SynthesisPsychoneuroendocrinology2023
Towards a consensus definition of allostatic load: a multi-cohort, multi-system, multi-biomarker individual participant data (IPD) meta-analysis.
Synthesis in Psychoneuroendocrinology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Biological Markers of Burnout Severity: A Systematic Review.Stress and health : journal of the International Society for the Investigation of Stress · 2026Pooled it
- Chronic psychosocial stress: a role in breast cancer etiology?Frontiers in oncology · 2026Pooled it
- Allostatic load index across the psychosis spectrum: a systematic review and meta-analysis.Frontiers in psychiatry · 2025Pooled it
- Neighborhood Access to the Built Environment and Allostatic Load: A Systematic Review of the Use of Geographic Information Systems.Public health reviews · 2024Pooled it
- Associations between volatile organic compound mixtures and allostatic load: Evidence from the Green Heart Louisville Project.Environmental research · 2026Article
- A systematic review and empiric examination of the conceptual and analytic overlap between allostatic load and multimorbidity.SSM - population health · 2026Article
- Biomolecular Pathways Linking Preoperative Chronic Stress to Postoperative Cardiovascular Dysfunction in Noncardiac Surgery.Biomolecules · 2026Review
- Prioritizing clinical utility to use allostatic load as a biomarker of the consequences of stress.GeroScience · 2026Article
- Stress Processes and Resilience Pathways of Sexually and Gender Diverse Communities: A Narrative Review of 15 Years of Evolving Research Priorities and Practices.American journal of human biology : the official journal of the Human Biology Council · 2026Review
- Comparing allostatic load scoring methods and timing: their links to preterm birth outcomes.AJOG global reports · 2026Article
- Comment on: The effect of stress on testosterone and sexual function.International journal of impotence research · 2026Article
- The effect of stress on testosterone and sexual function.International journal of impotence research · 2026Review
- Review
- Pre-diagnostic biomarkers and risk of stress-related disorders: a cohort study based on electronic health records.BMC medicine · 2026Article
- Integration of lung function in allostatic load scoring and its impact on mortality prediction.Scientific reports · 2026Article
- An ageing biomarker signature predicts chronic disease cluster trajectories, physical function and mortality: validation in the TILDA and HRS cohorts.Age and ageing · 2026Article
- Physiological health Age (PhysAge): a novel multi-system molecular timepiece predicts health and mortality in older adults.GeroScience · 2026Article
- Assessing all-cause mortality and years of life lost associated with impaired biological health over time: the Tromsø study.European journal of public health · 2026Article
- Immuno-inflammatory-metabolic interactions in cardiovascular diseases: a review from basic mechanisms to clinical translation.Frontiers in immunology · 2026Review
- Human limits in next-generation fighter aviation: psychophysiological stressors, readiness, health, performance, and countermeasures.Frontiers in physiology · 2026Review
Corrections and comments
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Authors and funding
18 authors.
Funding
Abstract
backgroundAllostatic load (AL) is a multi-system composite index for quantifying physiological dysregulation caused by life course stressors. For over 30 years, an extensive body of research has drawn on the AL framework but has been hampered by the lack of a consistent definition.
methodsThis study analyses data for 67,126 individuals aged 40-111 years participating in 13 different cohort studies and 40 biomarkers across 12 physiological systems: hypothalamic-pituitary-adrenal (HPA) axis, sympathetic-adrenal-medullary (SAM) axis, parasympathetic nervous system functioning, oxidative stress, immunological/inflammatory, cardiovascular, respiratory, lipidemia, anthropometric, glucose metabolism, kidney, and liver. We use individual-participant-data meta-analysis and exploit natural heterogeneity in the number and type of biomarkers that have been used across studies, but a common set of health outcomes (grip strength, walking speed, and self-rated health), to determine the optimal configuration of parameters to define the concept.
resultsThere was at least one biomarker within 9/12 physiological systems that was reliably and consistently associated in the hypothesised direction with the three health outcomes in the meta-analysis of these cohorts: dehydroepiandrosterone sulfate (DHEAS), low frequency-heart rate variability (LF-HRV), C-reactive protein (CRP), resting heart rate (RHR), peak expiratory flow (PEF), high density lipoprotein cholesterol (HDL-C), waist-to-height ratio (WtHR), HbA1c, and cystatin C. An index based on five biomarkers (CRP, RHR, HDL-C, WtHR and HbA1c) available in every study was found to predict an independent outcome - mortality - as well or better than more elaborate sets of biomarkers. DISCUSSION: This study has identified a brief 5-item measure of AL that arguably represents a universal and efficient set of biomarkers for capturing physiological 'wear and tear' and a further biomarker (PEF) that could usefully be included in future data collection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.