Perceived Discrimination and Longitudinal Change in Kidney Function Among Urban Adults.
Perceived Discrimination and Longitudinal Change in Kidney Function Among Urban Adults.
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DOI：
10.1097/psy.0000000000000478
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发表时间：
2017-09
影响因子：
3.3
通讯作者：
Crews DC
中科院分区：
文献类型：
--
作者：
Beydoun MA;Poggi-Burke A;Zonderman AB;Rostant OS;Evans MK;Crews DC
感觉到的歧视与心理社会痛苦和不利的健康后果有关。在一项前瞻性的队列研究中，我们检查了感知歧视措施与肾功能变化的关系，这项研究名为跨寿命多样性社区的健康老龄化。我们的研究包括1,620名基线肾功能(估计肾小球滤过率≥为60毫升/分钟/1.73平方米)的参与者(662名白人和958名非裔美国人(AA)，年龄30-)。采用多因素混合效应回归(γ基数，γ率)和OLS模型(γFollow)，考察了自我报告的种族歧视和感知的性别歧视以及受歧视经历的一般指标[中低、高和低]与基线、随访和年变化率之间的关系。在所有模型中，感觉到的性别歧视“高PGD与低PGD”与较低的基线EGFR相关(γBASE=−3.511.34，p=0.009)。在白人女性中，高排泄量与较低的基线EGFR相关，这种影响在全模型中得到加强(γ基数=−5.86(2.52)，p=0.020)。总体而言，高PGD与低PGD与较低的随访EGFR相关(γFollow=−3.03(1.45)，p=0.036)。在AA女性中，PRD和PGD都与较低的后续肾功能有关，这种影响通过协变量调整而减弱，表明通过与健康相关的心理社会和生活方式因素进行调节。相反，在按种族分组的任何性别中，EOD与随访EGFR没有联系。感知到的种族和性别歧视与肾小球滤过率评估的肾功能不良有关，而且这种关联的强度因性别和种族而异。在肾脏疾病的心理社会危险因素中，感知到的歧视值得进一步研究。
Perceived discrimination has been associated with psychosocial distress and adverse health outcomes. We examined associations of perceived discrimination measures with changes in kidney function in a prospective cohort study, the Healthy Aging in Neighborhoods of Diversity Across the LifeSpan. Our study included 1,620 participants with preserved baseline kidney function (estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73m2) (662 Whites and 958 African-Americans (AA), aged 30–64 years). Self-reported perceived racial discrimination (PRD) and perceived gender discrimination (PGD) and a general measure of experience of discrimination (EOD) [“Medium vs. low”, “High vs. low”] were examined in relation to baseline, follow-up and annual rate of change in eGFR using multiple mixed-effects regression (γbase, γrate) and OLS models (γfollow). Perceived gender discrimination “High vs. Low PGD” was associated with a lower baseline eGFR in all models (γbase=−3.51(1.34), p=0.009 for total sample). Among White women, High EOD was associated with lower baseline eGFR, an effect that was strengthened in the full model (γbase=−5.86(2.52), p=0.020). Overall, “High vs. Low” PGD was associated with lower follow-up eGFR (γfollow=−3.03(1.45), p=0.036). Among AA women, both PRD and PGD were linked to lower follow-up kidney function, an effect that was attenuated with covariate adjustment, indicating mediation through health-related, psychosocial and lifestyle factors. In contrast, EOD was not linked to follow-up eGFR in any of the sex by race groups. Perceived racial and gender discrimination are associated with poor kidney function assessed by glomerular filtration rate and the strength of associations differ by sex and race groups. Perceived discrimination deserves further investigation in psychsocial risk factors for kidney disease.