Association between allostatic load and long-term survival in populations with high or low PSA levels: a national...

The present study aims to investigate the associations between the allostatic load index (ALI), prostate-specific antigen (PSA) levels, and certain causes of death among the participants.

Participants in this study were selected from the NHANES database (2003-2010) and linked to mortality files (the National Death Index, 2003-2010). Multivariate Cox proportional hazards models were used to analyze the effect of the allostatic load (AL) on PSA levels and all-cause mortality in participants.

This study found that an increase in ALI exerted a certain impact on PSA levels in the entire participant population (especially in the subgroup with WWI < 0.5). Participants in the third quartile (T3) with the highest ALI index had a significantly 52% increased probability of all-cause mortality compared to those in T1 (OR = 1.52, 95% CI: 1.28, 1.76, P < 0.01). Both RCS analysis and the K-M curve provide corroboration. When treated as a continuous variable, it is also associated with cardiac mortality (OR = 1.14, 95% CI: 1.04, 1.26, P < 0.01).

In a specific range, higher ALI was significantly and positively associated with PSA levels, all-cause mortality, and cardiovascular disease risk, though its link to cancer-specific mortality risk was not statistically significant in this study.