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 性少数群体患肥胖症、哮喘、糖尿病、心血管疾病的风险明显更高， 与异性恋者相比，还有一些癌症。这些健康差距的一个关键驱动因素是与慢性压力有关的 走向污名化。雪上加霜的是，种族和民族性少数群体具有复杂的交叉身份 与非西班牙裔白人相比，有可能加剧负面健康后果的压力经历 性少数群体。慢性应激源可通过增加炎症和 细胞免疫受损，这是一种预测急性疾病、慢性病和死亡风险的因果模式。 由NICHD资助并在大流行期间现场部署的国家夫妇健康和时间研究 (NCHAT)包括5157名18-60岁的美国成年人，样本过多的是黑人、拉美裔和亚洲人 个人。有2230人(43.2%)认为自己是同性恋、双性恋或其他身份，NCHAT是唯一 人口代表性研究，对美国的性少数群体进行了全面调查。利用 解决性少数群体压力生物学数据的经验差距的非同寻常的机会， 特别是那些具有交叉身份的人，我们增加了一个试点生物数据收集(干血斑点； DBS)到NCHAT创建NCHAT应激生物学研究(NCHAT-BIO)。生物数据收集是 完成了，但样本还有待化验。在R21中，我们将对这些样本进行化验以测量 炎症(白介素6、C反应蛋白)和细胞免疫功能(爱泼斯坦-巴尔病毒重新激活)。 在763名NCHAT参与者的不同队列中，我们将解决这些经验性目标： 目标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力 女同性恋者、男同性恋者和双性恋者之间的作用不同。目标2：检查效果 免疫失调的生物标志物上的污名、歧视和交叉性 少数人强调框架。假设：耻辱和歧视的经历将预示更大的 炎症和较差的细胞免疫功能，在性少数群体中影响更大，在 特别是有色人种的少数性别参与者。目标3：确定可修改的行为和可治疗的行为 心理因素将压力与免疫失调联系在一起。假设：可修改的健康行为 (物质使用、锻炼、饮食)和可治疗的心理因素(抑郁、焦虑、睡眠障碍) 调停性少数群体压力与免疫失调之间的联系，提出干预目标。 NCHAT-BIO提供了一种独特的全面和严谨的压力研究方法 美国性少数群体的生物学，允许对压力和健康之间的联系进行新的测试 在少数族裔压力框架内。此R21将支持未来的R01，以解决以下纵向变化 NCHAT队列中的应激生物学。

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.