Online Program

Allostatic Load Score and Communicable Diseases: An Exploratory Study

Monday, November 2, 2015 : 2:50 p.m. - 3:10 p.m.

Alexander Chaitoff, MPH, Cleveland Clinic Lerner College of Medicine, Cleveland, OH
Joshua Niforatos, MTS, Cleveland Clinic Lerner College of Medicine, Cleveland, OH
Jennifer J. Furin, MD, PhD, Department of Medicine, TB Research Unit, Case Western Reserve University, Cleveland, OH
Purpose: The literature exploring allostatic load relates mainly to only chronic pathologies. However, chronic stress has also been shown increase risk of certain infections. In this study, we examine the association of allostatic load (AL) scores with risk of communicable disease.

Methods: Data were obtained from the 1999-2002 National Health and Nutrition Examination Survey (NHANES IV). AL scores were calculated in accordance with group allostatic load index utilizing albumin, BMI, C-reactive protein, creatinine clearance, diastolic blood pressure, glycated hemoglobin, homocysteine, systolic blood pressure, total cholesterol, and triglyceride measurements. Acute illness was determined by subjects’ responses to three questions concerning whether they had had symptoms of upper respiratory infection, gastrointestinal infection, or the flu during a previous four week period. Logistic regression models that controlled for age, sex, race, income, and education status were used to evaluate the associations between AL score and infection symptom status.

Results: AL scores were calculated for 10018 individuals and ranged from 0 to 10 (x̄=2.40).  Having an AL score of 3 or more was significantly associated with the probability of reporting symptoms of infection (OR= 0.851, p<.01). Higher AL scores were generally associated with higher likelihood of reporting symptoms of infection, and subjects in the highest AL score category (6 or more) were at 31.4% increased odds of reporting symptoms of infection compared with subjects with in the lowest AL score category (1 or less, p<.001).

Conclusions: Allostatic load scores may provide insights into communicable disease risk.

Learning Areas:

Clinical medicine applied in public health
Public health or related research

Learning Objectives:
Explain how allostatic load has previously been used to associate chronic disease risk with wear and tear on the body Explain how chronic stress has been shown to relate to infectious disease risk Demonstrate how allostatic load score is directly correlated with risk of having symptoms of communicable diseases Discuss how the association between allostatic load and communicable diseases explain related health disparities

Keyword(s): Epidemiology, Stress

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: A current student at a medical school with the stated goal of training physician-investigators, I obtained my MPH as a 2013 Marshall Scholar at the University of Sheffield. I have worked under multiple federally-funded principal investigators and presented studies at both poster and oral sessions, including at a former APHA Annual Meeting. My research interests have included exploring potential versus realized access to care and other aspects of health disparities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.