Racial/ethnic and gender differences in the association between self-reported experiences of racial/ethnic discrimination and inflammation in the CARDIA cohort of 4 US communities.
Racial/ethnic and gender differences in the association between self-reported experiences of racial/ethnic discrimination and inflammation in the CARDIA cohort of 4 US communities.
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DOI：
10.1016/j.socscimed.2012.04.027
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发表时间：
2012-09
影响因子：
5.4
通讯作者：
Berkman, Lisa F.
中科院分区：
文献类型：
--
作者：
Cunningham, Timothy J.;Seeman, Teresa E.;Kawachi, Ichiro;Gortmaker, Steven L.;Jacobs, David R.;Kiefe, Catarina I.;Berkman, Lisa F.
关键词：
在病因学上，炎症与已知存在种族/民族差异的心脏代谢疾病有关。先前的研究表明，自我报告的种族/民族歧视经历与炎症，特别是c反应蛋白（CRP）之间可能存在关联。目前尚不清楚这种联系是否受到种族/族裔和性别的影响。在美国四个社区的年轻人冠状动脉风险发展（CARDIA）研究中，我们分别对901名黑人女性、614名黑人男性、958名白人女性和863名白人男性进行了带时变协变量的分层线性模型检验。在1992-93年和2000-01年确定了种族/民族歧视的自我报告经历。在这些年和2005-06年期间，用对数转化的CRP测量炎症。所有分析均根据血压、血浆总胆固醇、甘油三酯、胰岛素抵抗的稳态模型评估（HOMA-IR）、年龄、教育程度和社区进行调整。我们的研究结果扩展了先前的研究，表明从广义上讲，自我报告的种族/民族歧视经历与炎症有关；然而，这种联系是复杂的，并且在黑人和白人女性和男性中有所不同。经历过1或2次歧视的黑人妇女CRP水平高于没有经历过歧视的黑人妇女（β = 0.141, SE = 0.062, P < 0.05）。在报告3次或更多歧视经历的黑人女性中，这种关联在统计上并不显著，而且在最终模型中，这种关联并不独立于可改变的风险（吸烟和肥胖）。在最终模型中，报告3次或更多歧视经历的白人妇女的CRP水平明显高于报告没有歧视经历的白人妇女（独立于可修改风险）（β = 0.300, SE = 0.113, P < 0.01）。自我报告的种族/民族歧视经历与CRP之间的关联在报告1或2次歧视经历的黑人和白人男性中没有统计学意义。需要进一步的研究。
Inflammation is etiologically implicated in cardiometabolic diseases for which there are known racial/ethnic disparities. Prior studies suggest there may be an association between self-reported experiences of racial/ethnic discrimination and inflammation, particularly C-reactive protein (CRP). It is not known whether that association is influenced by race/ethnicity and gender. In separate hierarchical linear models with time-varying covariates we examined that association among 901 Black women, 614 Black men, 958 White women, and 863 White men in the Coronary Artery Risk Development in Young Adults (CARDIA) study of young adults in four US communities. Self-reported experiences of racial/ethnic discrimination were ascertained in 1992–93 and 2000–01. Inflammation was measured as log-transformed CRP in those years and 2005–06. All analyses were adjusted for blood pressure, plasma total cholesterol, triglycerides, homeostatic model assessment for insulin resistance (HOMA-IR), age, education, and community. Our findings extend prior research by suggesting that, broadly speaking, self-reported experiences of racial/ethnic discrimination are associated with inflammation; however, this association is complex and varies for Black and White women and men. Black women reporting 1 or 2 experiences of discrimination had higher levels of CRP compared to Black women reporting no experiences of discrimination (β = 0.141, SE = 0.062, P < 0.05). This association was not statistically significant among Black women reporting 3 or more experiences of discrimination and not independent of modifiable risks (smoking and obesity) in the final model. White women reporting 3 or more experiences of discrimination had significantly higher levels of CRP compared to White women reporting no experiences of discrimination independent of modifiable risks in the final model (β = 0.300, SE = 0.113, P < 0.01). The association between self-reported experiences of racial/ethnic discrimination and CRP was not statistically significant among Black and White men reporting 1 or 2 experiences of discrimination. Further research is needed.
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