Evidence map›Paper›PMID 42277721›Full record

ArticleBMC public health2026

Allostatic load associated with all-cause and cause-specific mortality: a large prospective cohort study.

Heng-Min Xu, Zong-Chao Liu, Xin-Ling Wang, Wen-Jing Zhao, Chao Zhang, Yang Zhang, Tong Zhou, Jing-Ying Zhang, Kai-Feng Pan, Wen-Qing Li

Abstract read
In one paragraph

Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Heng-Min Xu *State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, 52 Fu-cheng Road, Haidian District, Beijing, 100142, China.
Zong-Chao Liu *State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, 52 Fu-cheng Road, Haidian District, Beijing, 100142, China.
Xin-Ling WangState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, 52 Fu-cheng Road, Haidian District, Beijing, 100142, China.
Wen-Jing ZhaoState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, 52 Fu-cheng Road, Haidian District, Beijing, 100142, China.
Chao ZhangState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, 52 Fu-cheng Road, Haidian District, Beijing, 100142, China.
Yang ZhangKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
Tong ZhouKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
Jing-Ying ZhangKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
Kai-Feng PanState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, 52 Fu-cheng Road, Haidian District, Beijing, 100142, China.
Wen-Qing LiState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, 52 Fu-cheng Road, Haidian District, Beijing, 100142, China. wenqing_li@bjmu.edu.cn.

Funding

Beijing Hospitals Authority's Ascent Plan DFL20241102Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support ZLRK202325China Postdoctoral Science Foundation 2024M760152National Natural Science Foundation of China 82273704National Natural Science Foundation of China 82504482Noncommunicable Chronic Diseases-National Science and Technology Major Project 2023ZD0501400-2023ZD0501402Noncommunicable Chronic Diseases-National Science and Technology Major Project 2025ZD0545200-2025ZD0545203Peking University Medicine Fund for World's Leading Discipline or Discipline Cluster Development BMU2022XKQ004Postdoctoral Fellowship Program of CPSF GZB20250192Science Foundation of Peking University Cancer Hospital BJCH2024BJ02, XKFZ2410, and BJCH2025CZ04
6 · The paper itself

Abstract

backgroundAllostatic load (AL) is a composite measure of cumulative physiological burden from chronic stress, quantifying multisystem dysregulation. Whether AL may alter the risk of overall, cause-specific mortality, and premature mortality remains unclear.

methodsWe analyzed UK Biobank participants aged 40-69 years (mean 56.6; 53.8% female) with complete data of AL metrics. AL was assessed by integrating 12 commonly applied metrics covering cardiovascular, metabolic, immune, and kidney systems (score range: 0-12), with higher scores indicating greater physiological dysregulation. Associations of AL scores with mortality from all cause and cause-specific mortality were examined. Stratified analyses assessed effect modification by premature mortality (< 70 years at death) and age at recruitment.

resultsOver a median follow-up of 15.4 years, 39,804 deaths were recorded, including 14,852 from cancer, 7118 from cardiovascular disease, 1938 from respiratory disease, and 1521 from digestive disease. Higher AL scores were significantly associated with increased risks of all-cause and cause-specific mortality in a dose-response manner (all P-trend < 0.001). Among specific causes, each one-point rise in AL score yielded stronger associations with digestive disease mortality (subdistribution hazard ratio [sHR] = 1.25, 95% confidence interval [CI]: 1.21-1.29) and cardiovascular disease mortality (sHR = 1.20, 95% CI: 1.18-1.21) than for cancer mortality (sHR = 1.08, 95% CI: 1.07-1.09) and respiratory disease mortality (sHR = 1.11, 95% CI: 1.09-1.14). Age significantly modified these associations (all P-interaction < 0.01), with higher HRs for premature mortality (age at death < 70 years) or younger individuals (age at enrollment < 50 years).

conclusionsHigher AL scores were associated with increased risks of all-cause and cause-specific mortality. Such associations were particularly pronounced for digestive and cardiovascular disease mortality, and appeared stronger for premature deaths and among younger individuals. These findings suggest that AL may serve as a marker of early physiological dysregulation and may help identify individuals at elevated risk of premature mortality.

Indexed as

AllostasisMortalityAdultAgedCardiovascular DiseasesCause of DeathFemaleHumansMaleMiddle AgedMortality, PrematureNeoplasmsProspective StudiesUK BiobankUnited KingdomAllostatic loadChronic stressMortalityNon-communicable diseasesPremature mortalityPreventive medicineRisk stratification

Identifiers

PMID42277721
PMCPMC13625280

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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.