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

基本信息

批准号：
9922364
负责人：
Kathryn Elizabeth Keenan
金额：
$ 82.37万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-04-01 至 2023-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9922364
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 cardiometabolism childhood adversity cytokine emerging adult experience girls health assessment health disparity high risk innovation mortality peer victimization physical conditioning prospective protective factors racial diversity sexual minority social stigma stress reactivity stressor theories uptake waist circumference young adult young woman

项目摘要

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.

项目概要意义：与异性恋女性相比，女同性恋/男同性恋和双性恋 (LGB) 女性的身体健康状况更高目前的证据主要基于自我报告，表明不同条件下存在重要的健康差异。然而，迄今为止，还没有研究测试过发病率和死亡率（例如糖尿病、心脏病）的差异。我们的目标是对具有代表性的年轻人样本中 LGB 和异性恋女性之间的健康风险进行客观测量。通过使用严格的客观健康生物标志物（即心脏代谢功能）检查假定的健康差异来填补这一空白和炎症）在成年早期，在参与一项具有代表性的、种族多样化的年轻女性样本中正在进行的纵向研究，匹兹堡女孩研究（PGS）（目标 1）我们将链接前瞻性收集的歧视数据。压力和童年逆境，以确定压力暴露在性少数地位和性少数群体之间的关系中的作用最后，我们将测试青春期的健康促进是否会减弱两者之间的关联。 LGB 女性的歧视压力和健康风险（目标 3）：我们的计划是利用全面的、前瞻性地从 PGS 收集数据并测量 PGS 中 LGB 女性 (n=230) 和人口统计频率匹配成年早期（22-25 岁）异性恋女性样本（n=230）。健康包括：腰围、血压、血脂、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，我们建议通过实验室的皮质醇和心率反应来评估歧视压力。每年和前瞻性地从 15 岁到 21 岁期间测量基于歧视压力源和感知到的歧视经历 PGS 每年都会对童年逆境（家庭压力、创伤、虐待和同伴受害）进行评估。青少年和照顾者的报告对青少年时期的身体和情感健康促进进行了评估。 PGS 中的方式包括疫苗接种、安全性行为和身体活动、支持性成人存在，并将辅之以对学校氛围和出柜经历的采访：校长凯瑟琳·基南 (Kathryn Keenan) 博士。研究员，Alison Hipwell 博士、Stephanie Stepp、Karen Matthews、Alicia Matthews 和 Alida Bouris 是联合研究员， Kristen Wroblewski 女士是生物统计学家，Constance Hammen 博士是该研究的顾问。 NIH 资助的成功研究代表了发展精神病理学、女性心理健康、性总的来说，调查人员在少数民族身心健康、健康心理学和生物统计学方面拥有丰富的经验。对弱势群体进行 TSST，测量皮质醇反应性，并测试涉及心脏代谢的假设环境和炎症功能：该提案建立在长期、富有成效的合作基础上。芝加哥大学、伊利诺伊大学和匹兹堡大学的研究人员的创新/影响：拟议的研究提供了一项研究。前所未有的机会以严格的方式探索 LGB 女性的健康差异，通过以下方式检查潜在机制：哪些性取向会带来健康风险，并确定具有代表性和种族多样性的样本中的保护因素 LGB 和异性恋女性。