Pilot Study for Geospatial Analysis of Neighborhood Environmental Stress in Relation to Biological Markers of Cardiovascular Health and Health Behaviors in Women

我们利用1999-2002年全国健康与营养检查调查的流行病学数据，评估邻里剥夺指数(NDI)和对数转化白细胞端粒长度(LTL)之间的关系，以开始评估剥夺邻里条件可能导致心血管(CV)健康不良的生物学机制。我们使用多水平建模对人口普查区域水平聚类进行控制。我们使用NDI(REF=低NDI)的三分位数构建了模型。NDI是使用2000年美国人口普查的人口普查地区水平的社会经济指标来计算的。样本(n=5,106名成年人)是49.8%的女性，包括82.9%的非西班牙裔白人，9.4%的非西班牙裔黑人和7.6%的墨西哥裔美国人。平均年龄45.8岁。NDI高的社区的居民是年轻的、非白人的，社会经济水平较低(P&lt；0.0001)。在居住在中NDI和高NDI社区的个体中，与低NDI相比，邻里剥夺与LTL负相关。在男性中，与低NDI相比，中NDI和高NDI都与较短的LTL相关。在女性中，与低NDI相比，只有中度NDI与较短的LTL相关。在控制了个人特征，包括个人水平的社会经济地位后，在美国具有全国代表性的成年人样本中，社区社会经济贫困程度的增加与较短的LTL有关。我们的发现表明，端粒缩短可能是邻居剥夺导致不良CV健康结果的一种机制。 为了确定可能受到周围环境慢性应激源影响的免疫细胞的特征，我们在一个染色方案中结合了多种流式细胞仪抗体来表征低血量(500微升全血)的粒细胞、淋巴细胞和单核细胞亚群及其血小板聚集物。与完整的血细胞计数和分类相比，这一流式细胞仪仪表板可以进行更广泛的比较。在用血库献血者的血液样本建立低容量流动面板时，我们发现，在比较非裔美国人和高加索献血者时，免疫细胞群有所不同。我们发现之前报道的不同种族/民族之间的粒细胞和淋巴细胞计数的差异，支持了我们的小组的有效性。我们还检测到了以前没有报道过的差异，如单核细胞亚群分布、自然杀伤(NK)细胞亚群、NKT细胞和血小板-单核细胞亚群聚集的差异。确定单核细胞和NK亚型的种族/民族差异是重要的初步数据，因为1)单核细胞对动脉粥样硬化的形成至关重要；2)NK细胞特别是NK细胞可以因社会压力而改变；3)单核细胞-血小板聚集已被强调为对女性心肌梗死风险的重要意义。这些发现使我们专注于单核细胞和NK细胞群体作为感兴趣的免疫细胞，以及它们在将不利环境条件造成的慢性应激与心血管风险联系起来的潜在参与。

We used epidemiologic data from the 1999-2002 National Health and Nutrition Examination Surveys to assess the relationship between neighborhood deprivation index (NDI) and log-transformed leukocyte telomere length (LTL) to begin to assess the biological mechanisms by which deprived neighborhood conditions may lead to poor cardiovascular (CV) health. We used multilevel modeling to control for census tract level clustering. We constructed models using tertiles of NDI (ref = low NDI). NDI was calculated using census tract level socioeconomic indicators from the 2000 U.S. Census. The sample (n = 5,106 adults) was 49.8% female and consisted of 82.9% non-Hispanic whites, 9.4% non-Hispanic blacks, and 7.6% Mexican Americans. Mean age was 45.8 years. Residents of neighborhoods with high NDI were younger, non-white, and had lower socioeconomic levels (all p < 0.0001). Neighborhood deprivation was inversely associated with LTL among individuals living in neighborhoods with medium NDI and high NDI as compared to low NDI. Among men, both medium and high NDI were associated with shorter LTL as compared to low NDI. Among women, only medium NDI was associated with shorter LTL as compared to low NDI. After controlling for individual characteristics, including individual-level socioeconomic status, increasing neighborhood socioeconomic deprivation is associated with shorter LTL among a nationally representative sample of adults in the United States. Our findings suggest that telomere shortening may be a mechanism through which neighborhood deprivation results in poor CV health outcomes. To characterize immune cells that may be impacted by the chronic stressors of neighborhood environment, we combined a variety of flow cytometry antibodies in one staining protocol to characterize granulocyte, lymphocyte, and monocyte sub-populations and their platelet aggregates with low blood volumes (500 microliters of whole blood). This flow cytometry panel enabled a more extensive comparison than what is possible with a complete blood count and differential. While establishing the low-volume flow panel with blood samples from blood bank donors, we found that the immune cell populations differed when comparing African-American and Caucasian blood donors. We found previously reported differences in granulocyte and lymphocyte counts between the racial/ethnic groups, supporting the validity of our panel. We also detected differences that had not been previously reported, like differences in the monocyte subset distribution, natural killer (NK) cell subsets, NKT cells, and platelet-monocyte subset aggregates. Identifying racial/ethnic differences in monocyte and NK subtypes are important preliminary data as 1) monocytes are crucial to atherogenesis; 2) NK cells, in particular, can be altered by social stress, and 3) monocyte-platelet aggregates have been highlighted to be of significance for myocardial infarction risk among women. These findings have led us to focus on monocyte and NK cell populations as immune cells of interest and their potential involvement in linking chronic stress from adverse environmental conditions to CV risk.