Study is the first to validate allostatic load
as measurable in teens
PHILADELPHIA, May 14, 2024
/PRNewswire/ -- A new study from researchers at Children's Hospital
of Philadelphia (CHOP) reveals
that the cumulative "wear and tear" on the body known as allostatic
load (AL) can be measured in early adolescence and that childhood
adversity correlates with increased stress and mental health
challenges during adolescence. The findings were published today in
the journal Nature Mental Health.
Since the COVID-19 pandemic began, children and teens have
experienced an influx of behavioral health challenges. Driven by
CHOP's strong commitment to addressing the pediatric mental health
crisis, researchers aimed to quantify how the exposome,
environmental exposure, "gets under the skin" and affects
physiological systems and mental health, further testing how
differences in exposome can explain health disparities. The authors
further tested gene-environment mechanisms that lead to AL, with
the idea that better understanding how stress influences physical
and mental health could potentially improve prevention and
intervention strategies.
"The collective wisdom has been that if you are chronically
exposed to stress, your body pays a price, but that it happens over
time," said Ran Barzilay, MD, PhD, psychiatrist with the Youth
Suicide Prevention, Intervention and Research Center at CHOP and
the study's lead author. "Our data shows that while less developed,
we can quantify AL in adolescents as young as 12 years old and link
it to childhood adversity and inequity."
In the study, conducted by Kevin
Hoffman, MD, PhD, a child and adolescent psychiatry fellow
at CHOP, the research team analyzed data of more than 5,000 diverse
youth, averaging 12 years old, from the longitudinal Adolescent
Brain Cognitive Development Study. They calculated a latent AL
score using body mass index, waist circumference, blood pressure,
blood hemoglobin-A1C, blood cholesterol, and salivary
dehydroepiandrosterone (DHEA) hormonal levels. Childhood exposomic
risk was determined by reviewing their environment before age 11
through lifestyle factors like diet, exposure to abuse, poverty,
and pollutants. Genetic risk was quantified by using polygenic risk
scores for metabolic issues, such as Type 2 Diabetes (T2D), and
psychiatric conditions such as major depressive disorder (MDD).
Using linear mixed-effects models, researchers evaluated the
interplay between exposomic and polygenic risks and their impact on
AL. Overall, they found that an association between childhood
environmental exposures and adolescent AL was stronger in
individuals with higher genetic risk of T2D and MDD. The study also
showed that environmental factors like childhood adversity, such as
abuse, family dysfunction and poverty increased AL, which in turn
influenced mental health outcomes in teens.
"The findings expand existing literature suggesting a mediating
role of AL from childhood adversity to adult mental health and
support the hypothesis that AL could be a mechanism that
contributes to health disparities," Barzilay
added. "Critically, we show evidence of disparities in AL at
an early age, well before expected onset of many chronic medical
illnesses."
For example, Non-Hispanic White youth had significantly lower AL
compared to Hispanic and Non-Hispanic Black youth. Childhood
environmental burdens, such as day-to-day challenges in the home
and community were linked to higher AL in adolescence.
Given the severe health disparities in America, researchers hope
the findings propel more studies in diverse populations, where AL
measurements can improve their understanding of differences in
pediatric health outcomes and related inequities.
"The future of mental health is precision medicine, which allows
holistic understanding of how the individual and structural
environment, and genes, contribute to health outcomes in early age,
both from a physical and mental health perspective," said
Barzilay.
This research was supported by supported by the National
Institute of Mental Health grant K23MH120437.
Barzilay et al. "Exposomic and polygenic contributions to
allostatic load in early adolescence." Nature Mental Health.
Online May 14, 2024.
DOI:10.1038/s44220-024-00255-9
About Children's Hospital of Philadelphia:
A non-profit, charitable organization, Children's Hospital of
Philadelphia was founded in 1855
as the nation's first pediatric hospital. Through its long-standing
commitment to providing exceptional patient care, training new
generations of pediatric healthcare professionals, and pioneering
major research initiatives, the hospital has fostered many
discoveries that have benefited children worldwide. Its pediatric
research program is among the largest in the country. The
institution has a well-established history of providing advanced
pediatric care close to home through its CHOP Care Network, which
includes more than 50 primary care practices, specialty care and
surgical centers, urgent care centers, and community hospital
alliances throughout Pennsylvania
and New Jersey, as well as the
Middleman Family Pavilion and its dedicated pediatric
emergency department in King of
Prussia. In addition, its unique family-centered care and
public service programs have brought Children's Hospital of
Philadelphia recognition as a
leading advocate for children and adolescents. For more
information, visit https://www.chop.edu.
Contact: Kaitlyn Tivenan
Children's Hospital of Philadelphia
(610) 618-0542
tivenank@chop.edu
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SOURCE Children's Hospital of Philadelphia