DORMIR: Determinants, Outcomes, Responses and Markers of Insufficient sleep in Rural-Urban settings

DORMIR：城乡睡眠不足的决定因素、结果、反应和标志

• 批准号: 10706339
• 负责人: Azizi Seixas
• 金额: $ 71.89万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-05 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10706339
• 关键词: Address; Adverse effects; Affect; Age; Air; Bayesian learning; Behavioral; Biological; Biometry; Birth Place; Blood Pressure; Cardiovascular Diseases; Cause of Death; Cessation of life; Circadian desynchrony; Collection; Communities; Data; Devices; Diabetes Mellitus; Diet; Diet and Nutrition; Discrimination; Disease Marker; Disease Outcome; Disparity; Dyslipidemias; Emotional; Enrollment; Environment; Environmental Risk Factor; Epidemiology; Ethnic Population; Exhibits; Foundations; Funding; Genetic; Genetic Markers; Genotype; Geographic Information Systems; Glucose; Glycosylated hemoglobin A; Health; High Prevalence; Home; Hour; Household; Hypertension; Individual; Inflammation; Inflammatory; Insulin Resistance; Interleukin-10; Interleukin-6; Intervention; Latino; Length of Stay; Life; Life Style; Light; Link; Lipids; Machine Learning; Methodology; Modeling; Morbidity - disease rate; Nature; Neighborhoods; New York; Noise; Not Hispanic or Latino; Obesity; Outcome; Overweight; Physical activity; Policies; Population Study; Predictive Factor; Process; Psychosocial Factor; Public Health; Reduce health disparities; Research; Research Personnel; Risk; Risk Factors; Risk Marker; Rural; Rural Community; Sampling; Science; Seminal; Sleep; Sleep Apnea Syndromes; Sleep Deprivation; Sleep Disorders; Sleeplessness; Socioeconomic Status; Stress; System; TNF gene; Temperature; Time; United States National Institutes of Health; Urban Community; actigraphy; arterial stiffness; built environment; burden of illness; cardiovascular disorder risk; circadian; clinically actionable; community engagement; density; design; disease disparity; diverse data; ethnic minority; ethnic minority population; experience; fasting plasma glucose; good diet; health data; health disparity; improved; inflammatory marker; innovation; instrumentation; mHealth; models and simulation; modifiable risk; mortality; multidisciplinary; novel; population based; psychosocial; racial minority; racial population; recruit; response; rural area; rural setting; sex; smoking cessation; social; success; tool; urban area; urban disparity; urban setting

Project Summary The widening gap in all-cause and CVD-mortality and morbidity rates in rural and urban America is at an all- time high. Latino/as, the largest minority ethnic group in the U.S., appear to be most affected by rural-urban divide in CVD outcomes, as they are disproportionately burdened by CVD risk (overweight/obesity, hypertension, dyslipidemia, diabetes) and CVD mortality (20%, 2nd leading cause of death among Latino/as) relative to other racial/ethnic groups. Unlike other groups where individuals in rural and urban areas have differing CVD risk, rural and urban Latino/as have similarly high rates of CVD risk. Although, healthy diets/ nutrition, smoking cessation, and regular physical activity are linked to CVD risk, they have not been very effective in reducing the CVD burden among racial/ethnic groups, specifically among Latino/as. Several studies indicate that insufficient sleep (<7hrs./day) explains a significant amount of the CVD burden among Latino/as. Preliminary evidence indicates that insufficient sleep may contribute to the observed CVD burden among Latino/as, as Latino/as have greater odds of experiencing insufficient sleep compared with non-Hispanic whites. Evidence also shows that insufficient sleep, which is associated with potentially life-threatening CVD, is a key modifiable risk factor with great potential to reduce health disparities. However, it is unclear what factors contribute to insufficient sleep (IS) disparities and IS-related CVD burden among rural and urban Latino/as. To address these gaps, we will enroll 525 Latino/as in rural and urban communities to participate in home-based studies using novel mHealth devices. The multidisciplinary team will: 1) identify behavioral, genetic, psychosocial, and environmental factors that are associated with insufficient sleep and IS-related CVD and 2) assess effects of insufficient sleep on CVD risk markers (obesity, blood pressure, lipid profile, and fasting plasma glucose/ HbA1C) and inflammatory risk markers (IL-6, IL-10, and TNF-α). This study will provide multi-level evidence supporting epidemiological findings of greater rates of insufficient sleep among Latino/as, which may explain their disproportionate burden of CVD risk. It will also assess whether and why rural and urban differences in IS exist among Latino/as and how that may lead to IS-related CVD outcomes. These data will provide: 1) the foundation for interventions to mitigate adverse effects of insufficient sleep on CVD health outcomes, 2) evidence to delineate factors underlying insufficient sleep and CVD burden among Latino/as in rural and urban settings, and 3) a possible explanation of behavioral, genetic, environmental and psychosocial determinants of insufficient sleep and related CVD risk factors in rural and urban Latino/as. Findings can lead to actionable clinical, lifestyle, and policy interventions to improve Latino health.

项目摘要 美国农村和城市全因和心血管疾病死亡率和发病率的差距不断扩大， 时间高。拉丁美洲人是美国最大的少数民族，似乎受农村-城市 在心血管疾病的结果，因为他们是不成比例的心血管疾病风险负担（超重/肥胖， 高血压、血脂异常、糖尿病）和心血管疾病死亡率（20%，拉丁美洲人死亡的第二大原因） 相对于其他种族/民族。与其他群体不同，农村和城市地区的个人 不同的心血管疾病风险，农村和城市拉丁美洲人/有类似的高心血管疾病风险率。虽然，健康饮食/ 营养、戒烟和定期体育活动与心血管疾病风险有关， 有效减少种族/民族群体的心血管疾病负担，特别是拉丁美洲人/美国人。几项研究 表明睡眠不足（<7小时/天）解释了拉丁美洲人/as之间的CVD负担的显着量。 初步证据表明，睡眠不足可能会导致观察到的心血管疾病负担， 与非西班牙裔相比，拉丁裔/as，as拉丁裔/as有更大的机会经历睡眠不足 白人证据还表明，睡眠不足，这是与潜在的危及生命的心血管疾病， 是一个可以改变的关键风险因素，具有减少健康差距的巨大潜力。然而，目前还不清楚 因素有助于睡眠不足（IS）的差距和IS相关的心血管疾病负担之间的农村和城市 拉丁美洲人。为了解决这些差距，我们将在农村和城市社区招募525名拉丁美洲人， 使用新型移动医疗设备的家庭研究。多学科团队将：1）识别行为， 与睡眠不足和IS相关CVD相关的遗传、社会心理和环境因素 和2）评估睡眠不足对CVD风险标志物（肥胖、血压、血脂谱和 空腹血糖/HbA 1C）和炎症风险标志物（IL-6、IL-10和TNF-α）。本研究将 提供多层次的证据支持流行病学调查结果，即 拉丁美洲人/as，这可能解释了他们CVD风险的不成比例的负担。它还将评估是否以及为什么 拉丁美洲人/美洲人之间存在IS的城乡差异，以及这可能导致IS相关的CVD结果。 这些数据将提供：1）干预措施的基础，以减轻睡眠不足对 CVD健康结果，2）描述睡眠不足和CVD负担的潜在因素的证据， 拉丁美洲人/如在农村和城市环境中，以及3）行为，遗传，环境和 农村和城市拉丁美洲人睡眠不足和相关心血管疾病危险因素的心理社会决定因素 调查结果可以导致可操作的临床，生活方式和政策干预，以改善拉丁美洲人的健康。