Systemic Inflammation in Midlife: Race, Socioeconomic Status, and Perceived Discrimination.
Systemic Inflammation in Midlife: Race, Socioeconomic Status, and Perceived Discrimination.
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DOI：
10.1016/j.amepre.2016.09.026
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发表时间：
2017-01
影响因子：
5.5
通讯作者：
Oates GR
中科院分区：
文献类型：
--
作者：
Stepanikova I;Bateman LB;Oates GR
本研究调查了全身性炎症的社会决定因素，重点是种族，SES和感知歧视。884名白色和170名黑人参与者的数据来自美国中年调查，一项结合调查措施、人体测量和生物标志物测定的横断面观察性研究。2004-2009年收集的数据在2016年进行了分析。主要结果指标为C反应蛋白、白细胞介素6、纤维蛋白原和E选择素的空腹血浓度。对于每种生物标志物，针对合并样品以及分别针对黑人和白人估计一系列多变量线性回归模型。完整的模型包括社会决定因素;心理，生活方式和健康因素;和人口统计学协变量。双变量分析表明，与白人相比，黑人中所有炎症标志物的浓度更高（p<0.001）。在使用合并样本的完全校正模型中，白细胞介素6（p<0.001）和纤维蛋白原（p<0.01）的种族差异持续存在。对于E-选择素和C-反应蛋白，在调整协变量后解释了种族差异。在完全校正的模型中，受教育程度与较低的纤维蛋白原浓度有关（p<0.05），在校正人口统计学因素和收入后，受教育程度与C反应蛋白浓度有关（p<0.01）。在完全校正的模型中，终生感知歧视与较高的纤维蛋白原浓度相关（p<0.05），在校正社会经济地位（SES）和人口统计学因素后，与较高的E-选择素和白细胞介素6浓度相关（p<0.05）。这项研究阐明了种族，SES和感知歧视对炎症的贡献。这表明，减少炎症的干预措施应侧重于黑人和面临社会经济不利因素的个人，特别是教育程度低的人。
This study investigates social determinants of systemic inflammation, focusing on race, SES, and perceived discrimination. Data on 884 white and 170 black participants were obtained from the Survey of Midlife in the U.S., a cross-sectional observational study combining survey measures, anthropometry, and biomarker assay. Data, collected in 2004–2009, were analyzed in 2016. Main outcome measures were fasting blood concentrations of C-reactive protein, interleukin 6, fibrinogen, and E-selectin. For each biomarker, series of multivariate linear regression models were estimated for the pooled sample and separately for blacks and whites. Full models included social determinants; psychological, lifestyle, and health factors; and demographic covariates. Bivariate analyses indicated higher concentrations of all inflammation markers among blacks compared with whites (p<0.001). In fully adjusted models using the pooled sample, racial differences persisted for interleukin 6 (p<0.001) and fibrinogen (p<0.01). For E-selectin and C-reactive protein, racial differences were explained after adjusting for covariates. Education was linked to lower fibrinogen concentration (p<0.05) in the fully adjusted model and C-reactive protein concentration (p<0.01) after adjusting for demographic factors and income. Lifetime perceived discrimination was related to higher concentrations of fibrinogen (p<0.05) in the fully adjusted model, and higher concentrations of E-selectin and interleukin 6 (p<0.05) after adjusting for socioeconomic status (SES) and demographic factors. This study clarifies the contributions of race, SES, and perceived discrimination to inflammation. It suggests that inflammation-reducing interventions should focus on blacks and individuals facing socioeconomic disadvantages, especially low education.