With disappointing frequency, all surgeons are too often presented with the corpulent,
55-year-old, cigar-chomping banker whose idea of exercise is to walk down a single
flight of stairs rather than taking the elevator, and even the 21-year-old single
mother of three with no high school diploma who must lock and bolt her door and is
constantly short of food stamps. These psychosocial–physiologic demographics of biologic
stressors provoke increasingly predictable epigenetic alterations that confer enhanced
surgical risk. The purposes of this report are as follows: (1) provide a primer on
epigenetics; (2) relate socioeconomic status (SES) to changes in the epigenome; (3)
suggest that SES-induced epigenetic alterations can be identified and targeted; and
(4) introduce surgeons to the molecular tools for altering the epigenome, which governs
the expression of the genome, as an accessible strategy of decreasing surgical risk.
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Article info
Publication history
Published online: May 20, 2019
Accepted:
February 4,
2019
Identification
Copyright
© 2019 Published by Elsevier Inc.
