Early origins of health disparities: Chronic inflammation

健康差异的早期根源：慢性炎症

• 批准号: 10160940
• 负责人: THOMAS W MC DADE
• 金额: $ 19.92万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-15 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10160940
• 关键词: Adolescent; Adult; Back; Behavior; Behavioral; Biogenesis; Biological; Biological Markers; Biosocial; Birth; Birth Weight; Body fat; Body mass index; C-reactive protein; Cardiovascular Diseases; Childhood; Chronic; Clinic; Data; Development; Economics; Elderly; Environment; Epidemiology; Equation; Ethnic Origin; Event; Exposure to; Family; Female; Future; Gestational Age; Health; Health behavior; Inequality; Inflammation; Inflammatory; Knowledge; Lead; Life; Life Cycle Stages; Link; Literature; Longitudinal Studies; Low Birth Weight Infant; Measures; Mediating; Mediator of activation protein; Metabolic Diseases; Metabolic syndrome; Modeling; Mothers; Obesity; Outcome; Participant; Pathway interactions; Phenotype; Physiological; Pregnancy; Pregnancy Complications; Premature Birth; Prevention; Process; Psychosocial Stress; Public Health; Race; Regulation; Reporting; Research; Resolution; Risk; Risk Factors; Sampling; Scientific Advances and Accomplishments; Series; Siblings; Skin; Smoking; Social Environment; Socioeconomic Status; Source; Structure; Subgroup; Testing; Time; United States; adverse birth outcomes; base; cardiovascular disorder risk; cohort; cost; delivery complications; disability; early childhood; early experience; emerging adult; experience; health data; health disparity; infancy; low socioeconomic status; mortality; motherhood; novel; offspring; perceived stress; perinatal period; prenatal; psychosocial stressors; social; social inequality; socioeconomic disadvantage; socioeconomic disparity; socioeconomics; young adult

Project Summary The United States is characterized by persistent and growing socioeconomic and race-based disparities in a wide range of health outcomes, including chronic inflammation. Measuring inflammation in early adulthood is important because it predicts risk for major public health burdens, including cardiovascular disease, metabolic syndrome, disability, and adverse birth outcomes. As such, there is an urgent need to understand the pathways through which social and economic environments contribute to chronic inflammation, and recent research provides compelling evidence that infancy and childhood are sensitive time periods during which exposure to socioeconomic disadvantage can have lasting effects on health, including the regulation of inflammation. The proposed research applies a biosocial life course approach to investigate the early-life origins of disparities in chronic inflammation, with the following specific aims: 1) Document socioeconomic disparities in chronic inflammation, and investigate body fat, health behaviors, and psychosocial stress as pathways mediating associations between socioeconomic status and inflammation; 2) Investigate early-life socioeconomic status—and correlated exposures—as predictors of chronic inflammation in young adulthood; and 3) Evaluate chronic inflammation as a risk factor for adverse birth outcomes, including pregnancy complications, pre-term delivery, and lower birth weight. These aims will be implemented using existing data from five waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health), a large, nationally-representative cohort with rich contextual and behavioral data, as well as physiological and health data, collected at multiple time points over the life course. C-reactive protein (CRP)—a key biomarker of inflammation—will be the primary dependent variable in a series of structural equation models (SEM) that test the hypothesis that lower socioeconomic status contributes to higher inflammation through its associations with increased body fat, health-damaging behaviors, and increased exposure to psychosocial stressors. Models representing sensitive time period effects (stronger and independent associations between early SES and adult CRP), cumulative adversity (additive effects of early and later SES), and environmental continuity (early SES predicts adult SES) will also be compared to reveal the life course processes through which early-life SES contributes to disparities in chronic inflammation in adulthood. In addition, since dysregulated inflammation is associated with adverse birth outcomes, pregnancy represents an important life stage for evaluating the public health significance of chronic inflammation. Among the female participants who have transitioned to motherhood, we will test the hypothesis that elevated CRP—during pregnancy, as well as preconception— predicts pregnancy/birth complications, pre-term delivery, and offspring birth weight. Knowledge gained from these analyses may provide evidence that inequalities in chronic inflammation trace their origins to experiences early in the life course, and thereby inform future efforts at prevention.

项目摘要 美国的特点是社会经济和种族不平等持续存在并不断扩大， 广泛的健康结果，包括慢性炎症。测量成年早期的炎症是 重要的是，它预测了主要公共卫生负担的风险，包括心血管疾病，代谢， 综合征、残疾和不良出生结果。因此，迫切需要了解 社会和经济环境导致慢性炎症的途径， 研究提供了令人信服的证据，婴儿期和儿童期是敏感的时期， 暴露于不利的社会经济地位可能对健康产生持久的影响， 炎症本研究采用生物社会生命历程的研究方法， 慢性炎症差异的起源，具体目标如下：1）记录社会经济学 慢性炎症的差异，并调查身体脂肪，健康行为和心理压力， 介导社会经济地位和炎症之间关联的途径; 2）调查早期生活 社会经济状况--以及相关因素--作为青年期慢性炎症的预测因子; 和3）评估慢性炎症作为不良出生结果（包括妊娠）的危险因素 并发症、早产和低出生体重。这些目标将利用现有数据来实现 从五波国家青少年到成人健康纵向研究（添加健康），一个大的， 具有全国代表性的队列，具有丰富的背景和行为数据，以及生理和健康 在生命过程中的多个时间点收集的数据。C-反应蛋白（CRP）-一个关键的生物标志物， 炎症-将是一系列结构方程模型（SEM）中的主要因变量， 假设较低的社会经济地位有助于通过其与炎症的关联， 增加身体脂肪，损害健康的行为，并增加暴露于社会心理压力。模型 代表敏感的时间段效应（早期SES和 成人CRP），累积逆境（早期和晚期SES的累加效应）和环境连续性（早期 SES预测成人SES）也将进行比较，以揭示生命历程的过程，通过早期生活SES 导致成年期慢性炎症的差异。此外，由于炎症失调， 与不良的出生结果相关，怀孕是评估公众的重要生命阶段。 慢性炎症的健康意义。在已经过渡到 母亲，我们将测试的假设，升高CRP-在怀孕期间，以及preconception- 预测妊娠/分娩并发症、早产和后代出生体重。获得的消息 这些分析可能提供证据表明，慢性炎症的不平等性可以追溯到它们的起源， 在生命早期的经验，从而为今后的预防工作提供信息。