Examining associations of sexual identity, life experiences, and cardiovascular disease risk in sisters

项目总结。尽管在预防和治疗方面有所改进，但心血管疾病(CVD) 仍然是妇女死亡和残疾的主要原因。目前的证据，主要是基于自我报告 数据显示，性少数族裔妇女(SMW；女同性恋和双性恋)表现出明显更高的 与异性恋女性相比，心血管疾病的可改变危险因素(包括压力、吸烟、饮酒和 肥胖)。然而，人们对将性别少数认同与女性心血管疾病风险联系起来的因素知之甚少。 限制了有针对性的预防工作的发展。尽管不利的生活经历(例如，人际关系创伤 和歧视)被认为对SMW的心血管疾病风险有贡献，但很少有研究研究这种潜在的 不良生活经历对这一人群的心血管影响。这一职业发展奖将 为比利·卡塞雷斯博士提供必要的培训和研究技能，以启动一个独立的 研究的重点是确定和减轻压力对性少数群体交往的影响 身份认同与心血管健康。这个K01应用程序的总体目标是使用兄弟设计来估计 性别少数认同对女性心血管疾病风险的贡献以及这种联系是否受到 不利的生活经历。拟议的研究是基于这样一个科学前提，即通过解释 未观察到的与心血管疾病风险相关的家庭混乱(遗传、父母因素和童年 环境)，生物异性姐妹将提供一个强有力的对比组来研究心血管疾病的风险 SMW。在一个跨学科导师团队的支持下，卡塞雷斯博士将延长芝加哥健康和生命 妇女的经历(CHLEW；R01AA13328)研究，运行时间最长的SMW健康研究，以进行比较 参加CHLEW研究的SMW(N=65)及其异性恋姐妹(N=65)的心血管疾病风险。 该提案将检验性少数认同与以下方面的联系：目标1：心理(抑郁， 焦虑症和创伤后应激症状)；目标2：行为(吸烟、酗酒、身体 活动、饮食和睡眠质量)；和目标3：生理学(心脏代谢[体重指数，糖化 血红蛋白、血脂和炎症[C-反应蛋白和白介素6])是心血管疾病的危险因素。穿过 课程、研讨会、体验式培训、会议和有指导的会议，卡塞雷斯博士将发表演讲 在以下方面发展技能的培训之前存在差距：1)妇女健康研究，2)行为心血管健康，3) 社会流行病学，以及4)二元分析的定量方法。这些研究和培训活动 将通知R01应用程序，该应用程序将全面检查与性有关的生理机制 少数民族认同和不良生活经历对女性心血管疾病风险的影响。调查结果将确定可修改的 可作为心血管疾病预防工作目标的心理、行为和生理危险因素 为SMW量身定做。这项工作为研究心血管疾病的风险因素提供了一个独特的机会，心血管疾病是一个主要的健康问题。 在美国，在SMW及其异性恋姐妹的种族多样性样本中。

PROJECT SUMMARY. Despite improvements in prevention and treatment, cardiovascular disease (CVD) remains the leading cause of death and disability in women. Current evidence, primarily based on self-reported data, indicates that sexual minority women (SMW; lesbian and bisexual) demonstrate significantly higher modifiable risk factors for CVD than heterosexual women (including stress, tobacco use, alcohol use, and obesity). However, little is known about factors that link sexual minority identity with CVD risk in women, which limits development of tailored prevention efforts. Although adverse life experiences (e.g., interpersonal trauma and discrimination) are posited to contribute to CVD risk in SMW, few studies have examined the potential cardiovascular effects of adverse life experiences in this population. This Career Development Award will provide Dr. Billy Caceres with the training and research skills needed to launch an independent program of research focused on identifying and mitigating the effects of stress on the association of sexual minority identity and cardiovascular health. The overall aim of this K01 application is to use a sibling design to estimate the contribution of sexual minority identity on CVD risk in women and whether this association is impacted by adverse life experiences. The proposed research is based on the scientific premise that, by accounting for unobserved familial confounding associated with CVD risk (genetics, parental factors, and childhood environment), biological heterosexual sisters will provide a strong comparison group to study CVD risk in SMW. Supported by an interdisciplinary team of mentors, Dr. Caceres will extend the Chicago Health and Life Experiences of Women (CHLEW; R01AA13328) study, the longest running study of SMW's health, to compare CVD risk among SMW enrolled in the CHLEW study (N=65) and their biological heterosexual sisters (N=65). This proposal will examine the association of sexual minority identity with: Aim 1: psychological (depressive, anxiety, and post-traumatic stress symptoms); Aim 2: behavioral (tobacco use, heavy drinking, physical activity, diet, and sleep quality); and Aim 3: physiological (cardiometabolic [body mass index, glycosylated hemoglobin, and lipids] and inflammatory [C-reactive protein and interleukin-6]) risk factors for CVD. Through coursework, seminars, experiential training, conferences, and mentored meetings, Dr. Caceres will address prior gaps in training to develop skills in: 1) women's health research, 2) behavioral cardiovascular health, 3) social epidemiology, and 4) quantitative methods for dyadic analyses. These research and training activities will inform an R01 application that will comprehensively examine physiological mechanisms that link sexual minority identity and adverse life experiences to CVD risk in women. Findings will identify modifiable psychological, behavioral, and physiological risk factors that can serve as targets for CVD prevention efforts tailored to SMW. This work provides a unique opportunity to study risk factors for CVD, a major health problem in the U.S., in a racially diverse sample of SMW and their biological heterosexual sisters.