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Allostatic load as a complex clinical construct: a case-based computational modeling approach

Galen Buckwalter, J; Castellani, Brian; Mcewen, Bruce; Karlamangla, Arun S; Rizzo, Albert A; John, Bruce; O'donnell, Kyle; Seeman, Teresa

Authors

J Galen Buckwalter

Bruce Mcewen

Arun S Karlamangla

Albert A Rizzo

Bruce John

Kyle O'donnell

Teresa Seeman



Abstract

Allostatic load (AL) is a complex clinical construct, providing a unique window into the cumulative impact of stress. However, due to its inherent complexity, AL presents two major measurement challenges to conventional statistical modeling (the field's dominant methodology): it is comprised of a complex causal network of bioallostatic systems, represented by an even larger set of dynamic biomarkers; and, it is situated within a web of antecedent socioecological systems, linking AL to differences in health outcomes and disparities. To address these challenges, we employed case‐based computational modeling (CBM), which allowed us to make four advances: (1) we developed a multisystem, 7‐factor (20 biomarker) model of AL's network of allostatic systems; (2) used it to create a catalog of nine different clinical AL profiles (causal pathways); (3) linked each clinical profile to a typology of 23 health outcomes; and (4) explored our results (post hoc) as a function of gender, a key socioecological factor. In terms of highlights, (a) the Healthy clinical profile had few health risks; (b) the pro‐inflammatory profile linked to high blood pressure and diabetes; (c) Low Stress Hormones linked to heart disease, TIA/Stroke, diabetes, and circulation problems; and (d) high stress hormones linked to heart disease and high blood pressure. Post hoc analyses also found that males were overrepresented on the High Blood Pressure (61.2%), Metabolic Syndrome (63.2%), High Stress Hormones (66.4%), and High Blood Sugar (57.1%); while females were overrepresented on the Healthy (81.9%), Low Stress Hormones (66.3%), and Low Stress Antagonists (stress buffers) (95.4%) profiles.

Citation

Galen Buckwalter, J., Castellani, B., Mcewen, B., Karlamangla, A. S., Rizzo, A. A., John, B., …Seeman, T. (2016). Allostatic load as a complex clinical construct: a case-based computational modeling approach. Complexity, 21(S1), 291-306. https://doi.org/10.1002/cplx.21743

Journal Article Type Article
Acceptance Date Nov 25, 2015
Online Publication Date Dec 23, 2015
Publication Date 2016-09
Deposit Date Sep 24, 2018
Journal Complexity
Print ISSN 1076-2787
Publisher Hindawi
Peer Reviewed Peer Reviewed
Volume 21
Issue S1
Pages 291-306
DOI https://doi.org/10.1002/cplx.21743
Related Public URLs http://europepmc.org/abstract/MED/28190951