Racial/Ethnic Disparities in All-Cause Mortality in US Adults: The Effect of Allostatic Load
Racial/Ethnic Disparities in All-Cause Mortality in US Adults: The Effect of Allostatic Load
复制标题
DOI：
10.1177/003335491012500608
复制
发表时间：
2010-11-01
影响因子：
3.3
通讯作者：
Nguyen, Norma
中科院分区：
文献类型：
--
作者：
Borrell, Luisa N.;Dallo, Florence J.;Nguyen, Norma
Objective.我们研究了累积生物学风险或非稳态评分与全因死亡风险之间的关系。我们使用了与国家死亡指数相关的第三次全国健康和营养检查调查（NHANES III）中的13，715名25岁及以上参与者的记录。我们使用死亡证明中的潜在死亡原因指定全因死亡率。我们使用NHANES III访谈月和年计算从访谈日到2000年12月31日的死亡时间，作为随访的人年。我们使用考克斯比例风险回归来估计非稳态评分为2和>= 3的患者相对于非稳态评分为结果的患者的全因死亡风险的风险比（HR）。在控制了年龄、性别、种族/民族、教育和收入后，与非稳态评分>= 1的受试者相比，非稳态评分为2和>= 3的受试者的死亡率分别高出40%（HR=1.40，95%置信区间[CI] 1.11，1.76）和88%（HR=1.88，95% CI 1.56，2.26）。与各种族/民族的非稳态评分相关的死亡率随年龄而异。非稳态评分增加了全因死亡的风险。此外，在65岁以下的成年人中观察到这种风险增加，无论其种族/民族如何。因此，在美国，变应性评分可能是导致过早死亡的一个因素。
Objective. We investigated the association between a cumulative biological risk or allostatic score and all-cause mortality risk. We used 13,715 records of participants aged 25 years and older from the Third National Health and Nutrition Examination Survey (NHANES III) linked to the National Death Index.Methods. We specified all-cause mortality using the underlying cause of death in the death certificate. We calculated time to death from interview date through December 31, 2000, as person-years of follow-up using the NHANES III interview month and year. We used Cox proportional hazards regression to estimate hazard ratios (HRs) relating all-cause mortality risk for those with an allostatic score of 2 and >= 3 relative to those with an allostatic score ofResults. After controlling for age, gender, race/ethnicity, education, and income, mortality rates were 40% (HR=1.40, 95% confidence interval [Cl] 1.11, 1.76) and 88% (HR=1.88, 95% Cl 1.56, 2.26) higher for participants with an allostatic score of 2 and >= 3, respectively, compared with those with a score of >= 1. The death rate associated with allostatic score for each racial/ethnic group differed with age.Conclusions. The allostatic score increased the risk of all-cause mortality. Moreover, this increased risk was observed for adults younger than 65 years of age regardless of their race/ethnicity. Thus, allostatic score may be a contributor to premature death in the U.S.