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An unprecedented window into how diseases take hold years before symptoms appear

(www.bloomberg.com)
202 points helsinkiandrew | 1 comments | 18 Jul 25 08:55 UTC | HN request time: 0s | source
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chithanh ◴[22 Jul 25 06:46 UTC] No.44643879[source]▶
> What UK Biobank is revealing, scan by scan and layer by layer, is that disease doesn’t arrive out of nowhere. It accumulates quietly, shaped by genes, environment, and habits.

I think that is already known for a while. It's called functional reserve, and was a big topic in HIV patients (and then again for SARS-CoV-2).

Like people with higher cognitive capabilities will be protected by those a bit longer before onset of HIV-associated neurocognitive disorder (or even dementia).

Same for kidneys: They have a functional reserve that you are born with gets used up during life, until it is gone. Acute kidney disease treatment is aimed at preserving whatever little function is left.

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manmal ◴[22 Jul 25 07:18 UTC] No.44644084[source]▶
It would be interesting what this functional reserve is, right? The microbiome perhaps, or intracellular minerals? Some other thing we haven’t even identified?
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1. krisoft ◴[22 Jul 25 09:59 UTC] No.44645042[source]▶
> It would be interesting what this functional reserve is, right?

It is most likely not a single thing.

Looking for "the functional reserve" is like looking for which part of an airplane is the "multiple redundancy". Or which line of code is the "fault tolerance" in google's code base. It is not a single part, it is all the parts working together.

Just looking at the kidney example (which is not the only kind of function we can describe having functional reserve.) functional reserve is that there are two kidneys, and each kidney have multiple renal pyramids, and if this or that part of the kidney functions worse other parts compensate and will work overtime.

Depletion of functional reserve is not something literally running out (like a fuel tank running empty), it is more like a marauding gang shooting computers in a cloud data center. Sure initially all works as it used to, because the system identifies the damaged components and routes the processing to other ones. But if they keep it up they will damage enough that the data center will keel over and can't do what it could do before.

(No, I'm not saying that a human body is literally a data center, or literally an airplane. What I'm saying is that all three shares the common theme that some process is maintained in the presence of faults.)