Given the strong links between stress and allostatic load, one would predict that psychosocial factors would play a major role in attenuating the SEP–allostatic load association. In this study we have used a measure of psychological distress, one mechanism linking psychosocial circumstances and health, and predicted that this psychological mediator would have the greatest attenuating effect, followed by material factors and then behavioral mediators. Data were from the West of Scotland Twenty-07 Study, a community-based, prospective study, with respondents aged approximately 35 in 1987 (wave 1/W1) and followed up in a further

four waves Sotrastaurin mw over the

next 20 years. This is an important stage in the life course for the early development of disease and therefore a key life stage to investigate allostatic load. A more detailed description of the study is available elsewhere Benzeval et al. (2009). Data, including blood samples at wave 5 (W5) (2007/8), were collected by trained nurses in the homes of the study participants when respondents were aged approximately 55. Ethical approval for the baseline study was granted in 1986 by the GP Sub-Committee ABT-263 nmr of Greater Glasgow Health Board and the ethics sub-committee of the West of Scotland Area Medical Committees. Wave 5 was approved by the Tayside Committee on Medical Research Ethics. Allostatic Cobimetinib ic50 load was operationalized based on methods described by

Seeman et al. (2008) and Bird et al. (2010), although this operationalization does not include any stress markers. The strengths and weaknesses of this operationalization are discussed later. The selected biomarkers represent three physiological systems: cardiovascular [systolic and diastolic blood pressure, and pulse rate]; metabolic [glycated hemoglobin (HbA1c), total cholesterol, high density lipoprotein (HDL) cholesterol and waist-hip ratio (WHR)]; and inflammatory [C-reactive protein (CRP) and serum albumin]. Adjustments were made to the biomarkers to account for the effect of medications. For those on anti-hypertensive medication, systolic and diastolic blood pressures were adjusted by adding 10 mmHG and 5 mmHG, respectively (Law et al., 2003). Respondents taking diabetes medication had 1% added to their HbA1c values (Kinshuck et al., 2013). Where respondents were taking statins, total cholesterol values had 21.24 mg/dL (1.18 mmol/l) added Law et al., 2003. Where respondents were taking diuretic medication, total cholesterol values were reduced by 4% (Weir and Moser, 2000). HDL values were increased by 10% where respondents were taking beta-blockers (Weir and Moser, 2000).