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Handbook of Clinical Gender Medicine


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      Pathogenesis Temporal Cascade of Allostatic Load Mediators

      Multiple mediators of adaptation are involved and interconnected in nonlinear networks [7]. When chronically stressed, the biphasic effects of numerous biomarkers eventually lead to AL and disease in a tripartite sequence: (1) overactivation of primary mediators such as stress hormones and pro-and anti-inflammatory cytokines induce primary effects on cellular activities; (2) subsequent secondary outcomes, whereby metabolic, cardiovascular, and second-order immune biomarkers become dysregulated, and (3) culmination in tertiary outcomes or clinical endpoints [7].

      Allostatic Load Index

      Clinical Allostatic Load Index Formula

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      Summary of Allostatic Load Research Findings

      A recent review by Juster et al. [8] of nearly 60 empirical studies suggests that AL indices incorporating subclinical ranges for numerous biomarkers (mean = 10; range = 4-17) predict clinical outcomes better than traditional biomedical methods that address only clinical thresholds for single biomarkers. Importantly, AL inclusion of neuroendocrine and/or immune biomarkers is stronger than metabolic syndrome parameters or systemic clusters.

      Epidemiology

      Age and Sex Differences