Early origins of health disparities: Chronic inflammation

项目摘要 美国的特点是社会经济和基于种族的差距持续存在并不断扩大 广泛的健康后果，包括慢性炎症。测量成年早期的炎症是 重要是因为它预测了主要公共卫生负担的风险，包括心血管疾病、代谢 综合症、残疾和不利的出生结果。因此，迫切需要了解 社会和经济环境促进慢性炎症的途径，以及最近 研究提供了令人信服的证据，婴儿期和儿童期是敏感时期 暴露于社会经济劣势可对健康产生持久影响，包括调节 发炎。建议的研究应用生物社会生命过程的方法来调查早期生命 慢性炎症差异的来源，具体目标如下：1)记录社会经济 慢性炎症的差异，并调查身体脂肪、健康行为和心理社会压力 调节社会经济地位和炎症之间关系的途径；2)调查早期生活 社会经济地位--以及相关的暴露--作为青年时期慢性炎症的预测指标； 3)评估慢性炎症是不良分娩结局的危险因素，包括怀孕 并发症、早产和较低的出生体重。这些目标将利用现有数据实现 从国家青少年到成人健康纵向研究(Add Health)的五次浪潮， 具有全国代表性的队列，具有丰富的背景和行为数据，以及生理和健康 在生命过程中的多个时间点收集的数据。C-反应蛋白(CRP)--糖尿病的关键生物标志物 炎症-将是一系列结构方程模型(SEM)中的主要因变量 社会经济地位越低，炎症程度越高的假说 增加身体脂肪，损害健康的行为，以及更多地暴露在心理社会应激源中。模型 代表敏感的时间段影响(早期的SES和 成人C反应蛋白)、累积逆境(早期和后期SES的相加效应)和环境连续性(早期 SES预测成人SES也将被比较，以揭示早期生命SES所经历的生命过程 导致成年后慢性炎症的差异。此外，由于失调的炎症是 与不良生育结局相关的是，怀孕是评估公众的一个重要的人生阶段 慢性炎症的健康意义。在转变为 作为母亲，我们将测试在怀孕期间升高CRP的假设，以及先入为主的- 预测怀孕/分娩并发症、早产和后代出生体重。从以下方面获得的知识 这些分析可能会提供证据，证明慢性炎症中的不平等可以追溯到 在生命过程中的早期经历，从而为今后的预防工作提供信息。

Project Summary The United States is characterized by persistent and growing socioeconomic and race-based disparities in a wide range of health outcomes, including chronic inflammation. Measuring inflammation in early adulthood is important because it predicts risk for major public health burdens, including cardiovascular disease, metabolic syndrome, disability, and adverse birth outcomes. As such, there is an urgent need to understand the pathways through which social and economic environments contribute to chronic inflammation, and recent research provides compelling evidence that infancy and childhood are sensitive time periods during which exposure to socioeconomic disadvantage can have lasting effects on health, including the regulation of inflammation. The proposed research applies a biosocial life course approach to investigate the early-life origins of disparities in chronic inflammation, with the following specific aims: 1) Document socioeconomic disparities in chronic inflammation, and investigate body fat, health behaviors, and psychosocial stress as pathways mediating associations between socioeconomic status and inflammation; 2) Investigate early-life socioeconomic status—and correlated exposures—as predictors of chronic inflammation in young adulthood; and 3) Evaluate chronic inflammation as a risk factor for adverse birth outcomes, including pregnancy complications, pre-term delivery, and lower birth weight. These aims will be implemented using existing data from five waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health), a large, nationally-representative cohort with rich contextual and behavioral data, as well as physiological and health data, collected at multiple time points over the life course. C-reactive protein (CRP)—a key biomarker of inflammation—will be the primary dependent variable in a series of structural equation models (SEM) that test the hypothesis that lower socioeconomic status contributes to higher inflammation through its associations with increased body fat, health-damaging behaviors, and increased exposure to psychosocial stressors. Models representing sensitive time period effects (stronger and independent associations between early SES and adult CRP), cumulative adversity (additive effects of early and later SES), and environmental continuity (early SES predicts adult SES) will also be compared to reveal the life course processes through which early-life SES contributes to disparities in chronic inflammation in adulthood. In addition, since dysregulated inflammation is associated with adverse birth outcomes, pregnancy represents an important life stage for evaluating the public health significance of chronic inflammation. Among the female participants who have transitioned to motherhood, we will test the hypothesis that elevated CRP—during pregnancy, as well as preconception— predicts pregnancy/birth complications, pre-term delivery, and offspring birth weight. Knowledge gained from these analyses may provide evidence that inequalities in chronic inflammation trace their origins to experiences early in the life course, and thereby inform future efforts at prevention.