Sociodemographic Disparities in SLE Incidence: Behavioral and Psychosocial Factors

SLE 发病率的社会人口统计学差异：行为和社会心理因素

基本信息

批准号：
9146273
负责人：
Karen H Costenbader
金额：
$ 63.33万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-15 至 2020-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9146273
关键词：
Accounting Adolescence Adult Age Alcohol consumption American Anti-Inflammatory Agents Anti-inflammatory Antinuclear Antibodies Anxiety Area Attention Autoantibodies Autoimmunity Behavioral Biological Markers Biometry Blood specimen Body fat Clinical Cohort Studies Collection Complex Consumption Data Development Diet Dietary Factors Dietary Practices Disadvantaged Disease End stage renal failure Enrollment Environmental Exposure Epidemiology Exposure to Fishes Genetic Grant Health High Prevalence Hormone use Incidence Inflammation Inflammatory Insurance Intake Life Life Experience Life Style Light Link Low income Lupus Nephritis Mediating Medicaid Menarche Nurses&apos Health Study Obesity Omega-3 Fatty Acids Oral Contraceptives Outcome Patients Pattern Pharmaceutical Preparations Play Population Population Attributable Risks Postmenopause Potato Prevalence Prevention Processed Meats Production Psychosocial Factor Public Health Race Rheumatology Risk Role Self Tolerance Silicon Dioxide Smoking Socioeconomic Status Staging Stress Systemic Lupus Erythematosus Time Tissues Up-Regulation Weight Gain Woman Women&apos s Health Work cohort cytokine depressive symptoms disparity reduction experience fast food health care quality innovation lifestyle factors lifestyle intervention low socioeconomic status multidisciplinary nutritional epidemiology prevent prospective psychologic saturated fat social socioeconomics soft drink stressor sugar western diet

项目摘要

DESCRIPTION (provided by applicant): In this competitive renewal of a highly successful grant investigating sociodemographic disparities in outcomes from systemic lupus erythematosus (SLE), including lupus nephritis and end-stage renal disease, we will turn our attention to the alarming and unexplained sociodemographic disparities that exist in SLE incidence. Most SLE patients are women and blacks have much higher incidence and poorer outcomes than whites. Moreover, within the population enrolled in Medicaid, the Federal-state insurance for low income Americans, we have shown increased SLE among those living in poorer areas. We will investigate three classes of potentially modifiable social and behavioral factors that may contribute to increased SLE incidence among black and low socioeconomic status women: 1. dietary factors and patterns, specifically fish (rich in anti-inflammatory omega-3 fatty acids), and the Western "pro-inflammatory" dietary pattern, characterized by fast food, high saturated fat, processed meats, potatoes, and sugar-sweetened soft drinks; 2. obesity, which induces systemic inflammation, and; 3. psychosocial factors including depressive symptoms, anxiety and exposure to abuse. We hypothesize that these exposures are associated with elevated biomarkers of SLE autoimmunity, as well as with incident SLE. We will utilize the largest collection of women followed prospectively prior to SLE, the Nurses' Health Study and the Black Women's Health Study cohorts, with rich data on dietary, lifestyle, psychosocial factors, and banked blood samples. With excellent statistical power, we will examine whether and how these exposures at different time periods of life may alter SLE risk among white and black women of a range of socioeconomic backgrounds. Our multidisciplinary investigative team spanning nutritional epidemiology, social and behavioral epidemiology, biostatistics, and rheumatology will employ advanced and innovative epidemiologic concepts and analyses. The proposed analyses will provide currently lacking information concerning potential epidemiologic explanations for observed sociodemographic disparities in SLE. The findings will have important public health and clinical implications, directly informing lifestyle interventions aimed at preventing and reducing disparities in SLE.

描述（由适用提供）：在这种非常成功的补助金的竞争更新中，调查了系统性狼疮红斑（SLE）（包括狼疮肾炎和终末期肾脏疾病）的社会人口统计学差异，我们将把注意力转向令人震惊的和无法解释的社会学障碍，这些疾病存在于SLE遇到的事故。大多数SLE患者是女性，黑人的事件的发生率要高得多，而效果较差。此外，在招收医疗补助的人口中，低收入美国人的联邦国家保险，我们显示出在贫困地区的人们中的SLE增加。我们将研究三类可能改变的社会和行为因素，这些因素可能导致黑人和低社会经济地位的SLE入射女性：1。饮食因素和模式，尤其是鱼类，特别是抗炎的omega-3脂肪酸），以及西方的“饮食”，“促进性”的饮食模式，以快速食物为特征，高饱和食品，饱和脂肪，肥胖的肥胖，加工肉类，糖，糖，糖，糖，以及糖，糖，以及糖，糖，糖，; 2。肥胖，引起全身感染，并且； 3。社会心理因素，包括抑郁症状，焦虑和暴露于虐待。我们假设这些暴露与SLE自身免疫性的生物标志物以及事件SLE有关。威尔会在SLE，护士的健康研究和黑人妇女健康研究队列之前使用最大的妇女收集，并提供有关饮食，生活方式，社会心理因素和储存血液样本的丰富数据。凭借出色的统计能力，我们将研究这些在不同时期的暴露量是否以及如何改变各种社会经济背景的白人和黑人妇女中的SLE风险。多学科的调查团队涵盖营养流行病学，社会和行为流行病学，生物统计学和风湿病学将采用先进和创新的流行病学概念和分析。拟议的分析将提供目前缺乏有关SLE中观察到的社会人口统计学差异的潜在流行病学解释的信息。这些发现将具有重要的公共卫生和临床意义，直接告知旨在防止和减少SLE差异的生活方式干预措施。