Background Metabolic stressors, including metabolic syndrome (MetS), circadian syndrome (CircS), and allostatic load (AL), measure the metabolic and stress‐related physiological dysregulations that are associated with the risk of frailty and cardiovascular mortality in the adult population. Aim To assess the effects of MetS, CircS, and AL on all‐cause mortality in U.S. adults by age and sex. Methods We performed a retrospective cohort analysis using the National Health and Nutrition Examination Survey (NHANES) data, including 7 cycles (2005–2018). The associations between metabolic stressors and mortality were evaluated using stratified Cox regression analyses. Results The study included 37434 adults for analysis of CircS and MetS, while 26480 adults were included for AL analysis. All exposures, including CircS (hazard ratio HR: 1.29; 95% confidence interval CI 1.18–1.42), MetS (HR: 1.09; 95% CI 1.00–1.18), and AL (HR: 1.25; 95% CI 1.11–1.41), were associated with all‐cause mortality in the entire cohort. In adjusted analyses, CircS (HR: 1.55; 95% CI 1.34–1.80), MetS (HR: 1.32; 95% CI 1.14–1.53), and AL (HR: 1.44; 95% CI 1.21–1.70) were only associated with all‐cause mortality in individuals with age < 70 years. In subgroup analyses by sex, all three exposures were strongly associated with mortality in males as well as in the subgroup of males with age < 70 years. The CircS was found to be a strong marker for all‐cause mortality in individuals aged < 70 and in both sexes. Conclusion The strength of association between CircS and all‐cause mortality was stronger than that of MetS and AL, irrespective of sex. Our findings indicate that metabolic biomarkers, specifically CircS, may help refine risk stratification and prognostic evaluation among adults aged less than 70 years.
Ahmed et al. (Thu,) studied this question.
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