBJECTIVE
  Allostatic load (AL) is a cumulative measure of physiological deregulation and is influenced by multiple factors including nutrition. The objectives of the study were to assess AL among adolescent boys (15-19 yr) and delineate its association with psychological stress and micronutrient status.
  
  
  METHODS
  A cross-sectional, school-based study was conducted among 370 adolescent boys of five higher secondary schools from Hyderabad, India. Perceived stress, adolescent life event stress (ALES), psychological morbidity and coping were measured. Biomarkers of AL included dehydroepiandrosterone sulphate, 12-h urinary cortisol, interleukin-6, C-reactive protein, lipid profile, body mass index and blood pressure. Micronutrient status with respect to iron (haemoglobin, ferritin, hepcidin, soluble transferrin receptor), folate, vitamins B12, C and A were analyzed in a sub-sample of 146 boys. AL score ≥3 was calculated from eight biomarkers.
  
  
  RESULTS
  Fourteen per cent participants had no AL but 34.3 per cent had AL score of ≥ 3. Unadjusted means of ALES scores were significantly different (P = 0.045) among participants with low [mean, 95% confidence interval (CI): 580, 531-629] and high (663, 605-721) AL. After controlling for confounders, the means were significantly different for controllable life event sub-scale of ALES (P = 0.048). Adjusted hepcidin concentrations were significantly higher among participants with high AL (means, 95% CI, 27.2, 24.0-30.8 for high AL; 22.1, 20.2-24.2 μg/l for low AL, P = 0.014).
  
  
  CONCLUSIONS
  Build-up of AL was found in adolescent boys and was positively associated with life event stress. Iron nutrition and stress exhibited a positive association through hepcidin. The study provides a link between iron nutrition, physiological deregulation and stress.
authors.affiliation: Divisions of Micronutrient Research, National Institute of Nutrition, (ICMR), Hyderabad, India.
authors.forename: Little Flower
authors.initials: LF
authors.lastname: Augustine
authors.affiliation: Divisions of Micronutrient Research, National Institute of Nutrition, (ICMR), Hyderabad, India.
authors.forename: Krishnapillai Madhavan
authors.initials: KM
authors.lastname: Nair
authors.affiliation: Behavioural Sciences, National Institute of Nutrition, (ICMR), Hyderabad, India.
authors.forename: Sylvia Fernandez
authors.initials: SF
authors.lastname: Rao
authors.affiliation: Biostatistics, National Institute of Nutrition, (ICMR), Hyderabad, India.
authors.forename: Mendu Vishnu Vardhana
authors.initials: MV
authors.lastname: Rao
authors.affiliation: Divisions of Micronutrient Research, National Institute of Nutrition, (ICMR), Hyderabad, India.
authors.forename: Punjal
authors.initials: P
authors.lastname: Ravinder
authors.affiliation: Community Studies, National Institute of Nutrition, (ICMR), Hyderabad, India.
authors.forename: Avula
authors.initials: A
authors.lastname: Laxmaiah
mesh_terms: D000293:Adolescent; D000328:Adult; D052636:Allostasis; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005293:Ferritins / Q000097:blood; D005492:Folic Acid / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007194:India; D015850:Interleukin-6 / Q000097:blood; D007501:Iron / Q000097:blood; D008297:Male; D018977:Micronutrients / Q000097:blood* / Q000502:physiology; D009752:Nutritional Status; D013315:Stress, Psychological / Q000097:blood* / Q000503:physiopathology; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D018977:Micronutrients; D019314:Dehydroepiandrosterone Sulfate; D002097:C-Reactive Protein; D005293:Ferritins; D005492:Folic Acid; D007501:Iron; D014805:Vitamin B 12; D006854:Hydrocortisone