Epigenomic and Genomic Factors emerging from Poor Social Determinants of Health and their impact on Breast Cancer associated with Obesity and Comorbidities in African American and Latino Women

摘要： 这项研究的目的是确定社会和表观经济因素如何与社会 健康的决定因素会导致肥胖和合并症的增加，从而增加乳腺癌的风险。 具体地说，这项研究将检查与肥胖和其他合并症相关的癌症健康差异 居住在洛杉矶南部的非洲裔美国人和拉丁裔美国人。在中提出了多种原因 可能导致这些现象的社会经济和生物现象的文献 差距。查尔斯·R·德鲁医学与科学大学(CDU)为最缺乏服务的人提供服务- 位于南洛杉矶服务规划区6(SPA6)地区的资源人口。我们的 社区主要由非洲裔美国人(27%)和拉丁裔美国人(68%)组成。从SPA6的居民那里， 31%的人口生活在贫困中(家庭收入和100%联邦贫困水平)和中位数 家庭收入为36,400美元，而洛杉矶县为17%，家庭收入中位数为 56241美元。与西洛杉矶相比，医疗保健和物理环境资源明显较差 (SPA5)。 这项拟议研究的假设和基本原理是：服务不足和资源不足的社区 健康的社会决定因素较差，更有可能出现健康差距，如肥胖、糖尿病 (T2D)和高血压(HTN)。这些人患几种癌症的风险更高。 我们将研究这些人中乳腺癌的发病率和进展情况。我们将使用生物标记物 如：性激素、生长因子、炎性细胞因子、DNA甲基化、RNA甲基化以及 组蛋白修饰与表观基因组和基因组的变化及其与风险和 临床结果。为了实现我们建议的目标，我们将进行以下具体研究 目标：

Abstract: The Purpose of this study is to determine how social and epigenomic factors that are associated with social determinants of health cause increase in Obesity and Comorbidities, resulting in increased risk for breast cancer. Specifically, this study will examine cancer health disparities associated with obesity and other comorbidities in African American and Latina populations residing South Los Angeles. Multiple reasons have been presented in the literature suggesting both socioeconomic and biological phenomena which may contribute to these disparities. Charles R. Drew University of Medicine and Science (CDU) serves the most underserved and under- resourced populations located in the Service Planning Area 6 (SPA6) region of South Los Angeles. Our communities comprise primarily of African Americans (27%) and Latinos (68%). From the residents in SPA6, 31% of the population lives in poverty (household income < 100% federal poverty level (FPL)) and median household income is $36,400, while Los Angeles county is at 17% FPL and with median household income of $56,241. Healthcare and physical environment resources are significantly poor compared to west Los Angeles (SPA5). The Hypothesis and Rationale of this proposed study are: Underserved and Under-resourced communities with poor social determinants of health, are more likely to develop health disparities such as Obesity, Diabetes (T2D), and Hypertension (HTN). These individuals are at increased risk for developing several types of cancers. We will study the incidence and progression of Breast Cancer in these individuals. We will employ biomarkers such as: Sex Hormones, Growth Factors, Inflammatory Cytokines, DNA Methylation, RNA Methylation, and Histone Modifications as they relate to Epigenomic and Genomic changes and their association with risk and clinical outcomes. To accomplish the objectives of our proposal, we will employ the following specific research aims: