Allostatic load in adults with airflow obstruction – a new concept to understand health challenges?

<bold>Background:</bold> Allostatic load (ALLO) refers to the individual ability to cope with environmental challenges and involves interaction of several physiological systems. <bold>Objectives:</bold> This study aims to compare ALLO between adults with and without airflow obstruction (AO). <bold>Methods:</bold> Data from Austrian LEAD study (N=11,785, age 18-82 yrs) were used and AO was defined by post-BD FEV1/FVC<0.7. ALLO was calculated using 13 biomarkers. The at-risk range was defined as the highest age-specific quartile of systolic and diastolic blood pressure (SBP/DBP), pulse wave velocity (PWV), HbA1c, cholesterol, triglycerides, CRP, fat mass index (FMI), and visceral adipose tissue (VAT) and the lowest quartile of high-density lipoprotein (HDL), glomerular filtration rate (GFR), bone density (BD), and appendicular lean mass index (ALMI). Participants scored 1 point per at-risk marker and 1 for medication for hypertension, diabetes, and dyslipidaemia. Total points constituted ALLO. <bold>Results:</bold> 833 (7.2%) participants had AO and 678 had complete data for ALLO calculation. An age/sex/smoking status-matched control group with no AO (N=678) was randomly selected from LEAD study population. Mean±SD for ALLO was 3.6±2.4 for controls and 4.2±2.5 for AO (p<0.001). The proportion of participants in the at-risk range for SBP, PWV, CRP, BD, ALMI and VAT was higher in AO than in controls (p<0.05). <bold>Conclusions:</bold> These findings provide important information about the association of obstructive lung function and stress-related health outcomes.