Examining biomarkers and mechanisms of health disparities in sexual minority women

检查性少数女性健康差异的生物标志物和机制

• 批准号: 9291370
• 负责人: Kathryn Elizabeth Keenan
• 金额: $ 80.05万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-04-01 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9291370
• 关键词: Abstinence; Adolescence; Adult; Adverse effects; Affect; Age; Alcohol or Other Drugs use; Attenuated; Behavior; Biological Markers; Biometry; Blood Pressure; C-reactive protein; Cardiovascular Diseases; Cardiovascular system; Caregivers; Chicago; Childhood; Cholesterol; Chronic; Climate; Collaborations; Communities; Complement; Data; Development; Diabetes Mellitus; Discrimination; Disease; Emotional; Environment; Exposure to; Family; Fatty Acids; Frequencies; Funding; Glucose; Goals; Grant; Health; Health Promotion; Health Psychology; Heart Diseases; Heart Rate; Heterosexuals; Hydrocortisone; Hypertension; Illinois; Inflammation; Inflammatory; Insulin; Interleukin-6; Intervention; Interview; Lead; Lesbian Gay Bisexual; Link; Lipids; Longitudinal Studies; Measures; Mediating; Mediator of activation protein; Mental Health; Metabolic; Minority; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Patient Self-Report; Physical activity; Prejudice; Preventive Intervention; Principal Investigator; Prospective Studies; Psychopathology; Recording of previous events; Reporting; Research Personnel; Risk; Role; Safe Sex; Sampling; Schools; Sex Orientation; Stress; System; TNF gene; Testing; Trauma; United States National Institutes of Health; Universities; Vaccination; Vaccines; Vulnerable Populations; Woman; Youth; adolescent health; austin; base; cytokine; emerging adult; experience; girls; health disparity; high risk; innovation; mortality; peer victimization; physical conditioning; prospective; racial diversity; sexual minority; social stigma; stress reactivity; stressor; theories; uptake; waist circumference; young adult; young woman

Project Summary Significance: Compared to heterosexual women, lesbian/gay and bisexual (LGB) women report higher rates of physical health problems. Current evidence, which is largely based on self-report, suggests that important health disparities exist in conditions with high rates of morbidity and mortality (e.g., diabetes, heart disease). To date, however, no study has tested differences in objective measures of health risks between LGB and heterosexual women in a representative sample of young adults. We aim to fill this gap by examining putative health disparities using rigorous objective biomarkers of health (i.e. cardiometabolic functioning and inflammation) in young adulthood in a representative, racially diverse sample of young women who are participating in an ongoing longitudinal study, the Pittsburgh Girls Study (PGS) (Aim 1). We will link prospectively gathered data on discrimination stress and childhood adversity to determine the role of stress exposure in the association between sexual minority status and early adult health (Aim 2). Finally, we will test whether health promotion during adolescence attenuates the association between discrimination stress and health risks among LGB women (Aim 3). Approach: Our plan is to leverage comprehensive, prospectively collected data from the PGS and measure current health indicators among LGB women in the PGS (n=230) and a demographic frequency matched sample of heterosexual women (n=230) in early adulthood (ages 22-25 years). Assessments of health will include: waist circumference, blood pressure, lipids, cholesterol, fatty acids, glucose, insulin, proinflammatory cytokines (IL-6; TNF-α), and C-reactive protein. We propose to assess discrimination stress via cortisol and heart rate reactivity to a lab- based discrimination stressor and perceived discrimination experiences measured annually and prospectively from ages 15 to 21 years. Childhood adversity (family stress, trauma, abuse, and peer victimization) has been assessed annually for in the PGS from youth and caregiver reports. Physical and emotional health promotion during adolescence has been assessed in a number of ways in the PGS including vaccine uptake, safe sexual practices, and physical activity, supportive adult presence, and will be complemented by interviews on school climate and coming out experiences. Investigators: Dr. Kathryn Keenan is the Principal Investigator, Drs. Alison Hipwell, Stephanie Stepp, Karen Matthews, Alicia Matthews and Alida Bouris are Co-Investigators, and Ms. Kristen Wroblewski is the biostatistician. Dr. Constance Hammen is the consultant. The investigators have led many successful NIH-funded studies and represent expertise in developmental psychopathology, women's mental health, sexual minority physical and mental health, health psychology, and biostatistics. Collectively, the investigators have experience in administering the TSST to vulnerable populations, measuring cortisol reactivity, and testing hypotheses involving cardiometabolic and inflammatory functioning. Environment: This proposal builds on long-standing, productive collaborations among investigators at the Universities of Chicago, Illinois, and Pittsburgh. Innovation/Impact: The proposed study provides an unprecedented opportunity to explore health disparities in LGB women in a rigorous manner, examine potential mechanisms by which sexual orientation confers health risks, and identify protective factors in a representative and racially diverse sample of LGB and heterosexual women.

项目摘要 意义：与异性恋妇女，女同性恋/同性恋（LGB）妇女报告的身体健康率更高 问题。当前的证据主要基于自我报告，这表明在条件下存在重要的健康分布 发病率和死亡率高（例如糖尿病，心脏病）。但是，迄今为止，尚无研究测试 在代表性的年轻人样本中，LGB和异性恋妇女之间健康风险的客观度量。我们的目标 通过使用严格的健康目标生物标志物检查推定的健康差异来填补这一空白（即心脏代谢功能 和炎症）在成年的年轻人中，有代表性的，种族多样的年轻女性的样本 正在进行的纵向研究，匹兹堡女孩研究（PGS）（AIM 1）。我们将链接前瞻性收集有关歧视的数据 压力和儿童逆境，以确定压力暴露在性少数群体状况与性少数群体与 早期的成人健康（AIM 2）。最后，我们将测试青少年期间的健康促进是否减弱 LGB妇女的歧视压力和健康风险（AIM 3）。方法：我们的计划是利用全面的 前瞻性收集了PGS的数据，并测量了PG中LGB女性的当前健康指标（n = 230）和A 人口统计学频率与成年初期（22-25岁）的异性恋妇女的样本相匹配（n = 230）。评估 健康将包括：腰围，血压，脂质，胆固醇，脂肪酸，葡萄糖，胰岛素，促炎细胞因子 （IL-6; TNF-α）和C反应蛋白。我们建议通过皮质醇和对实验室的心率反应性评估歧视应激 基于歧视压力源和感知的歧视经验，每年从15至21岁时测量 年。儿童期广告（家庭压力，创伤，虐待和同伴胜利）每年在PG中评估 青年和照料者报告。在青少年期间的身体和情感健康促进已在许多人中进行了评估 PG中的方法包括疫苗吸收，安全的性行为和体育锻炼，支持成人的支持，将是 通过对学校攀岩和出来的经验的采访完成。调查人员：凯瑟琳·基南（Kathryn Keenan）博士是校长 调查员，博士。 Alison Hipwell，Stephanie Stepp，Karen Matthews，Alicia Matthews和Alida Bouris是共同研究者，以及 克里斯汀·沃布尔维斯基（Kristen Wroblewski）女士是生物统计学家。 Constance Hammen博士是顾问。调查人员领导了许多 成功的NIH资助研究并代表了发展心理病理学，妇女心理健康，性行为的专家 少数族裔身心健康，健康心理学和生物统计学。调查人员共同有经验 管理TSST对脆弱人群，测量皮质醇反应性以及涉及心脏代谢的假设 和炎症功能。环境：该提案建立在长期存在的产品合作的基础上 芝加哥，伊利诺伊州和匹兹堡大学的调查人员。创新/影响：拟议的研究提供了 前所未有的机会，以严格的方式探索LGB妇女的健康分配，检查潜在的机制 哪种性取向赋予了健康风险，并在代表性的，大致不同的样本中确定保护因素 LGB和异性妇女。