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@ARTICLE{Huang:280970,
      author       = {Huang, Yan and Han, Lin and Xiao, Yefei and Wang, Ruiqi and
                      Liu, Dan and Cao, Bing},
      title        = {{M}ediating role of depression in the relationship between
                      allostatic load and mortality.},
      journal      = {Psychoneuroendocrinology},
      volume       = {180},
      issn         = {0306-4530},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DZNE-2025-01052},
      pages        = {107550},
      year         = {2025},
      abstract     = {Allostatic load (AL), an indicator of chronic stress that
                      reflects the cumulative cost of repeated environmental
                      stressors on neural and neuroendocrine responses, has been
                      considered as a potential factor in the development of
                      depression and may increase mortality risk. This study aimed
                      to investigate the association between AL, depression, and
                      mortality in the general population and to evaluate the
                      mediating role of depression in the relationship between AL
                      and mortality. Cross-sectional data from 15,571 participants
                      of the US National Health and Nutrition Examination Survey
                      (NHANES) 2009-2016 were analyzed. AL was calculated by
                      summing numerical values for each biomarker based on
                      predefined risk zones, yielding a score from 0 to 11.
                      Depressive symptoms were assessed by the Patient Health
                      Questionnaire-9 (PHQ-9). The results showed a significant
                      association between AL and mortality (HR = 1.16, 95 $\%$ CI:
                      1.09, 1.23, p < 0.001), with larger effects observed in
                      women and participants aged 40-49. Mediation analysis
                      revealed that depression significantly mediated the
                      relationship between AL and mortality (β = 0.0158, p <
                      0.001), the indirect effect accounting for approximately
                      10.45 $\%$ of the total effect. Overall, our findings
                      underscore the significant link between AL and mortality,
                      with depression playing a notable mediating role. Future
                      research should focus on exploring the vulnerability of
                      elderly females and middle-aged individuals to chronic
                      stress, using larger, more diverse cohorts and longer
                      follow-up periods to better elucidate mechanisms underlying
                      their increased mortality risk.},
      keywords     = {Allostatic load (Other) / Depression (Other) / Mortality
                      (Other) / NHANES (Other) / Stress (Other)},
      cin          = {AG Liu},
      ddc          = {610},
      cid          = {I:(DE-2719)1012009},
      pnm          = {354 - Disease Prevention and Healthy Aging (POF4-354)},
      pid          = {G:(DE-HGF)POF4-354},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40680486},
      doi          = {10.1016/j.psyneuen.2025.107550},
      url          = {https://pub.dzne.de/record/280970},
}