Danting Yang, Meghann Wheeler, Shama D. Karanth, Livingstone Aduse-Poku, Christiaan Leeuwenburgh, Stephen Anton, Yi Guo, Jiang Bian, Muxuan Liang, Hyung-Suk Yoon, Tomi Akinyemiju, Dejana Braithwaite, Dongyu Zhang
{"title":"老年癌症幸存者的适应负荷与全因、癌症特异性和心血管死亡风险:1999-2010年全国健康与营养调查分析","authors":"Danting Yang, Meghann Wheeler, Shama D. Karanth, Livingstone Aduse-Poku, Christiaan Leeuwenburgh, Stephen Anton, Yi Guo, Jiang Bian, Muxuan Liang, Hyung-Suk Yoon, Tomi Akinyemiju, Dejana Braithwaite, Dongyu Zhang","doi":"10.1002/aac2.12064","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Allostatic load (AL) has been linked to an increased risk of death in various populations. However, to date, there is no research specifically investigating the effect of AL on mortality in older cancer survivors.</p>\n </section>\n \n <section>\n \n <h3> Aims</h3>\n \n <p>To investigate the association between AL and mortality in older cancer survivors.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>A total of 1291 adults aged 60 years or older who survived for ≥1 year since cancer diagnoses were identified from the 1999 to 2010 National Health and Nutrition Examination Survey. AL was the exposure of interest incorporating nine clinical measures/biomarkers; one point was added to AL if any of the measures/biomarkers exceeded the normal level. The sum of points was categorized as an ordinal variable to reflect low, moderate, and high ALs. Our outcomes of interest were all-cause, cancer-specific, and cardiovascular disease–specific mortality. Death was identified by linkage to the National Death Index. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratio (aHR) and 95% confidence intervals (CI) of mortality by AL category.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Overall, 53.6% of participants were male and 78.4% were white. The mean age of study participants at interview was 72.8 years (standard deviation = 7.1). A total of 546 participants died during the follow-up (median follow-up time: 8.0 years). Among them, 158 died of cancer, and 106 died of cardiovascular events. Results from multivariable Cox proportional hazards models showed that higher ALS was positively associated with higher all-cause mortality (ALS = 4–9 vs. ALS = 0–1: aHR = 1.52, 95% CI = 1.17–1.98, <i>p</i>-trend < 0.01) and higher cancer-specific mortality (ALS = 4–9 vs. ALS = 0–1: aHR = 1.80, 95% CI = 1.12–2.90, <i>p</i>-trend = 0.01). The association between ALS and cardiovascular mortality was positive but nonsignificant (ALS = 4–9 vs. ALS = 0–1: aHR = 1.59, 95% CI = 0.86–2.94, <i>p</i>-trend = 0.11).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Our study suggests that older cancer survivors can have a higher risk of death if they have a high burden of AL.</p>\n </section>\n </div>","PeriodicalId":72128,"journal":{"name":"Aging and cancer","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421616/pdf/nihms-1919026.pdf","citationCount":"1","resultStr":"{\"title\":\"Allostatic load and risk of all-cause, cancer-specific, and cardiovascular mortality in older cancer survivors: An analysis of the National Health and Nutrition Examination Survey 1999–2010\",\"authors\":\"Danting Yang, Meghann Wheeler, Shama D. Karanth, Livingstone Aduse-Poku, Christiaan Leeuwenburgh, Stephen Anton, Yi Guo, Jiang Bian, Muxuan Liang, Hyung-Suk Yoon, Tomi Akinyemiju, Dejana Braithwaite, Dongyu Zhang\",\"doi\":\"10.1002/aac2.12064\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Allostatic load (AL) has been linked to an increased risk of death in various populations. However, to date, there is no research specifically investigating the effect of AL on mortality in older cancer survivors.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>To investigate the association between AL and mortality in older cancer survivors.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Method</h3>\\n \\n <p>A total of 1291 adults aged 60 years or older who survived for ≥1 year since cancer diagnoses were identified from the 1999 to 2010 National Health and Nutrition Examination Survey. AL was the exposure of interest incorporating nine clinical measures/biomarkers; one point was added to AL if any of the measures/biomarkers exceeded the normal level. The sum of points was categorized as an ordinal variable to reflect low, moderate, and high ALs. Our outcomes of interest were all-cause, cancer-specific, and cardiovascular disease–specific mortality. Death was identified by linkage to the National Death Index. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratio (aHR) and 95% confidence intervals (CI) of mortality by AL category.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Overall, 53.6% of participants were male and 78.4% were white. The mean age of study participants at interview was 72.8 years (standard deviation = 7.1). A total of 546 participants died during the follow-up (median follow-up time: 8.0 years). Among them, 158 died of cancer, and 106 died of cardiovascular events. Results from multivariable Cox proportional hazards models showed that higher ALS was positively associated with higher all-cause mortality (ALS = 4–9 vs. ALS = 0–1: aHR = 1.52, 95% CI = 1.17–1.98, <i>p</i>-trend < 0.01) and higher cancer-specific mortality (ALS = 4–9 vs. ALS = 0–1: aHR = 1.80, 95% CI = 1.12–2.90, <i>p</i>-trend = 0.01). The association between ALS and cardiovascular mortality was positive but nonsignificant (ALS = 4–9 vs. ALS = 0–1: aHR = 1.59, 95% CI = 0.86–2.94, <i>p</i>-trend = 0.11).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Our study suggests that older cancer survivors can have a higher risk of death if they have a high burden of AL.</p>\\n </section>\\n </div>\",\"PeriodicalId\":72128,\"journal\":{\"name\":\"Aging and cancer\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-05-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421616/pdf/nihms-1919026.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Aging and cancer\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/aac2.12064\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aging and cancer","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/aac2.12064","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
摘要
背景:在不同人群中，适应负荷(AL)与死亡风险增加有关。然而，到目前为止，还没有专门研究AL对老年癌症幸存者死亡率的影响。目的探讨老年癌症幸存者AL与死亡率之间的关系。方法选取1999 ~ 2010年全国健康与营养调查中确诊癌症后存活≥1年的60岁以上成人1291例。AL是包括9项临床测量/生物标志物的兴趣暴露;如果任何一项测量/生物标志物超过正常水平，则给AL加1分。积分的总和被归类为一个顺序变量，以反映低、中、高的ALs。我们感兴趣的结果是全因死亡率、癌症特异性死亡率和心血管疾病特异性死亡率。死亡是通过与国家死亡指数的联系确定的。采用多变量Cox比例风险模型估计AL类别死亡率的调整风险比(aHR)和95%置信区间(CI)。结果总体上，53.6%的参与者为男性，78.4%为白人。访谈时研究参与者的平均年龄为72.8岁(标准差= 7.1)。随访期间共有546名参与者死亡(中位随访时间:8.0年)。其中158人死于癌症，106人死于心血管疾病。多变量Cox比例风险模型结果显示，ALS越高，全因死亡率越高(ALS = 4-9 vs. ALS = 0-1); aHR = 1.52, 95% CI = 1.17-1.98, p-trend <0.01)和更高的癌症特异性死亡率(ALS = 4-9 vs. ALS = 0-1: aHR = 1.80, 95% CI = 1.12-2.90, p-trend = 0.01)。ALS与心血管疾病死亡率呈正相关，但不显著(ALS = 4-9 vs. ALS = 0-1: aHR = 1.59, 95% CI = 0.86-2.94, p-trend = 0.11)。结论:我们的研究表明，老年癌症幸存者如果有较高的AL负担，死亡风险可能更高。
Allostatic load and risk of all-cause, cancer-specific, and cardiovascular mortality in older cancer survivors: An analysis of the National Health and Nutrition Examination Survey 1999–2010
Background
Allostatic load (AL) has been linked to an increased risk of death in various populations. However, to date, there is no research specifically investigating the effect of AL on mortality in older cancer survivors.
Aims
To investigate the association between AL and mortality in older cancer survivors.
Method
A total of 1291 adults aged 60 years or older who survived for ≥1 year since cancer diagnoses were identified from the 1999 to 2010 National Health and Nutrition Examination Survey. AL was the exposure of interest incorporating nine clinical measures/biomarkers; one point was added to AL if any of the measures/biomarkers exceeded the normal level. The sum of points was categorized as an ordinal variable to reflect low, moderate, and high ALs. Our outcomes of interest were all-cause, cancer-specific, and cardiovascular disease–specific mortality. Death was identified by linkage to the National Death Index. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratio (aHR) and 95% confidence intervals (CI) of mortality by AL category.
Results
Overall, 53.6% of participants were male and 78.4% were white. The mean age of study participants at interview was 72.8 years (standard deviation = 7.1). A total of 546 participants died during the follow-up (median follow-up time: 8.0 years). Among them, 158 died of cancer, and 106 died of cardiovascular events. Results from multivariable Cox proportional hazards models showed that higher ALS was positively associated with higher all-cause mortality (ALS = 4–9 vs. ALS = 0–1: aHR = 1.52, 95% CI = 1.17–1.98, p-trend < 0.01) and higher cancer-specific mortality (ALS = 4–9 vs. ALS = 0–1: aHR = 1.80, 95% CI = 1.12–2.90, p-trend = 0.01). The association between ALS and cardiovascular mortality was positive but nonsignificant (ALS = 4–9 vs. ALS = 0–1: aHR = 1.59, 95% CI = 0.86–2.94, p-trend = 0.11).
Conclusions
Our study suggests that older cancer survivors can have a higher risk of death if they have a high burden of AL.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
