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Examining differential effects of obesity on inflammation in ex-smokers to understand racial disparities in cancer risk

检查肥胖对戒烟者炎症的不同影响，以了解癌症风险的种族差异

基本信息

批准号：
10058695
负责人：
Marcia McNutt Tan
金额：
$ 29.74万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-01 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10058695
关键词：
Abdomen African American Age Behavior Therapy Behavioral Biological Biological Markers Body mass index C-reactive protein Central obesity Cessation of life Chronic Complex Data Development Disease Elderly Etiology Exhibits General Population Genetic Goals Health and Retirement Study Histologic Incidence Inflammation Intervention Link Malignant Neoplasms Malignant neoplasm of lung Measures Mediating Minority Groups Modeling Not Hispanic or Latino Obesity Pathway interactions Persons Physical assessment Population Preventable cancer cause Preventive treatment Process Psychosocial Factor Race Research Risk Risk Factors Sampling Smoke Smoker Smoking Techniques Testing Time Weight Weight Gain biobehavior cancer health disparity cancer risk carcinogenesis cigarette smoking disorder risk experience health data high risk innovation middle age modifiable risk mortality multilevel analysis never smoker prevent public health priorities racial and ethnic racial and ethnic disparities racial difference racial disparity recruit screening guidelines smoking cessation sociodemographics waist circumference

项目摘要

PROJECT SUMMARY/ABSTRACT Although African Americans smoke at similar or lower rates than non-Hispanic whites, their rates of lung cancer incidence and mortality are significantly higher. Cigarette smoking contributes to approximately 80-90% of lung cancer deaths; however, it does not fully elucidate racial disparities in lung cancer development. Understanding mechanisms that contribute to racial disparities in lung cancer is a public health priority. Chronic inflammation is a well-known pathway that directly links cigarette use to lung cancer carcinogenesis, and smokers have an elevated level of C-reactive protein (CRP), a biomarker for systemic inflammation. Although smoking cessation leads to a reduction in CRP over time, studies have shown that CRP does not fully return to levels similar to never smokers. Thus, increased levels of CRP are associated with elevated risk of lung cancer in former smokers. Several studies have shown that African Americans in the general population have higher levels of CRP than non-Hispanic whites. However, no studies have documented race differences in long- term change in CRP levels among those who have quit smoking. Research is needed to understand differences in the mechanisms that predict how CRP levels change and eventually increase disease risk. Although African Americans have similar smoking rates than non-Hispanic whites, they experience disproportionate rates of obesity and post-cessation weight gain, or weight gain attributable to quitting smoking. This weight gain may compound inflammation-related disease risk in former smokers, underlying disparities seen in lung cancer development. The objective of our proposed study is to examine changes in obesity and inflammation in African American and non-Hispanic white ex-smokers. We aim to: a) characterize race differences in inflammation over time, b) examine race differences in the effect of obesity on inflammation change, and c) explore associations of race, obesity, and inflammation with lung cancer incidence. Data will be drawn from the Health and Retirement Study, a longitudinal panel study on middle-aged to older adults. Using random effects multilevel modeling, we will compare different types of obesity (i.e., general vs. abdominal) to determine whether there are unique effects on inflammation between races. We will use propensity scores to isolate effects of race. These advanced statistical techniques will strengthen causal inference and control for confounding of socio-demographic and behavioral factors. By isolating the obesity-inflammation effect in ex- smokers, we will be able to determine bio-behavioral mechanisms that may contribute to racial disparities in cancer risk, and ultimately incidence, taking into account lasting effects of smoking. Our results will help to elucidate the currently unknown mechanisms of lung cancer disparities and inform interventions and screening guidelines to target racial/ethnic minority groups at high-risk for lung cancer.

项目总结/摘要虽然非裔美国人吸烟率与非西班牙裔白人相似或更低，但他们的肺结核发病率癌症的发病率和死亡率明显较高。吸烟约占80-90% 然而，它并没有完全阐明肺癌发展中的种族差异。了解导致肺癌种族差异的机制是公共卫生的优先事项。慢性炎症是一个众所周知的途径，它直接将吸烟与肺癌致癌联系起来，吸烟者的C反应蛋白（CRP）水平升高，CRP是全身炎症的生物标志物。虽然戒烟导致CRP随着时间的推移而降低，研究表明CRP不会完全恢复到正常水平。与从不吸烟者相似。因此，CRP水平升高与肺癌风险升高相关在以前的吸烟者。一些研究表明，非裔美国人在一般人群中有较高的 CRP水平高于非西班牙裔白人。然而，没有研究证明种族差异在长期- 戒烟者CRP水平的长期变化。需要研究来了解预测CRP水平如何变化并最终增加疾病风险的机制存在差异。虽然非裔美国人的吸烟率与非西班牙裔白人相似，但他们的经验肥胖和戒烟后体重增加的比例不成比例，或归因于戒烟的体重增加 smoking.这种体重增加可能会增加前吸烟者患炎症相关疾病的风险，肺癌发展存在差异。我们建议进行的研究，目的是探讨非裔美国人和非西班牙裔白色戒烟者的肥胖和炎症。我们的目标是：a）表征炎症随时间的种族差异，B）检查肥胖对炎症影响的种族差异改变，以及c）探索种族、肥胖和炎症与肺癌发病率的关联。数据将来自健康与退休研究，一项针对中年人到老年人的纵向小组研究。使用随机效应多级模型，我们将比较不同类型的肥胖（即，全身与腹部）至确定种族之间是否对炎症有独特的影响。我们将使用倾向分数来种族隔离效应。这些先进的统计技术将加强因果推理和控制，社会人口统计学和行为因素的混杂。通过将肥胖-炎症效应分离出来，吸烟者，我们将能够确定可能导致种族差异的生物行为机制，癌症风险，最终发病率，考虑到吸烟的持久影响。我们的研究结果将有助于阐明目前未知的肺癌差异机制并为干预和筛查提供信息针对肺癌高危种族/少数民族群体的指南。