The Interplay of Sociodemographic and Genetic Factors in SLE Health Disparities

社会人口学和遗传因素在 SLE 健康差异中的相互作用

• 批准号: 7612004
• 负责人: Lindsey Ann Criswell
• 金额: $ 14.14万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7612004
• 关键词: Address; Affect; African American; Age; Autoimmune Diseases; Behavioral; Behavioral Genetics; Biological; Candidate Disease Gene; Categories; Caucasians; Caucasoid Race; Characteristics; Clinical; Collection; Communities; Country; Data; Depth; Disease; Education; Employee Strikes; Employment; Enrollment; Ethnic Origin; Ethnic group; European; Gene Frequency; Genes; Genetic; Genetic Markers; Genetic Polymorphism; Genetic Variation; Geographic Locations; Health; Health Status; Hispanics; Income; Individual; Insurance Coverage; Interview; Kidney; Lupus; Lupus Erythematosus; Marital Status; Measures; Mediator of activation protein; Medical Records; Morbidity - disease rate; Nature; Numbers; Occupational; Organ; Other Genetics; Outcome; Outcome Study; Patient Self-Report; Patients; Performance; Physicians; Population Study; Proxy; Questionnaires; Range; Recording of previous events; Relative (related person); Research; Resources; Risk; Risk Factors; Role; SF-36; Score; Severities; Severity of illness; Societies; Socioeconomic Factors; Stress; Study Subject; Study models; Systemic Lupus Erythematosus; Time; Variant; base; cigarette smoking; cohort; cost; depressive symptoms; ethnic difference; experience; health disparity; indexing; instrument; mortality; novel; psychosocial; sex; size; social; socioeconomics

Systemic lupus erythematosus (SLE) is the prototypic systemic autoimmune disease that has the potential to cause serious morbidity and early mortality and is responsible for tremendous costs to affected individuals and society. A striking feature of SLE is variation in health outcomes. In particular, substantial research documents ethnic disparities in SLE risk and severity. In spite of the magnitude of variation in SLE health outcomes, and the potential importance for patients, physicians and society, many questions remain about the underlying causes. For example, it remains unclear whether ethnic disparities in SLE outcomes reflect primarily individual, social, environmental or genetic variation in risk or interactions among these factors. Our lack of understanding is at least partially due to the challenges of assembling a sufficiently large and diverse cohort of SLE patients, measuring the full range of potentially important risk factors, and accurately assessing health outcomes. The current proposal represents a unique combination of clinical and investigative resources that has been developed to address this critically important issue. Specifically, we will: 1) determine the relative contributions of demographic, socioeconomic, psychosocial, behavioral and genetic factors to health outcomes in SLE; and 2) characterize changes in health outcomes over time and the contribution of these explanatory factors to temporal changes in outcome. A primary focus of this project will be the relationship of ethnicity to SLE outcomes, and in particular understanding the roles of genetics and other factors (e.g., socioeconomic, psychosocial, etc.) as mediators of ethnic disparities in outcome. Our study population will be approximately 1,000 SLE patients enrolled in the Lupus Outcome Study. We will use validated instruments to assess the following outcomes: general health status, disease activity and cumulative damage. A unique feature of the current proposal is the depth and breadth of potentially important explanatory factors that will be considered. In addition to traditional risk factors, these include novel measures of community characteristics obtained through "geocoding" to small geographic areas and ancestry informative genetic markers. Due to the size and scope of this project, in conjunction with the rich resources and expertise of the MCRC, this project should substantially increase our understanding of health disparities in SLE and their underlying causes and guide efforts to remedy these disparities.

全身性红斑狼疮（SLE）是原型全身自身免疫性疾病，有可能 引起严重的发病率和早期死亡率，并为受影响的个体负责 和社会。 SLE的惊人特征是健康结果的变化。特别是大量研究 记录SLE风险和严重性的种族差异。尽管SLE健康的变化很大 结果以及对患者，医师和社会的潜在重要性，许多问题仍然存在 基础原因。例如，尚不清楚SLE结果中的种族差异是否反映 这些因素之间主要是个人，社会，环境或遗传差异或相互作用。 我们缺乏了解至少部分是由于组装足够大的挑战和 SLE患者的各种队列，测量了全部重要的重要风险因素，并准确地测量 评估健康结果。当前的提案代表了临床和 已经开发出来解决这个至关重要的问题的调查资源。具体来说，我们 意志：1）确定人口统计学，社会经济，社会心理，行为和行为的相对贡献 SLE健康结果的遗传因素； 2）表征健康结果随着时间的变化，并且 这些解释性因素对结果的时间变化的贡献。该项目的主要重点 将是种族与SLE结果的关系，特别是了解遗传学的作用 和其他因素（例如，社会经济，社会心理等），作为结果中种族差异的介体。 我们的研究人群将大约有1,000名参加狼疮结果研究的SLE患者。我们 将使用经过验证的工具来评估以下结果：一般健康状况，疾病活动和 累积损害。当前提案的独特特征是潜在的深度和广度 将要考虑的重要解释因素。除了传统的风险因素外，这些还包括 通过“地理编码”到小地理区域获得的社区特征的新颖衡量标准 祖先提供的遗传标记。由于该项目的大小和范围，与富人一起 MCRC的资源和专业知识，该项目应大大提高我们对健康的理解 SLE及其根本原因的差异和指导纠正这些差异的努力。