The National Couples Health and Time Use Stress Biology Study (NCHAT-BIO): Biobehavioral Pathways to Population Health Disparities in Sexual Minorities

项目摘要 性少数群体患肥胖、哮喘、糖尿病、心血管疾病的风险明显更大， 和某些癌症的比例这些健康差异的一个关键驱动因素是与慢性压力有关的 污名化。雪上加霜的是，种族和族裔性少数群体具有复杂的交叉身份 与非西班牙裔白色人相比， 性少数慢性应激源可以通过增加炎症和炎症反应来影响免疫系统。 损害细胞免疫，这是一种预测急性疾病、慢性疾病和死亡风险的模式。 由NICHD资助并在大流行期间进行的全国夫妇健康和时间研究 （NCHAT）包括5，157名18-60岁的美国成年人，其中包括黑人，拉丁裔和亚洲人的过度样本 个体有2，230人（43.2%）被确定为男同性恋，女同性恋，双性恋或其他身份，NCHAT是唯一的 人口代表性研究，在美国的性少数群体的充分动力子样本。充分利用 这是一个难得的机会，可以解决性少数群体压力生物学数据方面的经验差距， 特别是那些有交叉身份的人，我们增加了一个试点生物数据收集（干血点， DBS）到NCHAT创建NCHAT应激生物学研究（NCHAT-BIO）。生物数据收集是 已完成，但样品尚未化验。在本R21中，我们将分析这些样本， 炎症（白细胞介素-6，C-反应蛋白）和细胞免疫功能（EB病毒再活化）。 在一个由763名NCHAT参与者组成的多元化队列中，我们将解决这些经验目标： 目的1：描述性少数群体与 异性恋者假设：性少数群体将表现出更大的炎症和更差的细胞免疫 在男女同性恋和双性恋男女之间具有不同的作用。目标2：检查效果 免疫失调的生物标志物上的耻辱，歧视和交叉性， 少数民族压力框架。假设：耻辱和歧视的经历将预测更大的 炎症和细胞免疫功能较差，在性少数群体中影响更大， 特别是有色人种的性少数参与者。目标3：确定可改变的行为和可治疗的行为 将压力与免疫失调联系起来的心理因素。假设：可改变的健康行为 （物质使用，运动，饮食）和可治疗的心理因素（抑郁，焦虑，睡眠障碍）将 调解性少数压力与免疫失调之间的联系，提出干预目标。 NCHAT-BIO提供了一个独特的全面和方法上严格的调查压力 美国性少数群体的生物学，允许对压力和健康之间联系的机制进行新的测试 在少数民族压力框架内。该R21将支持未来的R 01，解决以下方面的纵向变化： 应激生物学的研究。

Project Summary Sexual minorities have significantly greater risk for obesity, asthma, diabetes, cardiovascular disease, and some cancers compared to heterosexuals. A key driver of these health disparities is chronic stress related to stigmatization. Compounding this, racial and ethnic sexual minorities have complex intersecting identities and experiences of stress that may exacerbate negative health outcomes relative to non-Hispanic White sexual minorities. Chronic stressors can affect the immune system by both increasing inflammation and impairing cellular immunity, a pattern causally predictive of risk for acute illness, chronic disease, and mortality. Funded by NICHD and fielded during the pandemic, the National Couples’ Health and Time Study (NCHAT) includes 5,157 US adults 18-60 years of age, with oversamples of Black, Latinx, and Asian individuals. With 2,230 (43.2%) identifying as gay, lesbian, bisexual, or other identifies, NCHAT is the only population-representative study with a fully-powered subsample of sexual minorities in the US. Capitalizing on the extraordinary opportunity to address the empirical gap in data on stress biology among sexual minorities, particularly those with intersecting identities, we added a pilot biological data collection (dried blood spots; DBS) to NCHAT to create the NCHAT Stress Biology Study (NCHAT-BIO). Biological data collection is complete, but samples are yet to be assayed. In this R21, we will assay these samples to measure inflammation (interleukin-6, C-reactive protein) and cellular immune function (Epstein-Barr virus reactivation). In a diverse cohort of 763 NCHAT participants, we will address these empirical aims: Aim 1: Delineate differences in immune regulation among sexual minorities versus heterosexuals. Hypothesis: Sexual minorities will exhibit greater inflammation and poorer cellular immune function with differential effects among lesbian, gay, and bisexual women and men. Aim 2: Examine effects of stigma, discrimination, and intersectionality on biomarkers of immune dysregulation within a minority stress framework. Hypotheses: Experiences of stigma and discrimination will predict greater inflammation and poorer cellular immune function with stronger effects among sexual minorities and, in particular, sexual minority participants of color. Aim 3: Identify modifiable behaviors and treatable psychological factors linking stress with immune dysregulation. Hypotheses: Modifiable health behaviors (substance use, exercise, diet) and treatable psychological factors (depression, anxiety, sleep disturbance) will mediate the link between sexual minority stress with immune dysregulation, presenting targets for intervention. NCHAT-BIO offers a uniquely comprehensive and methodologically rigorous investigation of stress biology among sexual minorities in the US, permitting novel tests of mechanisms linking stress and health within a minority stress framework. This R21 will support a future R01 addressing longitudinal changes in stress biology in the NCHAT cohort.