Social adversity, gestational stress physiology, and birth outcomes in Hispanic Americans

西班牙裔美国人的社会逆境、妊娠应激生理学和出生结果

• 批准号: 10038637
• 负责人: Molly Maurer Fox
• 金额: $ 11.7万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10038637
• 关键词: Accounting; Acculturation; Address; Adrenal Glands; Adult; Affect; Age; Alcohols; Animal Model; Biochemical; Biological; Biological Markers; Biological Process; Biology; Birth; Body Size; Body mass index; Child; Childhood; Chronic Disease; Communities; Data; Development; Dimensions; Disadvantaged; Discrimination; Early identification; Embryo; Endocrine; Environment; Epidemiology; Ethnic group; Etiology; Face; Fetal Development; Fetus; Foundations; Generations; Gestational Age; Goals; Grant; Health; Hispanic Americans; Hispanics; Human; Hypothalamic structure; Immigrant; Immigration; Individual; Inflammatory; Intervention; Interview; Investments; K-Series Research Career Programs; Lasso; Life; Life Experience; Light; Linear Regressions; Link; Longitudinal Studies; Maternal Age; Measures; Mediating; Mediation; Metabolic; Metabolic dysfunction; Metabolism; Modeling; Newborn Infant; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Participant; Pattern; Personal Satisfaction; Phase; Physiological; Physiology; Pituitary Gland; Plasma; Politics; Poverty; Predisposition; Pregnancy; Pregnancy Complications; Pregnant Women; Public Health; Questionnaires; Recording of previous events; Reporting; Research; Research Personnel; Risk; Series; Socioeconomic Status; Stress; Study models; Techniques; Telephone; Tissues; Tobacco; Training; Trauma; Urine; Victimization; Woman; adverse birth outcomes; base; cohort; embryo/fetus; experience; fetal; fetal programming; follow-up; girls; health care availability; health disparity; illicit drug use; intergenerational; metabolic phenotype; minority communities; minority health; multitask; neonate; novel; obesity risk; offspring; offspring obesity; postnatal; pregnant; prenatal; prepregnancy; prospective; psychological distress; sex; social; social culture; social health determinants; socioeconomics; stressor; theories; trait; trend

PROJECT SUMMARY/ABSTRACT This project addresses the epidemiological observation of increasing rates of obesity and type-2 diabetes mellitus (T2DM) across generations of Hispanic Americans. We propose a novel hypothesis to understand this phenomenon based on the concepts of fetal programming, social determinants of health, and biological embedding of life experience. Evidence suggests that the embryonic/fetal phase of life represents a critical window during which perturbations in the intrauterine biochemical environment affect development of body tissue patterning and metabolic function, influencing an individual’s lifelong health and susceptibility to obesity and T2DM. We posit that social and cultural stressors among Hispanic immigrant women may influence stress biology in ways that—for women who become pregnant—alter the biochemical environment to which the developing embryo/fetus is exposed. Hispanic immigrants are an exceptionally disadvantaged group who are vulnerable to high degrees of social adversity. We propose the original hypothesis that pregnant, Hispanic immigrant women’s perceived social adversity may alter stress-related biological processes to influence adiposity and metabolic phenotypes in the fetus, thereby pre-disposing the offspring to enhanced lifelong risk of obesity and T2DM. In a prospective, longitudinal study of 100 pregnant, Hispanic immigrant women established with the PI’s K-award, we will assess perceived social adversity from a series of original open-ended questions, Likert-scale items, and validated questionnaires, and relate these constructs to stress biology assessed from biosamples collected at two timepoints during pregnancy, and newborn body mass index percentiles (BMIP). Newborn body size has well-established correlations with childhood and adulthood adiposity and metabolic risk. In this context, we will pursue two specific aims. In Aim 1, we will examine how pregnant women’s perceived social adversity (immigration-related trauma, political victimization, discrimination) relates to four domains of gestational stress physiology: hypothalamic-pituitary-adrenal-placental, inflammatory, metabolic, and oxidative. In Aim 2, we will examine how pregnant women’s perceived social adversity relates to newborn BMIP. The expertise the PI gained in theory and analytic techniques for socio-cultural constructs, maternal-placental-fetal biology, adiposity and metabolism in her K01 training and research make her uniquely suited to successfully execute the R03 aims. Her K01 project, which focused on the possibility that acculturation may influence gestational biology, is logically extended in this R03 proposal by assessing other dimensions of socio-cultural stress, characterizing gestational stress physiology more comprehensively, and, importantly, directly measuring child outcomes. These endeavors will lay the foundation for an R01 proposal that will establish the PI as a fully independent investigator. Ultimately, these analyses may reveal new information about how experiences of social adversity can promote chronic disease states not only in the afflicted individuals but also across generations. Understanding the interplay between social, cultural, and biological mechanisms in minority health disparities may reveal new social, cultural, or biological targets of intervention to diminish inter-generational cycles of disadvantage and poor health in minority communities. This project emphasizes the possibility that investment in the well-being of girls and women can help alleviate health disparities.

项目摘要/摘要 该项目探讨了肥胖率和2型糖尿病（T2DM）的流行病学观察 在几代西班牙裔美国人中。我们提出了一个新的假设，以理解基于 胎儿编程的概念，对健康的社会确定以及生命经验的生物学嵌入。证据 表明生命的胚胎/胎儿阶段代表着一个关键窗口，在此窗口中扰动 生化环境影响人体组织形成和代谢功能的发展，影响个人的 终身健康和对肥胖和T2DM的敏感性。我们肯定西班牙裔社会和文化压力源 移民妇女可能会以生物化学的方式影响压力生物学 暴露于发育中的胚胎/胎儿的环境。西班牙裔移民是一个异常处境不利的 容易受到高度社交广告的群体。我们提出了一个原始的假设，即怀孕，西班牙裔 移民妇女的感知社会逆境可能会改变与压力有关的生物学过程，以影响肥胖 和胎儿中的代谢表型，从而预先说明后代以增加肥胖和 T2DM。在一项针对100位怀孕的前瞻性纵向研究中 我们将从一系列原始的开放式问题，李克特级项目中评估所感知的社会逆境，并经过验证 问卷调查，并将这些结构与从在两个时间点收集的生物样本进行评估的强调生物学联系 怀孕和新生儿体重指数百分位数（BMIP）。新生体大小与 童年和成年肥胖和代谢风险。在这种情况下，我们将追求两个具体的目标。在AIM 1中，我们将 检查孕妇如何感知的社会广告（与移民有关的创伤，政治胜利， 歧视）与妊娠应力生理的四个领域的关系：下丘脑 - 垂体 - 肾上腺叠纳尔， 炎症，代谢和氧化。在AIM 2中，我们将研究孕妇感知的社交广告 与新生儿BMIP有关。理论上获得的PI的专业知识和社会文化结构的分析技术， 在她的K01培训和研究中，孕产妇的生物学，肥胖和新陈代谢使她非常适合 成功执行R03目标。她的K01项目的重点是适应可能影响的可能性 通过评估社会文化压力的其他方面，妊娠生物学在逻辑上扩展了逻辑。 更全面地表征妊娠压力生理学，重要的是直接测量儿童的结果。 这些努力将为R01提案奠定基础，该提案将确立PI为完全独立的研究人员。 最终，这些分析可能会揭示有关社交广告体验如何促进慢性的新信息 疾病状态不仅在受苦的个体中，而且在几代人中。了解社会之间的相互作用， 少数族裔健康差异中的文化和生物学机制可能揭示了新的社会，文化或生物学目标 干预减少少数民族社区灾难和健康状况不佳的世代之间的干预。这个项目 强调对女孩和妇女福祉的投资可以帮助减轻健康差异的可能性。