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Assari S, Zare H. Poverty Status at Birth Predicts Epigenetic Changes at Age 15. JOURNAL OF BIOMEDICAL AND LIFE SCIENCES 2024; 4:989. [PMID: 39087138 PMCID: PMC11288982 DOI: 10.31586/jbls.2024.989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
Epigenetic studies have provided new opportunities to better understand the biological effects of poverty and racial/ethnic minority status. However, little is known about sex differences in these processes. Methods We used 15 years of follow up of 854 racially and ethnically diverse birth cohort who were followed from birth to age 15. Structural equation modeling (SEM) was used to examine the effects of race/ethnicity, maternal education, and family structure on poverty at birth, as well as the effects of poverty at birth on epigenetic changes at age 15. We also explored variations by sex. Results Our findings indicate that Black and Latino families had lower maternal education and married family structure which in turn predicted poverty at birth. Poverty at birth then was predictive of epigenetic changes 15 years later when the index child was 15. This suggested that poverty at birth partially mediates the effects of race/ethnicity, maternal education, and family structure on epigenetic changes of youth at age 15. There was an effect of poverty status at birth on DNA methylation of male but not female youth at age 15. Thus, poverty at birth may have a more salient effect on long term epigenetic changes of male than female youth. Conclusions Further studies are needed to understand the mechanisms underlying the observed sex differences in the effects of poverty as a mechanism that connects race/ethnicity, maternal education, and family structure to epigenetic changes later in life.
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Affiliation(s)
- Shervin Assari
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, CA, United States
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- School of Business, University of Maryland Global Campus (UMGC), College Park, MD, United States
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Assari S, Zare H. Race, Poverty Status at Birth, and DNA Methylation of Youth at Age 15. GLOBAL JOURNAL OF EPIDEMIOLOGY AND INFECTIOUS DISEASE 2024; 4:8-19. [PMID: 39055525 PMCID: PMC11271691 DOI: 10.31586/gjeid.2024.988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Epigenetic studies, which can reflect biological aging, have shown that measuring DNA methylation (DNAm) levels provides new insights into the biological effects of social environment and socioeconomic position (SEP). This study explores how race, family structure, and SEP (income to poverty ratio) at birth influence youth epigenetic aging at age 15. Data were obtained from the Future of Families and Child Wellbeing Study (FFCWS) cohort, with GrimAge used as a measure of DNAm levels and epigenetic aging. Our analysis included 854 racially and ethnically diverse participants followed from birth to age 15. Structural equation modeling (SEM) examined the relationships among race, SEP at birth, and epigenetic aging at age 15, controlling for sex, ethnicity, and family structure at birth. Findings indicate that race was associated with lower SEP at birth and faster epigenetic aging. Specifically, income to poverty ratio at birth partially mediated the effects of race on accelerated aging by age 15. The effect of income to poverty ratio at birth on DNAm was observed in male but not female youth at age 15. Thus, SEP partially mediated the effect of race on epigenetic aging in male but not female youth. These results suggest that income to poverty ratio at birth partially mediates the effects of race on biological aging into adolescence. These findings highlight the long-term biological impact of early-life poverty in explaining racial disparities in epigenetic aging and underscore the importance of addressing economic inequalities to mitigate these disparities. Policymakers should focus on poverty prevention in Black communities to prevent accelerated biological aging and associated health risks later in life. Interventions aimed at eliminating poverty and addressing racial inequities could have significant long-term benefits for public health. Future research should explore additional factors contributing to epigenetic aging and investigate potential interventions to slow down the aging process. Further studies are needed to understand the mechanisms underlying these associations and to identify effective strategies for mitigating the impact of SEP and racial disparities on biological aging.
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Affiliation(s)
- Shervin Assari
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, CA, United States
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- School of Business, University of Maryland Global Campus (UMGC), College Park, United States
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Beller J, Safieddine B, Sperlich S, Tetzlaff J, Geyer S. Socioeconomic differences in limited lung function: a cross-sectional study of middle-aged and older adults in Germany. Int J Equity Health 2024; 23:138. [PMID: 38982484 PMCID: PMC11234541 DOI: 10.1186/s12939-024-02224-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 07/01/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Limited lung function represents a serious health impairment. However, studies investigating social inequalities in limited lung function are rare. Thus, the current study investigates which socioeconomic groups are the most affected by overall limited lung function and severely limited lung function. METHODS Data from the population-based German Aging Survey were used (N = 4472), with participants being 40 + years old. Lung function was assessed by the peak flow test. Education, income, and occupational prestige were used as socioeconomic indicators. RESULTS We found that overall limited lung function was highly prevalent across the whole sample, with about 33% (Women: 35%; Men: 30%) having overall limited lung function and 8% (Women: 7%; Men: 8%) having severely limited lung function. Socioeconomic differences in limited lung function emerged for all three indicators, education, income, and occupational prestige, in both men and women in single effect analyses. These differences persisted for occupational prestige and income when controlling for all indicators simultaneously. CONCLUSIONS Thus, overall and severely limited lung function are highly prevalent health conditions. Men and women with a low occupational position and those with low income are the most affected. Socioeconomic indicators cannot be used interchangeably when studying health inequalities in lung functioning. Occupational hazards and physical working conditions are likely to constitute major risks of health inequalities in limited lung functioning and should be investigated as such by future studies.
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Affiliation(s)
- Johannes Beller
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, Hannover, 30625, Germany.
| | - Batoul Safieddine
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Stefanie Sperlich
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Juliane Tetzlaff
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Siegfried Geyer
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
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Baugh A, Buhr RG, Bush A, Foreman M, Mannino DM. Strategies to Classify Lung Function: It's Not Black and White. Am J Respir Crit Care Med 2024; 209:19-20. [PMID: 37878872 PMCID: PMC10870882 DOI: 10.1164/rccm.202305-0807vp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/25/2023] [Indexed: 10/27/2023] Open
Affiliation(s)
- Aaron Baugh
- College of Medicine, University of California, San Francisco, San Francisco, California
| | - Russell G. Buhr
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Andrew Bush
- Imperial Centre for Paediatrics and Child Health, Imperial College, London, United Kingdom
| | - Marilyn Foreman
- Pulmonary and Critical Care Medicine Division, Morehouse School of Medicine, Atlanta, Georgia
- Novartis Beacon of Hope Center of Excellence for Data Standards in Clinical Medicine, Atlanta, Georgia; and
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Noren Hooten N, Mode NA, Allotey S, Ezike N, Zonderman AB, Evans MK. Inflammatory proteins are associated with mortality in a middle-aged diverse cohort. Clin Transl Med 2023; 13:e1412. [PMID: 37743657 PMCID: PMC10518496 DOI: 10.1002/ctm2.1412] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Recent data indicate a decline in overall longevity in the United States. Even prior to the COVID-19 pandemic, an increase in midlife mortality rates had been reported. Life expectancy disparities have persisted in the United States for racial and ethnic groups and for individuals living at low socioeconomic status. These continued trends in mortality indicate the importance of examining biomarkers of mortality at midlife in at-risk populations. Circulating levels of cytokines and inflammatory markers reflect systemic chronic inflammation, which is a well-known driver of many age-related diseases. METHODS In this study, we examined the relationship of nine different inflammatory proteins with mortality in a middle-aged socioeconomically diverse cohort of African-American and White men and women (n = 1122; mean age = 47.8 years). RESULTS We found significant differences in inflammatory-related protein serum levels between African-American and White middle-aged adults. E-selectin and fibrinogen were significantly higher in African-American adults. IFN-γ, TNF-α trimer, monocyte chemoattractant protein-1 (MCP-1), soluble receptor for advanced glycation end-products (sRAGE) and P-selectin were significantly higher in White participants compared to African-American participants. Higher levels of E-selectin, MCP-1 and P-selectin were associated with a higher mortality risk. Furthermore, there was a significant interaction between sex and IL-6 with mortality. IL-6 levels were associated with an increased risk of mortality, an association that was significantly greater in women than men. In addition, White participants with high levels of sRAGE had significantly higher survival probability than White participants with low levels of sRAGE, while African-American participants had similar survival probabilities across sRAGE levels. CONCLUSIONS These results suggest that circulating inflammatory markers can be utilized as indicators of midlife mortality risk in a socioeconomically diverse cohort of African-American and White individuals.
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Affiliation(s)
- Nicole Noren Hooten
- Laboratory of Epidemiology and Population Science National Institute on AgingNational Institutes of HealthBaltimoreMarylandUSA
| | - Nicolle A. Mode
- Laboratory of Epidemiology and Population Science National Institute on AgingNational Institutes of HealthBaltimoreMarylandUSA
| | - Samuel Allotey
- Laboratory of Epidemiology and Population Science National Institute on AgingNational Institutes of HealthBaltimoreMarylandUSA
- Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Ngozi Ezike
- Laboratory of Epidemiology and Population Science National Institute on AgingNational Institutes of HealthBaltimoreMarylandUSA
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Science National Institute on AgingNational Institutes of HealthBaltimoreMarylandUSA
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Science National Institute on AgingNational Institutes of HealthBaltimoreMarylandUSA
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Wauye VM, Ho FK, Lyall DM. Psychosocial predictors of COVID-19 infection in UK biobank (N = 104 201). J Public Health (Oxf) 2023; 45:560-568. [PMID: 37144429 PMCID: PMC10470346 DOI: 10.1093/pubmed/fdad009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/05/2022] [Accepted: 01/25/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Since the outbreak of COVID-19, data on its psychosocial predictors are limited. We therefore aimed to explore psychosocial predictors of COVID-19 infection at the UK Biobank (UKB). METHODS This was a prospective cohort study conducted among UKB participants. RESULTS The sample size was N = 104 201, out of which 14 852 (14.3%) had a positive COVID-19 test. The whole sample analysis showed significant interactions between sex and several predictor variables. Among females, absence of college/university degree [odds ratio (OR) 1.55, 95% confidence interval (CI) 1.45-1.66] and socioeconomic deprivation (OR 1.16 95% CI 1.11-1.21) were associated with higher odds of COVID-19 infection, while history of psychiatric consultation (OR 0.85 95% CI 0.77-0.94) with lower odds. Among males, absence of college/university degree (OR 1.56, 95% CI 1.45-1.68) and socioeconomic deprivation (OR 1.12, 95% CI 1.07-1.16) were associated with higher odds, while loneliness (OR 0.87, 95% CI 0.78-0.97), irritability (OR 0.91, 95% CI 0.83-0.99) and history of psychiatric consultation (OR 0.85, 95% CI 0.75-0.97) were associated with lower odds. CONCLUSION Sociodemographic factors predicted the odds of COVID-19 infection equally among male and female participants, while psychological factors had differential impacts.
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Affiliation(s)
- Victor M Wauye
- School of Health & Wellbeing, University of Glasgow, Scotland, UK
- Department of Internal Medicine, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Frederick K Ho
- School of Health & Wellbeing, University of Glasgow, Scotland, UK
| | - Donald M Lyall
- School of Health & Wellbeing, University of Glasgow, Scotland, UK
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Simanek AM, Xiong M, Woo JMP, Zheng C, Zhang YS, Meier HCS, Aiello AE. Association between prenatal socioeconomic disadvantage, adverse birth outcomes, and inflammatory response at birth. Psychoneuroendocrinology 2023; 153:106090. [PMID: 37146471 PMCID: PMC10807729 DOI: 10.1016/j.psyneuen.2023.106090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 05/07/2023]
Abstract
Prenatal socioeconomic disadvantage is associated with inflammation in mid- to late-life, yet whether a pro-inflammatory phenotype is present at birth and the role of adverse birth outcomes in this pathway remains unclear. We utilized data on prenatal socioeconomic disadvantage at the individual- (i.e., mother's and father's education level, insurance type, marital status, and Women, Infants, and Children benefit receipt) and census-tract level as well as preterm (< 37 weeks gestation) and small-for-gestational-age (SGA) (i.e., < 10th percentile of sex-specific birth weight for gestational age) birth status, and assessed inflammatory markers (i.e., C-reactive protein, serum amyloid p, haptoglobin, and α-2 macroglobulin) in archived neonatal bloodspots from a Michigan population-based cohort of 1000 neonates. Continuous latent variables measuring individual- and combined individual- and neighborhood-level prenatal socioeconomic disadvantage were constructed and latent profile analysis was used to create a categorical inflammatory response variable (high versus low) based on continuous inflammatory marker levels. Structural equation models were used to estimate the total and direct effect of prenatal socioeconomic disadvantage on the inflammatory response at birth as well as indirect effect via preterm or SGA birth (among term neonates only), adjusting for mother's age, race/ethnicity, body mass index, smoking status, comorbidities, and antibiotic use/infection as well as grandmother's education level. There was a statistically significant total effect of both individual- and combined individual- and neighborhood-level prenatal socioeconomic disadvantage on high inflammatory response among all neonates as well as among term neonates only, and a positive but not statistically significant direct effect in both groups. The indirect effects via preterm and SGA birth were both negative, but not statistically significant. Our findings suggest prenatal socioeconomic disadvantage contributes to elevated neonatal inflammatory response, but via pathways outside of these adverse birth outcomes.
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Affiliation(s)
- Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | - Meng Xiong
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jennifer M P Woo
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Cheng Zheng
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Yuan S Zhang
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Helen C S Meier
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Allison E Aiello
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
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8
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Harsini S, Rezaei N. Autoimmune diseases. Clin Immunol 2023. [DOI: 10.1016/b978-0-12-818006-8.00001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Boddy AM, Rupp S, Yu Z, Hanson H, Aktipis A, Smith K. Early life adversity, reproductive history and breast cancer risk. Evol Med Public Health 2022; 10:429-438. [PMID: 36101671 PMCID: PMC9464099 DOI: 10.1093/emph/eoac034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 08/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background and objectives Individuals who experience early life adversity are at an increased risk for chronic disease later in life. Less is known about how early life factors are associated with cancer susceptibility. Here, we use a life history framework to test whether early life adversity increases the risk of breast cancer. We predict that early life adversity can shift investment in somatic maintenance and accelerate the timing of reproduction, which may mediate or interact with the risk of breast cancer. Methodology We use population-wide data from the Utah Population Database (UPDB) and Utah Cancer Registry, leading to 24 957 cases of women diagnosed with breast cancer spanning 20 years (1990-2010) and 124 785 age-matched controls. We generated a cumulative early life adversity summation score to evaluate the interaction (moderation) and mediation between early life adversity, reproductive history and their association with breast cancer risk. Results Our analyses led to three key findings: (i) more early life adversity, when considered as a main effect, accelerates the time to first birth and death, (ii) early age at first birth and high parity decreases the risk of breast cancer and (iii) we find no association between early adversity and breast cancer risk either as a main effect or in its interaction with reproductive history. Conclusion and implications Early adversity elevates the risk of overall mortality through mechanisms other than breast cancer risk. This suggests early life factors can generate different effects on health. Future work should incorporate more complex view of life history patterns, including multiple life stages, when making predictions about cancer susceptibility.
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Affiliation(s)
- Amy M Boddy
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Shawn Rupp
- Biodesign Center for Biocomputing, Security, and Society, Arizona State University, Tempe, AZ, USA
| | - Zhe Yu
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Heidi Hanson
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Athena Aktipis
- Department of Psychology & Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
| | - Ken Smith
- Department of Family and Consumer Studies and Population Science/Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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Khajavi A, Radvar M, Moeintaghavi A. Socioeconomic determinants of periodontitis. Periodontol 2000 2022; 90:13-44. [PMID: 35950737 DOI: 10.1111/prd.12448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Amin Khajavi
- Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Radvar
- Department of Periodontology, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Moeintaghavi
- Department of Periodontology, Mashhad University of Medical Sciences, Mashhad, Iran
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Rakesh D, Zalesky A, Whittle S. Assessment of Parent Income and Education, Neighborhood Disadvantage, and Child Brain Structure. JAMA Netw Open 2022; 5:e2226208. [PMID: 35980639 PMCID: PMC9389347 DOI: 10.1001/jamanetworkopen.2022.26208] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
IMPORTANCE Although different aspects of socioeconomic status (SES) may represent distinct risk factors for poor mental health in children, knowledge of their differential and synergistic associations with the brain is limited. OBJECTIVE To examine the independent associations between distinct SES factors and child brain structure. DESIGN, SETTING, AND PARTICIPANTS We used baseline data from participants aged 9 to 10 years in the Adolescent Brain Cognitive Development (ABCD) study. These data were collected from 21 US sites between September 2017 and August 2018. Study participants were recruited from schools to create a participant sample that closely reflects the US population. EXPOSURES Neighborhood disadvantage was measured using the area deprivation index. We also used data on total parent or caregiver educational attainment (in years) and household income-to-needs ratio. MAIN OUTCOMES AND MEASURES T1-weighted magnetic resonance imaging was used to assess measures of cortical thickness, surface area, and subcortical volume. RESULTS Data from 8862 ABCD participants aged 9 to 10 years were analyzed. The mean (SD) age was 119.1 (7.5) months; there were 4243 girls (47.9%) and 4619 boys (52.1%). Data on race or ethnicity were available for 8857 of 8862 participants: 173 (2.0%) were Asian, 1099 (12.4%) were Black or African American, 1688 (19.1%) were Hispanic, 4967 (56.1%) were White, and 930 (10.5%) reported multiple races or ethnicities. Using 10-fold, within-sample split-half replication, we found that neighborhood disadvantage was associated with lower cortical thickness in the following brain regions (η2 = 0.004-0.009): cuneus (B [SE] = -0.099 [0.013]; P < .001), lateral occipital (B [SE] = -0.088 [0.011]; P < .001), lateral orbitofrontal (B [SE] = -0.072 [0.012]; P < .001), lingual (B [SE] = -0.104 [0.012]; P < .001), paracentral (B [SE] = -0.086 [0.012]; P < .001), pericalcarine (B [SE] = -0.077 [0.012]; P < .001), postcentral (B [SE] = -0.069 [0.012]; P < .001), precentral (B [SE] = -0.059 [0.011]; P < .001), rostral middle frontal (B [SE] = -0.076 [0.011]; P < .001), and superior parietal (B [SE] = -0.060 [0.011]; P < .001). Exploratory analyses showed that the associations of low educational attainment or neighborhood disadvantage and low cortical thickness were attenuated in the presence of a high income-to-needs ratio (η2 = 0.003-0.007). CONCLUSIONS AND RELEVANCE The findings of this cross-sectional study suggest that different SES indicators have distinct associations with children's brain structure. A high income-to-needs ratio may play a protective role in the context of neighborhood disadvantage and low parent or caregiver educational attainment. This study highlights the importance of considering the joint associations of different SES indicators in future work.
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Affiliation(s)
- Divyangana Rakesh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne Health, Melbourne, Victoria, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne Health, Melbourne, Victoria, Australia
- Melbourne School of Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne Health, Melbourne, Victoria, Australia
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Wickrama KAS, Wickrama T, Bae D, Merten M. Early socioeconomic adversity and young adult diabetic risk: an investigation of genetically informed biopsychosocial processes over the life course. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2022; 67:203-223. [PMID: 36573270 DOI: 10.1080/19485565.2022.2161463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The present study investigated a comprehensive model that integrates contributions of early socioeconomic adversity (ESA) and multiple polygenic scores (PGSs) through different mechanisms leading to diabetic risk in early adulthood. The study used prospective, longitudinal data from the National Longitudinal Study of Adolescent and Adult Health (Add Health) with a sample of 5,728 youth of European ancestry. The results showed that both ESA and PGSs were involved in different mechanisms. ESA contributed additively to educational failures, BMI, depressive symptoms, and diabetes risk over the life course (an additive process). Also, ESA launched a cascading process that connected these outcomes in a successively contingent manner. In addition to ESA, youths' multiple PGSs directly contributed to educational, psychological, and BMI outcomes. Multiple PGSs for education, BMI, and type 2 diabetes influenced not only youth outcomes that they were supposed to predict directly but also additional youth outcomes showing biological pleiotropy. The findings highlight the value of incorporating molecular genetic information into longitudinal developmental life course research and provide insight into malleable characteristics and appropriate timing for interventions addressing youth developmental and health outcomes.
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Affiliation(s)
| | - Thulitha Wickrama
- Department of Child, Youth and Family Studies, University of Nebraska
| | - Dayoung Bae
- Child and Adolescent Department, Korea University, Seoul, South Korea
| | - Michael Merten
- Department of Child, Youth and Family Studies, University of Nebraska
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Hertiš Petek T, Petek T, Močnik M, Marčun Varda N. Systemic Inflammation, Oxidative Stress and Cardiovascular Health in Children and Adolescents: A Systematic Review. Antioxidants (Basel) 2022; 11:894. [PMID: 35624760 PMCID: PMC9137597 DOI: 10.3390/antiox11050894] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/16/2022] [Accepted: 04/24/2022] [Indexed: 12/02/2022] Open
Abstract
Recent studies indicate that cerebrovascular diseases and processes of atherosclerosis originate in the childhood era and are largely influenced by chronic inflammation. Some features of vascular dysfunction in adulthood may even be programmed prenatally via genetic influences and an unfavorable intrauterine milieu. Oxidative stress, defined by an imbalance between the production and generation of reactive oxygen species (ROS) in cells and tissues and the capability of an organism to scavenge these molecules via antioxidant mechanisms, has been linked to adverse cardiovascular health in adults, yet has not been systematically reviewed in the pediatric population. We performed a systematic search as per the PRISMA guidelines in PubMed/Medline and Cochrane Reviews and detected, in total, 1228 potentially eligible pediatric articles on systemic inflammation, oxidative stress, antioxidant use, cardiovascular disease and endothelial dysfunction. The abstracts and full-text manuscripts of these were screened for inclusion and exclusion criteria, and a total of 160 articles were included. The results indicate that systemic inflammation and oxidative stress influence cardiovascular health in many chronic pediatric conditions, including hypertension, obesity, diabetes mellitus types 1 and 2, chronic kidney disease, hyperlipidemia and obstructive sleep apnea. Exercise and diet may diminish ROS formation and enhance the total serum antioxidant capacity. Antioxidant supplementation may, in selected conditions, contribute to the diminution of the oxidative state and improve endothelial function; yet, in many areas, studies provide unsatisfactory results.
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Affiliation(s)
- Tjaša Hertiš Petek
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Tadej Petek
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Mirjam Močnik
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Nataša Marčun Varda
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
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14
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Natale BN, Manuck SB, Shaw DS, Matthews KA, Muldoon MF, Wright AGC, Marsland AL. Systemic Inflammation Contributes to the Association Between Childhood Socioeconomic Disadvantage and Midlife Cardiometabolic Risk. Ann Behav Med 2022; 57:26-37. [PMID: 35195688 PMCID: PMC9773371 DOI: 10.1093/abm/kaac004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Childhood socioeconomic disadvantage is associated with increased risk for chronic inflammation and cardiometabolic disease at midlife. PURPOSE As it is presently unknown whether inflammation mediates the relationship between childhood socioeconomic status (SES) and adulthood cardiometabolic risk, we investigated associations between retrospectively reported childhood SES, circulating levels of inflammatory markers, and a latent construct of cardiometabolic risk in midlife adults. METHODS Participants were 1,359 healthy adults aged 30-54 (Adult Health and Behavior I&II; 52% women, 17% Black) who retrospectively reported childhood SES (parental education, occupational grade). Measures included plasma interleukin (IL)-6, C-reactive protein (CRP), and cardiometabolic risk factors. Structural equation modeling was conducted, with cardiometabolic risk modeled as a second-order latent variable with adiposity, blood lipids, glucose control, and blood pressure as first-order components. RESULTS Lower childhood SES was associated with greater risk for cardiometabolic disease at midlife (β = -0.08, CI[-0.04, -0.01], p = .01) in models adjusted for demographics, but this association was attenuated in models that adjusted for adulthood SES and health behaviors. In fully-adjusted models, the relationship between lower childhood SES and adult cardiometabolic risk was partially explained by higher circulating levels of CRP (β = -0.05, CI[-0.02, -0.01], p = .001), but not by IL-6. In an exploratory model, lower adulthood SES was also found to independently contribute to the association between childhood SES and adult cardiometabolic risk (β = -0.02, CI[-0.01, -0.001], p = .02). CONCLUSIONS The current study provides initial evidence that systemic inflammation may contribute to childhood socioeconomic disparities in cardiometabolic risk in midlife. Future work would benefit from prospective investigation of these relationships.
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Affiliation(s)
| | - Stephen B Manuck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Matthew F Muldoon
- Department of Medicine, Heart & Vascular Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Anna L Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA
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15
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Dai XJ, Shao Y, Ren L, Tao W, Wang Y. Risk factors of COVID-19 in subjects with and without mental disorders. J Affect Disord 2022; 297:102-111. [PMID: 34687782 PMCID: PMC8526429 DOI: 10.1016/j.jad.2021.10.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Subjects with mental disorders are at a higher risk of various pandemic, but no specific studies concerning on screening and comparing the risk factors of COVID-19 for subjects with and without mental disorders, and the role of different classes of mental disorders with respect to the COVID-19. METHODS This study comprised 42,264 subjects with mental disorders and 431,694 subjects without. Logistic regression was used to evaluate the associations of exposure factors with COVID-19 risk. Interaction terms were employed to explore the potential interaction effect between mental disorders and each exposure factor on COVID-19 risk. RESULTS Mental disorders increased 1.45-fold risk of COVID-19 compared with non-mental disorders. There were significant interaction effects between mental disorders and age, sex, ethnicity, health ratings, socioeconomic adversity, lifestyle habits or comorbidities on COVID-19 risk. Subjects with and without mental disorders shared some overlapping risk factors of COVID-19, including the non-white ethnicity, socioeconomic adversity and comorbidities. Subjects without mental disorders carry some specific risk and protective factors. Among subjects with mental disorders, the COVID-19 risk was higher in subjects with a diagnosis of organic/symptomatic mental disorders, mood disorders, and neurotic, stress-related and somatoform disorders than that of their counterparts. Age, amount of alcohol consumption, BMI and Townsend deprivation showed non-linear increase with COVID-19 risk. LIMITATIONS Absence of replication. CONCLUSIONS Subjects with mental disorders are vulnerable populations to whom more attention should be paid. Public health guidance should focus on reducing the COVID-19 risk by advocating healthy lifestyle habits and preferential policies in populations with comorbidities.
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Affiliation(s)
- Xi-Jian Dai
- School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen 518020, China; Shenzhen Mental Health Center, Shenzhen Kangning Hospital, 1080#, Cuizhu Rd, Luohu District, Shenzhen 518003, China.
| | - Yuan Shao
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, 1080#, Cuizhu Rd, Luohu District, Shenzhen 518003, China
| | - Lina Ren
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, 1080#, Cuizhu Rd, Luohu District, Shenzhen 518003, China
| | - Weiqun Tao
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, 1080#, Cuizhu Rd, Luohu District, Shenzhen 518003, China
| | - Yongjun Wang
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, 1080#, Cuizhu Rd, Luohu District, Shenzhen 518003, China.
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16
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Chiang JJ, Lam PH, Chen E, Miller GE. Psychological Stress During Childhood and Adolescence and Its Association With Inflammation Across the Lifespan: A Critical Review and Meta-Analysis. Psychol Bull 2022; 148:27-66. [PMID: 39247904 PMCID: PMC11378952 DOI: 10.1037/bul0000351] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
Psychological stress during childhood and adolescence increases risk of health problems across the lifecourse, and inflammation is implicated as an underlying mechanism. To evaluate the viability of this hypothesis, we used meta-analysis to quantify the association between childhood/adolescent stress and inflammation over the lifecourse. Furthermore, we addressed three unresolved conceptual questions: (a) Does the strength of this association change over the lifecourse? (b) Are different types of childhood/adolescent stressors differentially associated with inflammation? (c) And which components of the inflammatory response are involved? A systematic search identified 187 articles reporting 922 associations. Meta-analyses were conducted using a three-level multilevel approach and controlled for study quality, conversion confidence, and whether effect sizes were unadjusted or adjusted (n = 662, 72%). Results indicated a small but reliable overall adjusted association ( r ^ = .04 ) . The magnitude of the association strengthened across the lifecourse-effect sizes were smallest in studies that measured inflammation in childhoodr ^ = .02 and became progressively larger in studies of adolescencer ^ = .04 and adulthoodr ^ = .05 , suggesting the impact of early stress strengthens with time. By contrast, effect sizes did not vary by adversity type (socioeconomic disadvantage, maltreatment, other interpersonal stressors, and cumulative exposure across stressors), or component of inflammation (circulating biomarkers of low-grade inflammation vs. cytokine responses to microbial stimuli). Implications and future directions are discussed.
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Affiliation(s)
| | - Phoebe H Lam
- Department of Psychology, Northwestern University
| | - Edith Chen
- Department of Psychology, Northwestern University
- Institute for Policy Research, Northwestern University
| | - Gregory E Miller
- Department of Psychology, Northwestern University
- Institute for Policy Research, Northwestern University
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17
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Wickrama KAS, Klopack ET, Sutton TE. Trajectories of adolescent stressful life events and young adults' socioeconomic and relational outcomes: Weight and depressive symptoms as mediators. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2021; 40:334-351. [PMID: 34962311 DOI: 10.1111/bjdp.12401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022]
Abstract
Little is known about how biological and psychological consequences of adolescent stressful life events (SLEs) are jointly associated with socioeconomic and relational outcomes in adulthood. To address this gap, the present study involved testing a model based on the life course perspective that posits adolescent SLE trajectories produce parallel trajectories of depressive symptoms and weight status, which are jointly associated with socioeconomic status and intimate relationship quality in adulthood. Prospective data over 13 years from a nationally representative sample of 11,677 US adolescents was utilized. The results demonstrated that trajectories of BMI and depressive symptoms, which showed contemporaneous and longitudinal comorbidities over the early life course, were influenced by adolescent SLEs. Both BMI and depressive symptoms trajectories are additively and jointly associated with socioeconomic status and intimate relationship quality in adulthood. Additionally, adolescent SLE trajectories are directly associated with these adult outcomes. These observed associations persisted even after controlling for early family socioeconomic adversity and race/ethnicity. The theoretical and practical implications of these findings are discussed.
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Affiliation(s)
- K A S Wickrama
- Department of Human Development & Family Science, University of Georgia, Athens, Georgia, USA
| | - Eric T Klopack
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Tara E Sutton
- Department of Sociology, Mississippi State University, Mississippi State, Mississippi, USA
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18
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Wadani ZH, Azam I, Irfan M, Fatmi Z. Pesticides Use and Impaired Lung Function Among Male Agricultural Farmers in Rural Sindh, Pakistan. Asia Pac J Public Health 2021; 34:230-235. [PMID: 34911377 DOI: 10.1177/10105395211065647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Use of pesticides implicated in decrement in lung function, manifested as restrictive or obstructive dysfunction or both. Using comparative cross-sectional study design, authors conducted the study to determine an association of pesticide use with impairment in lung function (restrictive/obstructive pattern of lung function) among agricultural farmers. The data were collected using modified American Thoracic Society Division of Lung Disease (ATS-DLD-78A) questionnaire and spirometer measurements. Using multinomial logistic regression, the risk of both restrictive and obstructive lung dysfunction was found to be almost twice among pesticides users with each increasing year of exposure to pesticides (1.92 and 1.95, respectively) after adjusting for other covariates. There is a need for reliable monitoring and reporting procedures along with appropriate environmental policies and regulations for handling of pesticides. Interventional studies are needed where farmers could be trained on the proper use of personal protective equipment (PPE) to limit the exposure to pesticides.
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Affiliation(s)
- Zahid Hyder Wadani
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Muhammad Irfan
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Zafar Fatmi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
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19
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Donofry SD, Stillman CM, Hanson JL, Sheridan M, Sun S, Loucks EB, Erickson KI. Promoting brain health through physical activity among adults exposed to early life adversity: Potential mechanisms and theoretical framework. Neurosci Biobehav Rev 2021; 131:688-703. [PMID: 34624365 PMCID: PMC8642290 DOI: 10.1016/j.neubiorev.2021.09.051] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/13/2021] [Accepted: 09/28/2021] [Indexed: 12/24/2022]
Abstract
Adverse childhood experiences such as abuse, neglect, and poverty, profoundly alter neurobehavioral development in a manner that negatively impacts health across the lifespan. Adults who have been exposed to such adversities exhibit premature and more severe age-related declines in brain health. Unfortunately, it remains unclear whether the negative effects of early life adversity (ELA) on brain health can be remediated through intervention in adulthood. Physical activity may represent a low-cost behavioral approach to address the long-term consequences of ELA on brain health. However, there has been limited research examining the impact of physical activity on brain health among adults with a history of ELA. Accordingly, the purpose of this review is to (1) review the influence of ELA on brain health in adulthood and (2) highlight evidence for the role of neurotrophic factors, hypothalamic-adrenal-pituitary axis regulation, inflammatory processes, and epigenetic modifications in mediating the effects of both ELA and physical activity on brain health outcomes in adulthood. We then propose a theoretical framework to guide future research in this area.
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Affiliation(s)
- Shannon D Donofry
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States; Psychiatric and Behavioral Health Institute, Allegheny Health Network Pittsburgh, PA, United States.
| | - Chelsea M Stillman
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jamie L Hanson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States; Learning Research and Development Center, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
| | - Margaret Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States; Mindfulness Center, Brown University, Providence, RI, United States
| | - Eric B Loucks
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States; Mindfulness Center, Brown University, Providence, RI, United States; Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Murdoch University, College of Science, Health, Engineering, and Education, Perth, Western Australia, Australia; PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
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20
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Rakesh D, Cropley V, Zalesky A, Vijayakumar N, Allen NB, Whittle S. Neighborhood disadvantage and longitudinal brain-predicted-age trajectory during adolescence. Dev Cogn Neurosci 2021; 51:101002. [PMID: 34411954 PMCID: PMC8377545 DOI: 10.1016/j.dcn.2021.101002] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 07/25/2021] [Accepted: 08/08/2021] [Indexed: 01/16/2023] Open
Abstract
Neighborhood disadvantage has consistently been linked to alterations in brain structure; however, positive environmental (e.g., positive parenting) and psychological factors (e.g., temperament) may buffer these effects. We aimed to investigate associations between neighborhood disadvantage and deviations from typical neurodevelopmental trajectories during adolescence, and examine the moderating role of positive parenting and temperamental effortful control (EC). Using a large dataset (n = 1313), a normative model of brain morphology was established, which was then used to predict the age of youth from a longitudinal dataset (n = 166, three time-points at age 12, 16, and 19). Using linear mixed models, we investigated whether trajectories of the difference between brain-predicted-age and chronological age (brainAGE) were associated with neighborhood disadvantage, and whether positive parenting (positive behavior during a problem-solving task) and EC moderated these associations. We found that neighborhood disadvantage was associated with positive brainAGE during early adolescence and a deceleration (decreasing brainAGE) thereafter. EC moderated this association such that in disadvantaged adolescents, low EC was associated with delayed development (negative brainAGE) during late adolescence. Findings provide evidence for complex associations between environmental and psychological factors, and brain maturation. They suggest that neighborhood disadvantage may have long-term effects on neurodevelopment during adolescence, but high EC could buffer these effects.
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Affiliation(s)
- Divyangana Rakesh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia.
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia; Melbourne School of Engineering, University of Melbourne, Melbourne, Australia
| | | | | | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia.
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21
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Rakesh D, Zalesky A, Whittle S. Similar but distinct - Effects of different socioeconomic indicators on resting state functional connectivity: Findings from the Adolescent Brain Cognitive Development (ABCD) Study®. Dev Cogn Neurosci 2021; 51:101005. [PMID: 34419766 PMCID: PMC8379618 DOI: 10.1016/j.dcn.2021.101005] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/15/2021] [Accepted: 08/11/2021] [Indexed: 02/07/2023] Open
Abstract
Early socioeconomic status (SES) has consistently been associated with child health and cognitive outcomes, in addition to alterations in brain function and connectivity. The goal of the present study was to probe the effects of different facets of SES (parent education, income, and neighborhood disadvantage), that likely represent varying aspects of the environment, on resting state functional connectivity (rsFC). We investigated this question in a large sample of 9475 children (aged 9–10 years) from the Adolescent Brain Cognitive Development (ABCD) Study. Specifically, we analyzed the association between household SES (parent education, income-to-needs ratio) and neighborhood disadvantage, and system-level rsFC using within-sample split-half replication. We then tested whether the associations were unique to each SES measure, and whether household SES and neighborhood disadvantage had interactive effects on rsFC. SES measures had both common and distinct effects on rsFC, with sensory-motor systems (e.g., sensorimotor network) and cognitive networks (e.g., front-parietal network) particularly implicated. Further, the association between neighborhood disadvantage and sensorimotor network connectivity was less pronounced in the presence of high income-to-needs. Findings demonstrate that different facets of SES have distinct and interacting effects on rsFC, highlighting the importance of considering different indicators when studying the effects of SES on the brain.
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Affiliation(s)
- Divyangana Rakesh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia.
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia; Melbourne School of Engineering, University of Melbourne, Melbourne, Australia
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia.
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22
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Kamis C, Stolte A, West JS, Fishman SH, Brown T, Brown T, Farmer HR. Overcrowding and COVID-19 mortality across U.S. counties: Are disparities growing over time? SSM Popul Health 2021; 15:100845. [PMID: 34189244 PMCID: PMC8219888 DOI: 10.1016/j.ssmph.2021.100845] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 12/23/2022] Open
Abstract
A growing line of research underscores that sociodemographic factors may contribute to disparities in the impact of COVID-19. Further, stages of disease theory suggests that disparities may grow as the pandemic unfolds and more advantaged areas are better able to apply growing knowledge and mitigation strategies. In this paper, we focus on the role of county-level household overcrowding on disparities in COVID-19 mortality in U.S. counties. We examine this relationship across three theoretically important periods of the pandemic from April–October 2020, that mark both separate stages of community knowledge and national mortality levels. We find evidence that the percentage of overcrowded households is a stronger predictor of COVID-19 mortality during later periods of the pandemic. Moreover, despite a relationship between overcrowding and poverty at the county-level, overcrowding plays an independent role in predicting COVID-19 mortality. Our findings underscore that areas disadvantaged by overcrowding may be more vulnerable to the effects of COVID-19 and that this vulnerability may lead to changing disparities over time. County-level overcrowding is positively associated with COVID-19 mortality rates. The overcrowding-mortality relationship is strongest during June and July. Overcrowding and poverty additively shape county-level COVID-19 mortality. Social disparities in mortality may change with new knowledge and disease spread. Policies must consider how social disadvantages shape COVID-19 mortality over time.
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Affiliation(s)
| | - Allison Stolte
- Department of Sociology, Duke University, Durham, NC, USA
| | - Jessica S West
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
| | | | - Taylor Brown
- Department of Sociology, Duke University, Durham, NC, USA
| | - Tyson Brown
- Department of Sociology, Duke University, Durham, NC, USA
| | - Heather R Farmer
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE, USA
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23
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Health disparities: Intracellular consequences of social determinants of health. Toxicol Appl Pharmacol 2021; 416:115444. [PMID: 33549591 DOI: 10.1016/j.taap.2021.115444] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/27/2021] [Accepted: 01/30/2021] [Indexed: 12/14/2022]
Abstract
Health disparities exist dependent on socioeconomic status, living conditions, race/ethnicity, diet, and exposures to environmental pollutants. Herein, the various exposures contributing to a person's exposome are collectively considered social determinants of health (SDOH), and the SDOH-exposome impacts health more than health care. This review discusses the extent of evidence of the physiologic consequences of these exposures at the intracellular level. We consider how the SDOH-exposome, which captures how individuals live, work and age, induces cell processes that modulate a conceptual "redox rheostat." Like an electrical resistor, the SDOH-exposome, along with genetic predisposition and age, regulate reductive and oxidative (redox) stress circuits and thereby stimulate inflammation. Regardless of the source of the SDOH-exposome that induces chronic inflammation and immunosenescence, the outcome influences cardiometabolic diseases, cancers, infections, sepsis, neurodegeneration and autoimmune diseases. The endogenous redox rheostat is connected with regulatory molecules such as NAD+/NADH and SIRT1 that drive redox pathways. In addition to these intracellular and mitochondrial processes, we discuss how the SDOH-exposome can influence the balance between metabolism and regulation of immune responsiveness involving the two main molecular drivers of inflammation, the NLRP3 inflammasome and NF-κB induction. Mitochondrial and inflammasome activities play key roles in mediating defenses against pathogens and controlling inflammation before diverse cell death pathways are induced. Specifically, pyroptosis, cell death by inflammation, is intimately associated with common disease outcomes that are influenced by the SDOH-exposome. Redox influences on immunometabolism including protein cysteines and ion fluxes are discussed regarding health outcomes. In summary, this review presents a translational research perspective, with evidence from in vitro and in vivo models as well as clinical and epidemiological studies, to outline the intracellular consequences of the SDOH-exposome that drive health disparities in patients and populations. The relevance of this conceptual and theoretical model considering the SARS-CoV-2 pandemic are highlighted. Finally, the case of asthma is presented as a chronic condition that is modified by adverse SDOH exposures and is manifested through the dysregulation of immune cell redox regulatory processes we highlight in this review.
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24
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Batty GD, Kivimaki M. Adverse childhood experiences and adult health: the need for stronger study designs to evaluate impact. J Epidemiol Community Health 2021; 75:jech-2020-215870. [PMID: 33495198 DOI: 10.1136/jech-2020-215870] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 12/23/2022]
Affiliation(s)
- G David Batty
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, UK
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25
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Herd P, Sicinski K, Asthana S. Does Rural Living in Early Life Increase the Risk for Reduced Cognitive Functioning in Later Life? J Alzheimers Dis 2021; 82:1171-1182. [PMID: 34151799 PMCID: PMC11168580 DOI: 10.3233/jad-210224] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is a robust consensus, most recently articulated in the 2020 Lancet Commission, that the roots of dementia can be traced to early life, and that the path to prevention may start there as well. Indeed, a growing body of research demonstrates that early life disadvantage may influence the risk for later life dementia and cognitive decline. A still understudied risk, however, is early life rural residence, a plausible pathway given related economic and educational disadvantages, as well as associations between later life rural living and lower levels of cognitive functioning. OBJECTIVE We aim to examine whether living in rural environments during early life has long term implications for cognitive health in later life. METHODS We employed the Wisconsin Longitudinal Study, which tracked 1 in every 3 high school graduates from the class of 1957, from infancy to ∼age 72. The data include a rich array of prospectively collected early life data, unique among existing studies, as well as later life measures of cognitive functioning. RESULTS We found a robust relationship between early life rural residence, especially living on a farm, and long-term risk for reduced cognitive performance on recall and fluency tasks. Controls for adolescent cognitive functioning, APOEɛ2 and APOEɛ4, as well as childhood and adult factors, ranging from early life socioeconomic conditions to later life health and rural and farm residency, did not alter the findings. CONCLUSION Rural living in early life is an independent risk for lower levels of cognitive functioning in later life.
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Affiliation(s)
- Pamela Herd
- Georgetown University, McCourt School of Public Policy, Washington, DC, USA
| | - Kamil Sicinski
- University of Wisconsin, Madison, Center for Demography of Health and Aging, Wisconsin Longitudinal Study, Madison, WI, USA
| | - Sanjay Asthana
- University of Wisconsin, Madison, UW-Madison Alzheimer's Disease Research Center, Department of Medicine, Division of Geriatrics and Gerontology, Madison, WI, USA
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26
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Ho FK, Celis-Morales CA, Gray SR, Katikireddi SV, Niedzwiedz CL, Hastie C, Ferguson LD, Berry C, Mackay DF, Gill JM, Pell JP, Sattar N, Welsh P. Modifiable and non-modifiable risk factors for COVID-19, and comparison to risk factors for influenza and pneumonia: results from a UK Biobank prospective cohort study. BMJ Open 2020; 10:e040402. [PMID: 33444201 PMCID: PMC7678347 DOI: 10.1136/bmjopen-2020-040402] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/08/2020] [Accepted: 10/11/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES We aimed to investigate demographic, lifestyle, socioeconomic and clinical risk factors for COVID-19, and compared them to risk factors for pneumonia and influenza in UK Biobank. DESIGN Cohort study. SETTING UK Biobank. PARTICIPANTS 49-83 year olds (in 2020) from a general population study. MAIN OUTCOME MEASURES Confirmed COVID-19 infection (positive SARS-CoV-2 test). Incident influenza and pneumonia were obtained from primary care data. Poisson regression was used to study the association of exposure variables with outcomes. RESULTS Among 235 928 participants, 397 had confirmed COVID-19. After multivariable adjustment, modifiable risk factors were higher body mass index and higher glycated haemoglobin (HbA1C) (RR 1.28 and RR 1.14 per SD increase, respectively), smoking (RR 1.39), slow walking pace as a proxy for physical fitness (RR 1.53), and use of blood pressure medications as a proxy for hypertension (RR 1.33). Higher forced expiratory volume in 1 s (FEV1) and high-density lipoprotein (HDL) cholesterol were both associated with lower risk (RR 0.84 and RR 0.83 per SD increase, respectively). Non-modifiable risk factors included male sex (RR 1.72), black ethnicity (RR 2.00), socioeconomic deprivation (RR 1.17 per SD increase in Townsend Index), and high cystatin C (RR 1.13 per SD increase). The risk factors overlapped with pneumonia somewhat, less so for influenza. The associations with modifiable risk factors were generally stronger for COVID-19, than pneumonia or influenza. CONCLUSION These findings suggest that modification of lifestyle may help to reduce the risk of COVID-19 and could be a useful adjunct to other interventions, such as social distancing and shielding of high risk.
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Affiliation(s)
- Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos A Celis-Morales
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | | | - Claire Hastie
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Lyn D Ferguson
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Colin Berry
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Daniel F Mackay
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jason Mr Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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Mishra N, Salvi S, Lyngdoh T, Agrawal A. Low lung function in the developing world is analogous to stunting: a review of the evidence. Wellcome Open Res 2020; 5:147. [PMID: 33381655 PMCID: PMC7745193 DOI: 10.12688/wellcomeopenres.15929.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 01/06/2023] Open
Abstract
Background: Low vital capacity, one of the consequences of restricted lung growth, is a strong predictor of cardiovascular mortality. Vital capacity is lower in the developing world than the developed world, even after adjusting for height, weight and gender. This difference is typically dismissed as ethnic variation, adjusted for by redefining normal. Whether this is a consequence of stunted lung growth, rather than just genetically smaller lungs, has not been investigated in detail. Therefore, we sought to compare factors implicated in both stunting and lung development, particularly in the developing world. Methods: We conducted a manual screen of articles identified through Google Scholar and assessed risk of bias. No language restrictions were applied, so long as there was an associated English abstract. We queried VizHub (Global Burden of Disease Visualization Tool) and Google Dataset search engines for disease burden and genome wide association studies. The scope of the article and the heterogeneity of the outcome measures reported required a narrative review of available evidence. To the extent possible, the review follows PRISMA reporting guidelines. Results: Early life influences operate in synergism with genetic, environmental and nutritional factors to influence lung growth and development in children. Low lung function and stunting have common anthropometric, environmental and nutritional correlates originating during early development. Similar anthropometric correlates shared chronic inflammatory pathways, indicated that the two conditions were analogous. Conclusion: The analogy between poor lung function and stunting is conspicuous in the developing world, with malnutrition at the center of non -achievement of growth potential, susceptibility to infectious diseases and intrauterine programming for metabolic syndrome. This counter the idea of redefining the normal for lung function measurements, since observed inter-ethnic variations are likely a mix of natural genetic differences as well as differences in nurture such that reduced lung function reflects early life adversities.
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Affiliation(s)
- Navya Mishra
- Public Health Foundation of India, Delhi, India.,Academy of Scientific and Innovative Research, Ghaziabad, India
| | | | | | - Anurag Agrawal
- Academy of Scientific and Innovative Research, Ghaziabad, India.,CSIR Institute of Genomics and Integrative Biology, Delhi, Delhi, India
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Wohlgemut JM, Ramsay G, Griffin RL, Jansen JO. Impact of deprivation and comorbidity on outcomes in emergency general surgery: an epidemiological study. Trauma Surg Acute Care Open 2020; 5:e000500. [PMID: 32789189 PMCID: PMC7392526 DOI: 10.1136/tsaco-2020-000500] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/23/2022] Open
Abstract
Background The impact of socioeconomic deprivation and comorbidities on the outcome of patients who require emergency general surgery (EGS) admission is poorly understood. The aim of this study was to examine the effect of deprivation and comorbidity on mortality, discharge destination and length of hospital stay (LOS) in patients undergoing EGS in Scotland. Methods Prospectively collected data from all Scottish adult patients (aged >15 years) requiring EGS admitted between 1997 and 2016 were obtained from the Scottish Government. Data included age, sex, Scottish Index of Multiple Deprivation (SIMD), 5-year Charlson Comorbidity Index (CCI), whether an operation took place and outcomes including mortality, discharge destination and LOS. Logistic regression was used for the analysis of mortality and discharge destination and Poisson regression was used for LOS. Results 1 477 810 EGS admissions were analyzed. 16.2% were in the most deprived SIMD decile and 5.6% in the least deprived SIMD decile. 75.6% had no comorbidity, 20.3% had mild comorbidity, 2.5% had moderate comorbidity and 1.6% had severe comorbidity. 78.6% were discharged directly home. Inpatient, 30-day, 90-day and 1-year crude mortality was 1.7%, 3.7%, 7.2% and 12.4%, respectively. Logistic regression showed that severe comorbidity was associated with not being discharged directly to home (OR 0.38, 95% CI 0.37 to 0.39) and higher inpatient mortality (OR 13.74, 95% CI 13.09 to 14.42). Compared with the most affluent population, the most deprived population were less likely to be discharged directly to home (OR 0.97, 95% CI 0.95 to 0.99) and had higher inpatient mortality (OR 1.36, 95% CI 1.8 to 1.46). Poisson analysis showed that severe comorbidity (OR 1.69, 95% CI 1.68 to 1.69) and socioeconomic deprivation (OR 1.11, 95% CI 1.11 to 1.12) were associated with longer LOS. Discussion Increased levels of comorbidity and, to a lesser extent, socioeconomic deprivation are key drivers of mortality, discharge destination and LOS following admission to an EGS service. Level of evidence III (prospective/retrospective with up to two negative criteria). Study type Epidemiological/prognostic.
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Affiliation(s)
- Jared M Wohlgemut
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen Division of Applied Health Sciences, Aberdeen, UK.,Department of General Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - George Ramsay
- Rowett Institute, University of Aberdeen Division of Applied Health Sciences, Aberdeen, UK.,Department of General Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Russell L Griffin
- Department of Epidemiology, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA
| | - Jan O Jansen
- Division of Acute Care Surgery, Department of Surgery, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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Mishra N, Salvi S, Lyngdoh T, Agrawal A. Low lung function in the developing world is analogous to stunting: a review of the evidence. Wellcome Open Res 2020; 5:147. [DOI: 10.12688/wellcomeopenres.15929.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Low vital capacity, one of the consequences of restricted lung growth, is a strong predictor of cardiovascular mortality. Vital capacity is lower in the developing world than the developed world, even after adjusting for height, weight and gender. This difference is typically dismissed as ethnic variation, adjusted for by redefining normal. Whether this is a consequence of stunted lung growth, rather than genetically smaller lungs, has not been investigated in detail. Therefore, we sought to compare factors implicated in both stunting and lung development, particularly in the developing world. Methods: We conducted a manual screen of articles identified through Google Scholar and assessed risk of bias. No language restrictions were applied, so long as there was an associated English abstract. We queried VizHub (Global Burden of Disease Visualization Tool) and Google Dataset search engines for disease burden and genome wide association studies. The scope of the article and the heterogeneity of the outcome measures reported required a narrative review of available evidence. To the extent possible, the review follows PRISMA reporting guidelines. Results: Early life influences operate in synergism with environmental and nutritional factors to influence lung growth and development in children. Low lung function and stunting have common anthropometric, environmental and nutritional correlates originating during early development. Similar anthropometric correlates and shared chronic inflammatory pathways indicated that the two conditions were analogous. Conclusion: The analogy between poor lung function and stunting is conspicuous in the developing world, where malnutrition lies at the center of non -achievement of growth potential, susceptibility to infectious diseases and intrauterine programming for metabolic syndrome. The common pathological mechanisms governing stunting and lung function deficits counter the idea of redefining the normal for lung function measurements.
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30
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Burton RF, Burton FL. When is sitting height a better measure of adult body size than total height, and why? The contrasting examples of body mass, waist circumference, and lung volume. Am J Hum Biol 2020; 33:e23433. [PMID: 32530561 DOI: 10.1002/ajhb.23433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/03/2020] [Accepted: 04/26/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES We aimed to establish which of sitting height (SH) and total height (Ht) is most appropriately used in the scaling of adult body mass (BM), waist circumference (WC), and forced vital capacity (FVC), considering likely explanations and proposing a suitable index for each. METHODS Data were from the US Third National Health and Nutrition Survey for white and black American women and men aged 20 to 50 years. Statistical analysis involved mainly correlation coefficients, the multiple regression of BM, WC, or FVC on SH and leg length (LL), and fitting of allometric regression equations relating each of BM, WC, and FVC to SH or Ht. RESULTS BM and WC correlated more strongly with SH than with Ht, and FVC correlated more strongly with Ht. Associations with LL were negative for WC, negative or nonsignificant for BM, and positive for FVC. Using round-number exponents for Ht and SH, the allometric relationships indicated that appropriate indices are BM/SH3 , WC/SH, and FVC/Ht2 . CONCLUSIONS Contrary to usual practice, BM and WC are better scaled in relation to SH than to Ht. FVC is slightly better scaled in relation to Ht, as is conventional. Interpretations involve the small influence of LL on BM and the influence both of gluteo-femoral fatness on measured SH and of childhood health and nutrition on adult LL, WC, and FVC. It is evident that SH should be measured more often for research purposes.
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Affiliation(s)
- Richard Francis Burton
- School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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31
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Assari S. Combined Effects of Ethnicity and Education on Burden of Depressive Symptoms over 24 Years in Middle-Aged and Older Adults in the United States. Brain Sci 2020; 10:E209. [PMID: 32252391 PMCID: PMC7225993 DOI: 10.3390/brainsci10040209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 12/20/2022] Open
Abstract
Ethnicity and educational attainment are among the major social determinants of depression in the general population. While high education credentials protect individuals against depressive symptoms, this protection may be weaker for ethnic minority groups such as Hispanic Whites compared to the majority group (non-Hispanic Whites). Built on marginalization-related diminished returns (MDRs), the current study used 24-year follow-up data from a nationally representative sample of middle-aged and older adults to explore ethnic variation in the protective effect of education levels against the burden of depressive symptoms over time. Data for this analysis were borrowed from the Health and Retirement Study (HRS 1992-ongoing), a nationally representative longitudinal study. HRS followed 8314 middle-aged and older adults (50+ years old) for up to 24 years. From this number, 763 (9.2%) were Hispanic White, and 7551 (90.8%) were non-Hispanic White Americans. Education level was the independent variable. We had two outcomes. Firstly, using cluster analysis, individuals were categorized to low- and high-risk groups (regarding the burden of depressive symptoms over 24 years); secondly, average depressive symptoms were observed over the 24 years of follow up. Age and gender were the covariates. Ethnicity was the moderator. Linear and logistic regression were used for analysis. Logistic regression showed that, overall, high educational credentials reduced the odds of chronic depressive symptoms over the 24 years of follow-up. Linear regression also showed that higher years of education were associated with lower average depressive symptoms over time. Both models showed statistically significant interactions between ethnicity and graduation, indicating a smaller protective effect of high education against depressive symptoms over the 24 years of follow-up time among Hispanic with respect to non-Hispanic White people. In line with the MDRs, highly educated Hispanic White Americans remain at high risk for depressive symptoms, a risk that is unexpected given their education. The burden of depressive symptoms, however, is lowest for highly educated non-Hispanic White Americans. Policies that exclusively focus on equalizing educational gaps across ethnic groups may fail to eliminate the ethnic gap in the burden of chronic depressive symptoms, given the diminished marginal health return of education for ethnic minorities. Public policies must equalize not only education but also educational quality across ethnic groups. This aim would require addressing structural and environmental barriers that are disproportionately more common in the lives of ethnic minorities across education levels. Future research should test how contextual factors, residential segregation, school segregation, labor market practices, childhood poverty, and education quality in urban schools reduce the health return of educational attainment for highly educated ethnic minorities such as Hispanics.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90095, USA
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Francis P, Mc Cormack W, Lyons M, Jakeman P. Age-Group Differences in the Performance of Selected Tests of Physical Function and Association With Lower Extremity Strength. J Geriatr Phys Ther 2020; 42:1-8. [PMID: 29494377 DOI: 10.1519/jpt.0000000000000152] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE It is not known whether short functional performance tests used in aging research are appropriate for use in healthy older adults. The purpose of this study was to investigate age-group differences (sixth decade vs seventh decade) in selected functional performance tests and the association between lower extremity strength and functional performance. METHODS One hundred fifty-nine (18.2% [n = 29] male) healthy older adults (mean (standard deviation) age 60.4 (5.3) years), adults were recruited from the University of Limerick Campus Community. Knee extensor (KE) peak torque (PT) was assessed from a maximal voluntary isometric contraction. Subsequently, participants completed 10-m maximal and habitual gait speed tests, 5 repetition and 30-second chair rise tests, and a 900-m gait speed test. RESULTS AND DISCUSSION There was no difference in 10-m gait speed between those in the sixth and seventh decades (P > .05). Compared with the sixth decade, those in the seventh decade required an extra 39 seconds to complete 900 m, an extra 0.6 seconds to complete 5 chair rises and performed 2 fewer chair rises in a 30-second time period (P < .05). All tests had a weak association with KE strength (r = 0.226-0.360; P < .05), except for 900-m gait speed that had a moderate association (r = -0.537; P < .001). Our findings suggest that gait speed tests of 10 m or less cannot detect age-related difference in functional capacity when used in healthy older adults. CONCLUSION Extended physical performance tests should be used in aging research on healthy older adults.
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Affiliation(s)
- Peter Francis
- Musculoskeletal Health Research Group, School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom.,Human Science Research Unit, Center for Intervention in Inflammation, Infection and Immunity, University of Limerick, Limerick, Ireland
| | - William Mc Cormack
- Human Science Research Unit, Center for Intervention in Inflammation, Infection and Immunity, University of Limerick, Limerick, Ireland
| | - Mark Lyons
- Human Science Research Unit, Center for Intervention in Inflammation, Infection and Immunity, University of Limerick, Limerick, Ireland
| | - Philip Jakeman
- Human Science Research Unit, Center for Intervention in Inflammation, Infection and Immunity, University of Limerick, Limerick, Ireland
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33
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Assari S. Blacks' Diminished Health Returns of Educational Attainment: Health and Retirement Study. JOURNAL OF MEDICAL RESEARCH AND INNOVATION 2020; 4. [PMID: 34966877 DOI: 10.32892/jmri.212] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Education level reduces the risk of health problems such as poor self-rated health (SRH), high body mass index (BMI), and depressive symptoms (DS). Marginalization - related Diminished Returns (MDRs), however, refer to smaller health benefits of socioeconomic status (SES) indicators particularly educational attainment for the members of racial minority groups such as non-Hispanic Blacks compared to the majority group (non-Hispanic Whites). It is not known, however, if MDRs also hold for middle-age and older adults over a long period of time. AIMS The current study used a nationally representative data set to explore racial variation in the predictive utility of baseline education level on protecting people against poor SRH, BMI, and DS. METHODS Data for this analysis were borrowed from the Health and Retirement Study (HRS 1992-ongoing), a nationally representative longitudinal study that followed 10,023 middle-aged and older adults (50+ years old) for up to 26 years. From this number, 1877 (18.7%) were non-Hispanic Black Americans, and 8,146 (81.3%) were non-Hispanic White Americans. Education level was the independent variable. We used cluster analysis to categorize individuals to low and high-risk groups (outcome) based on SRH, BMI, and DS over 26 years. Age and gender were the covariates. Race was the moderator. RESULTS Overall, high education level reduced the odds of poor SRH, BMI, and DS over the 26 years of follow up. Interactions were observed between race and education on all three health outcomes indicating smaller protective effects of baseline educational attainment on poor health over time, regardless of the outcome. CONCLUSIONS In line with the MDRs, highly educated non-Hispanic Black Americans remain at high risk for poor health across domains, a risk which is unexpected given their education. The risk of all health outcomes, however, is lowest for non-Hispanic White Americans with highest education. Policies that exclusively focus on equalizing racial gaps in SES (e.g., education) may fail to eliminate the racial and ethnic health inequalities because of the racial inequalities in the marginal health return of education. Public policies must equalize education quality and address structural and environmental barriers that are disproportionately more common in the lives of non-Hispanic Black Americans, even at high education levels. Future research should test how contextual factors, segregation, labor market practices, childhood poverty, and education quality reduces the health return of education for highly educated non-Hispanic Black Americans.
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de Mestral C, Bell S, Hamer M, Batty GD. Out-of-home care in childhood and biomedical risk factors in middle-age: National birth cohort study. Am J Hum Biol 2019; 32:e23343. [PMID: 31691459 PMCID: PMC7317568 DOI: 10.1002/ajhb.23343] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 09/18/2019] [Accepted: 09/21/2019] [Indexed: 11/25/2022] Open
Abstract
Objective With there being an apparent impact of experience of out‐of‐home care in childhood on chronic disease and mortality, we examined how such adversity might be embodied such that it has a measurable impact on human biology, so mediating this relationship. Methods We used data from the UK National Child Development Study in which exposure to public care was prospectively gathered on three occasions up to age 16. Study members also participated in a social survey at age 42 and a clinical examination at age 44/45 when cardiovascular, inflammatory, neuroendocrine, and respiratory risk markers for mortality were collected, 19 of which were included as endpoints in the present analyses. Results Of the 8012 participants in the biomedical survey, 4% (n = 322) had been in care at some point in childhood and/or adolescence. We found the expected marked differences in the early life characteristics of poverty, health, and disability in children with experience of public care relative to their unexposed counterparts. After controlling for these confounding factors, however, care in childhood was essentially unrelated to biomarkers in middle‐age. We also found no consistent links between these biomarkers and the duration, timing, or type of care. Conclusions Our results suggest that the biomarkers captured in the present study are unlikely to mediate the link between public care in childhood and later chronic disease or mortality. Processes involving mental health, socioeconomic position, and health behaviors would seem to be a potential alternative pathway warranting investigation.
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Affiliation(s)
- Carlos de Mestral
- Department of Epidemiology & Public Health, University College London, London, UK.,Center for Primary Care Medicine & Public Health, University of Lausanne, Lausanne, Switzerland
| | - Steven Bell
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Mark Hamer
- Division of Surgery & Interventional Science, University College London, London, UK
| | - George David Batty
- Department of Epidemiology & Public Health, University College London, London, UK.,School of Biological & Population Health Sciences, Oregon State University, Corvallis, Oregon
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35
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Thompson K, Lindeboom M, Portrait F. Adult body height as a mediator between early-life conditions and socio-economic status: the case of the Dutch Potato Famine, 1846-1847. ECONOMICS AND HUMAN BIOLOGY 2019; 34:103-114. [PMID: 31101592 DOI: 10.1016/j.ehb.2019.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 04/15/2019] [Accepted: 04/15/2019] [Indexed: 06/09/2023]
Abstract
Adult body height appears to be a relatively accurate summary variable of early-life exposures' influence on health, and may be a useful indicator of health in populations where more traditional health-related indicators are lacking. In particular, previous studies have shown a strong, positive relationship between environmental conditions in early life (particularly nutritional availability and the disease environment) and adult height. Research has also demonstrated positive associations between height and socioeconomic status. We therefore hypothesize that height mediates the relationship between early-life conditions and later-life socio-economic outcomes. We also hypothesize that the period of exposure in early life matters, and that conditions during pregnancy or the first years of life and/or the years during puberty have the largest effects on height and socio-economic status. To test these relationships, we use a sample of 1817 Dutch military conscripts who were exposed during early life to the Dutch Potato Famine (1846-1847). We conduct mediation analyses using structural equation modelling, and test seven different time periods in early-life. We use potato prices and real wages to proxy early-life environmental conditions, and occupational status (using the HISCAM scale) to proxy socioeconomic status. We find no evidence of mediation, partial or full, in any models. However, there are significant relationships between potato prices in adolescence, height and socio-economic status. To determine causality in these relationships, further research is needed.
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Affiliation(s)
| | - Maarten Lindeboom
- Department of economics, Vrije Universiteit Amsterdam; Tinbergen Institute Amsterdam; IZA Institute of Labor Economics
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36
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Stress and inflammation - The need to address the gap in the transition between acute and chronic stress effects. Psychoneuroendocrinology 2019; 105:164-171. [PMID: 30826163 DOI: 10.1016/j.psyneuen.2019.02.021] [Citation(s) in RCA: 171] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 02/13/2019] [Accepted: 02/19/2019] [Indexed: 12/19/2022]
Abstract
Stress responses help us navigate our environment and respond appropriately to threats. Stress systems communicate threats to the entire organism, and as such, also stimulate inflammatory mechanisms. This modulation might serve protective functions in the short term, but sustained low-grade inflammation has severe long-term health consequences. While we have reached a reasonable level of understanding of acute, as well as chronic stress effects on inflammatory mechanisms, there is a significant gap in our understanding of the transitional phase between acute and chronic stress. The purpose of this review is to first summarize current knowledge of our understanding of acute stress effects on inflammation, as well as of chronic stress effects on inflammation, and to then analyze the state of knowledge about the transitional phase between acute and chronic stress. Research discussed here shows that we are beginning to understand the early phase of repeated acute stress, but lack information on longer term exposure to repeated acute stress experiences. More research is needed to bridge this important gap und our conceptualization and understanding of the stress and health relationship.
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Milaniak I, Jaffee SR. Childhood socioeconomic status and inflammation: A systematic review and meta-analysis. Brain Behav Immun 2019; 78:161-176. [PMID: 30738842 DOI: 10.1016/j.bbi.2019.01.018] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 12/21/2018] [Accepted: 01/19/2019] [Indexed: 12/26/2022] Open
Abstract
Recent research suggests that risk for chronic diseases of aging including cardiovascular disease, diabetes, and even cancer can be programmed early in the lifespan as a result of exposure to chronic stressors like low socioeconomic status (SES) that are hypothesized to promote a pro-inflammatory response in immune cells that results in chronic, systemic inflammation. The present paper conducted a meta-analysis to establish whether exposure to low (versus higher) SES in childhood and adolescence is associated with higher levels of inflammation (as measured by C-reactive protein, IL-6, and fibrinogen) concurrently and in adulthood. We conducted meta-analyses with both unadjusted bivariate associations between SES and inflammation and with adjusted associations that controlled for a range of covariates including demographic factors, body mass index, smoking, physical activity and current SES. A systematic review of Pubmed and PsycINFO identified a total 35 studies (26 with unadjusted and 31 adjusted effect sizes) to be included in the meta-analysis. Random-effects meta-analysis showed that individuals who were exposed to low SES in childhood and adolescence had significantly higher levels of inflammatory markers (r = -0.07, p < .001, 95% CI = -0.09, -0.05). This association remained significant in adjusted analyses (r = -0.06, p < .001, 95% CI = -0.09, -0.03). However, the relationship between childhood SES and inflammation was non-significant in a meta-analysis with longitudinal studies that all controlled for adulthood SES (r = -0.03, p = .356, 95% CI = -0.08, 0.03). Future longitudinal research should utilize measurement of inflammatory markers at multiple time points to further examine the complex relationships between SES and health both in childhood and adulthood.
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Affiliation(s)
- Izabela Milaniak
- University of Pennsylvania, Department of Psychology, 425 S. University Avenue, Philadelphia, PA 19104, United States.
| | - Sara R Jaffee
- University of Pennsylvania, Department of Psychology, 425 S. University Avenue, Philadelphia, PA 19104, United States
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Langgartner D, Lowry CA, Reber SO. Old Friends, immunoregulation, and stress resilience. Pflugers Arch 2019; 471:237-269. [PMID: 30386921 PMCID: PMC6334733 DOI: 10.1007/s00424-018-2228-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/03/2018] [Accepted: 10/22/2018] [Indexed: 02/07/2023]
Abstract
There is a considerable body of evidence indicating that chronic adverse experience, especially chronic psychosocial stress/trauma, represents a major risk factor for the development of many somatic and affective disorders, including inflammatory bowel disease (IBD) and posttraumatic stress disorder (PTSD). However, the mechanisms underlying the development of chronic stress-associated disorders are still in large part unknown, and current treatment and prevention strategies lack efficacy and reliability. A greater understanding of mechanisms involved in the development and persistence of chronic stress-induced disorders may lead to novel approaches to prevention and treatment of these disorders. In this review, we provide evidence indicating that increases in immune (re-)activity and inflammation, potentially promoted by a reduced exposure to immunoregulatory microorganisms ("Old Friends") in today's modern society, may be causal factors in mediating the vulnerability to development and persistence of stress-related pathologies. Moreover, we discuss strategies to increase immunoregulatory processes and attenuate inflammation, as for instance contact with immunoregulatory Old Friends, which appears to be a promising strategy to promote stress resilience and to prevent/treat chronic stress-related disorders.
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Affiliation(s)
- Dominik Langgartner
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, University Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Christopher A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA
- Department of Physical Medicine & Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Denver Veterans Affairs Medical Center (VAMC), Denver, CO, 80220, USA
- Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO, 80220, USA
| | - Stefan O Reber
- Laboratory for Molecular Psychosomatics, Department of Psychosomatic Medicine and Psychotherapy, University Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
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Cermakova P, Formanek T, Kagstrom A, Winkler P. Socioeconomic position in childhood and cognitive aging in Europe. Neurology 2018; 91:e1602-e1610. [PMID: 30258021 DOI: 10.1212/wnl.0000000000006390] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 07/17/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES We aimed to investigate whether socioeconomic position (SEP) in childhood has an effect on the level of cognitive performance and the rate of cognitive decline in older adults. METHODS We performed a prospective cohort study of individuals enrolled in a multicenter population-based study, SHARE (Survey of Health, Ageing and Retirement in Europe). Interviews were conducted in 6 waves at approximately 2-year intervals and included examinations of cognitive performance (memory, verbal fluency, delayed recall) and measurements of childhood SEP (participants' household characteristics at the age of 10 years). We estimated the associations of SEP with the level of cognitive performance using linear regression and the relation to the rate of cognitive decline with mixed-effects models. RESULTS This study included 20,244 participants from 16 European countries (median age at baseline 71 years, 54% women). Adverse childhood SEP was associated with a lower level of baseline cognitive performance. This association was attenuated after adjustment for clinical and social risk factors but remained statistically significant. Childhood SEP was not related to the rate of cognitive decline. CONCLUSIONS Variation in childhood SEP helps to explain differences in cognitive performance between older people, but not the rate of decline from their previous level of cognition. Strategies to protect cognitive aging should be applied early in life.
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Affiliation(s)
- Pavla Cermakova
- From the National Institute of Mental Health (P.C., T.F., A.K., P.W.), Klecany, Czech Republic; and Health Service and Population Research Department (P.W.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Tomas Formanek
- From the National Institute of Mental Health (P.C., T.F., A.K., P.W.), Klecany, Czech Republic; and Health Service and Population Research Department (P.W.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Anna Kagstrom
- From the National Institute of Mental Health (P.C., T.F., A.K., P.W.), Klecany, Czech Republic; and Health Service and Population Research Department (P.W.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Petr Winkler
- From the National Institute of Mental Health (P.C., T.F., A.K., P.W.), Klecany, Czech Republic; and Health Service and Population Research Department (P.W.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Olvera Alvarez HA, Kubzansky LD, Campen MJ, Slavich GM. Early life stress, air pollution, inflammation, and disease: An integrative review and immunologic model of social-environmental adversity and lifespan health. Neurosci Biobehav Rev 2018; 92:226-242. [PMID: 29874545 PMCID: PMC6082389 DOI: 10.1016/j.neubiorev.2018.06.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 01/21/2023]
Abstract
Socially disadvantaged individuals are at greater risk for simultaneously being exposed to adverse social and environmental conditions. Although the mechanisms underlying joint effects remain unclear, one hypothesis is that toxic social and environmental exposures have synergistic effects on inflammatory processes that underlie the development of chronic diseases, including cardiovascular disease, diabetes, depression, and certain types of cancer. In the present review, we examine how exposure to two risk factors that commonly occur with social disadvantage-early life stress and air pollution-affect health. Specifically, we identify neuroimmunologic pathways that could link early life stress, inflammation, air pollution, and poor health, and use this information to propose an integrated, multi-level model that describes how these factors may interact and cause health disparity across individuals based on social disadvantage. This model highlights the importance of interdisciplinary research considering multiple exposures across domains and the potential for synergistic, cross-domain effects on health, and may help identify factors that could potentially be targeted to reduce disease risk and improve lifespan health.
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Affiliation(s)
- Hector A Olvera Alvarez
- School of Nursing, University of Texas at El Paso, Health Science and Nursing Building, Room 359, 500 West University Avenue, El Paso, TX, USA.
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Matthew J Campen
- Department of Pharmaceutical Sciences, University of New Mexico, Albuquerque, NM, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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McClelland R, Christensen K, Mohammed S, McGuinness D, Cooney J, Bakshi A, Demou E, MacDonald E, Caslake M, Stenvinkel P, Shiels PG. Accelerated ageing and renal dysfunction links lower socioeconomic status and dietary phosphate intake. Aging (Albany NY) 2017; 8:1135-49. [PMID: 27132985 PMCID: PMC4931858 DOI: 10.18632/aging.100948] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/16/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND We have sought to explore the impact of dietary Pi intake on human age related health in the pSoBid cohort (n=666) to explain the disparity between health and deprivation status in this cohort. As hyperphosphataemia is a driver of accelerated ageing in rodent models of progeria we tested whether variation in Pi levels in man associate with measures of biological ageing and health. RESULTS We observed significant relationships between serum Pi levels and markers of biological age (telomere length (p=0.040) and DNA methylation content (p=0.028), gender and chronological age (p=0.032). When analyses were adjusted for socio-economic status and nutritional factors, associations were observed between accelerated biological ageing (telomere length, genomic methylation content) and dietary derived Pi levels among the most deprived males, directly related to the frequency of red meat consumption. CONCLUSIONS Accelerated ageing is associated with high serum Pi levels and frequency of red meat consumption. Our data provide evidence for a mechanistic link between high intake of Pi and age-related morbidities tied to socio-economic status.
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Affiliation(s)
- Ruth McClelland
- Institute of Cancer Sciences, MVLS, University of Glasgow, Glasgow, UK
| | - Kelly Christensen
- Institute of Cancer Sciences, MVLS, University of Glasgow, Glasgow, UK
| | - Suhaib Mohammed
- Institute of Cancer Sciences, MVLS, University of Glasgow, Glasgow, UK
| | | | | | - Andisheh Bakshi
- Institute of Health and Wellbeing, MVLS, University of Glasgow, Glasgow, UK
| | - Evangelia Demou
- Institute of Health and Wellbeing, MVLS, University of Glasgow, Glasgow, UK
| | - Ewan MacDonald
- Institute of Health and Wellbeing, MVLS, University of Glasgow, Glasgow, UK
| | - Muriel Caslake
- School of Medicine, MVLS, University of Glasgow, Glasgow, UK
| | - Peter Stenvinkel
- Division of Renal Medicine M99, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Paul G Shiels
- Institute of Cancer Sciences, MVLS, University of Glasgow, Glasgow, UK
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Association between life-course socioeconomic position and inflammatory biomarkers in older age: a nationally representative cohort study in Taiwan. BMC Geriatr 2017; 17:201. [PMID: 28865434 PMCID: PMC5581430 DOI: 10.1186/s12877-017-0598-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 08/24/2017] [Indexed: 12/24/2022] Open
Abstract
Background Evidence of an association between low socioeconomic position (SEP) and inflammatory markers is scant. This study aimed to examine how life-course SEP predicted C-reactive protein (CRP) and interleukin (IL-6) in older age from a national cohort. Methods We collected data from 1036 participants in the Social Environment and Biomarkers of Aging Study in Taiwan. Four SEP time points, childhood, young adulthood, active professional life, and older age were measured retrospectively. A group-based trajectory analysis method was used to identify the distinct trajectories of life-course SEP, and trajectory group membership was used as the predictor of CRP and IL-6 levels in older age. Results Three trajectories of life-course SEP were identified within the total sample: Low-Low (36.5%), Low-High (26.8%), and High-High (36.7%). Participants in the High-High group had the lowest levels of CRP and IL-6. Compared with those in the Low-Low group, the participants in the Low-High group had a similar adjusted CRP [−0.032 ln mg/L; 95% confidence interval (CI) − 0.193, 0.128] and IL-6 (0.017 ln pg/mL; 95% CI −0.093, 0.128); the participants in the High-High group had a significantly lower level of adjusted CRP concentration (−0.279 ln mg/L; 95% CI: −0.434, −0.125) and similarly lower IL-6 concentration (−0.129 ln pg/mL; 95% CI −0.236, −0.023) . Conclusions Life-course SEP is related to the level of CRP and IL-6 in older age. Our data support the notion that life-course SEP predicts inflammatory markers in older age. Low SEP in childhood is related to elevated inflammatory markers in older age. Even after the transition from low SEP in childhood to high SEP in older age, the risk remains. Further study on SEP and inflammation-related disease is warranted.
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Kuhlman KR, Chiang JJ, Horn S, Bower JE. Developmental psychoneuroendocrine and psychoneuroimmune pathways from childhood adversity to disease. Neurosci Biobehav Rev 2017; 80:166-184. [PMID: 28577879 PMCID: PMC5705276 DOI: 10.1016/j.neubiorev.2017.05.020] [Citation(s) in RCA: 138] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 04/13/2017] [Accepted: 05/22/2017] [Indexed: 12/17/2022]
Abstract
Childhood adversity has been repeatedly and robustly linked to physical and mental illness across the lifespan. Yet, the biological pathways through which this occurs remain unclear. Functioning of the inflammatory arm of the immune system and the hypothalamic-pituitary-adrenal (HPA)-axis are both hypothesized pathways through which childhood adversity leads to disease. This review provides a novel developmental framework for examining the role of adversity type and timing in inflammatory and HPA-axis functioning. In particular, we identify elements of childhood adversity that are salient to the developing organism: physical threat, disrupted caregiving, and unpredictable environmental conditions. We propose that existing, well-characterized animal models may be useful in differentiating the effects of these adversity elements and review both the animal and human literature that supports these ideas. To support these hypotheses, we also provide a detailed description of the development and structure of both the HPA-axis and the inflammatory arm of the immune system, as well as recent methodological advances in their measurement. Recommendations for future basic, developmental, translational, and clinical research are discussed.
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Liu RS, Aiello AE, Mensah FK, Gasser CE, Rueb K, Cordell B, Juonala M, Wake M, Burgner DP. Socioeconomic status in childhood and C reactive protein in adulthood: a systematic review and meta-analysis. J Epidemiol Community Health 2017; 71:817-826. [PMID: 28490476 PMCID: PMC5843476 DOI: 10.1136/jech-2016-208646] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/18/2017] [Accepted: 04/11/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Inflammation plays a central role in cardiometabolic disease and may represent a mechanism linking low socioeconomic status (SES) in early life and adverse cardiometabolic health outcomes in later life. Accumulating evidence suggests an association between childhood SES and adult inflammation, but findings have been inconsistent. METHODS We conducted a systematic review and meta-analysis of observational studies to quantify the association between childhood (age <18 years) SES and the inflammatory marker C reactive protein (CRP) in adulthood. Studies were identified in Medline and Embase databases, and by reviewing the bibliographies of articles published from 1946 to December 2015. Study-specific estimates were combined into meta-analyses using random-effects models. RESULTS 15 of 21 eligible studies (n=43 629) were ultimately included in two separate meta-analyses. Compared with those from the most advantaged families, participants from the least advantaged families had 25% higher CRP levels (ratio change in geometric mean CRP: 1.25; 95% CI 1.19 to 1.32) in minimally adjusted analyses. This finding was attenuated by the inclusion of adult body mass index (BMI) in adjusted models, suggesting BMI has a strong mediating role in CRP levels. CONCLUSIONS We observed an inverse association between childhood SES and adulthood CRP, potentially mediated through BMI. Investigating how childhood SES is associated with childhood BMI and CRP would provide insight into the effective timing of social and clinical interventions to prevent cardiometabolic disease.
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Affiliation(s)
- Richard S Liu
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Allison E Aiello
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Fiona K Mensah
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Constantine E Gasser
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Kuna Rueb
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Billie Cordell
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Melissa Wake
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- The Royal Children's Hospital, Parkville, Victoria, Australia
| | - David P Burgner
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
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Francis P, McCormack W, Toomey C, Lyons M, Jakeman P. Muscle strength can better differentiate between gradations of functional performance than muscle quality in healthy 50-70y women. Braz J Phys Ther 2017; 21:457-464. [PMID: 28709586 PMCID: PMC5693432 DOI: 10.1016/j.bjpt.2017.06.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 12/09/2016] [Accepted: 01/31/2017] [Indexed: 12/25/2022] Open
Abstract
Muscle strength is a better predictor of functional performance than muscle quality. Extended gait speed is a functionally relevant measure in healthy 50–70 y women. Healthy adults need functional assessments that allow performance toward maximum.
Objective It is not known which laboratory indices of muscle mass, strength or quality can distinguish functional performance in healthy middle aged women. The aim of this study was to (a) examine the association between upper leg lean tissue mass, knee extensor strength, muscle quality (strength per unit lean tissue mass) and functional performance and (b) to determine the utility of tertiles of muscle strength and muscle quality to distinguish gradations of functional capacity in healthy 50–70 y women. Methods Using a cross-sectional study design, one hundred and twenty-eight healthy 50–70 y women (mean age: 60.4, SD = 5.1 y) underwent body composition assessment (dual X-ray absorptiometry) and performed maximal voluntary isometric contractions of the knee extensors (Con-Trex Dynamometer). Functional performance was assessed using a 5 repetition and 30 s chair rise test and 900 m gait speed test. Results Ordered by muscle strength or muscle quality, those in the highest tertile (T1) demonstrated greater functional performance than those in lowest tertile (T3). There was no association between upper leg lean tissue mass and functional performance (r = ≤0.06). Muscle strength explained a greater proportion of the variance in all functional performance measures relative to muscle quality (R2 = 0.13–0.36 vs. R2 = 0.11–0.16). Conclusion Upper leg lean tissue mass is not associated with physical performance in healthy 50–70 y women. These results suggest strength relative to the body mass being accelerated distinguishes gradations in functional performance better than muscle quality healthy 50–70 y women.
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Affiliation(s)
- Peter Francis
- Leeds Beckett University, School of Clinical and Applied Sciences, Musculoskeletal Health Research Group, Leeds, United Kingdom; University of Limerick, Faculty of Education and Health Sciences, Department of Physical Education and Sport Sciences, Limerick, Ireland.
| | - William McCormack
- University of Limerick, Faculty of Education and Health Sciences, Department of Physical Education and Sport Sciences, Limerick, Ireland
| | - Clodagh Toomey
- University of Limerick, Faculty of Education and Health Sciences, Department of Physical Education and Sport Sciences, Limerick, Ireland; University of Calgary, Faculty of Kinesiology, Calgary, Alberta, Canada
| | - Mark Lyons
- University of Limerick, Faculty of Education and Health Sciences, Department of Physical Education and Sport Sciences, Limerick, Ireland
| | - Philip Jakeman
- University of Limerick, Faculty of Education and Health Sciences, Department of Physical Education and Sport Sciences, Limerick, Ireland
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Shiels PG, McGuinness D, Eriksson M, Kooman JP, Stenvinkel P. The role of epigenetics in renal ageing. Nat Rev Nephrol 2017. [PMID: 28626222 DOI: 10.1038/nrneph.2017.78] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
An ability to separate natural ageing processes from processes specific to morbidities is required to understand the heterogeneity of age-related organ dysfunction. Mechanistic insight into how epigenetic factors regulate ageing throughout the life course, linked to a decline in renal function with ageing, is already proving to be of value in the analyses of clinical and epidemiological cohorts. Noncoding RNAs provide epigenetic regulatory circuits within the kidney, which reciprocally interact with DNA methylation processes, histone modification and chromatin. These interactions have been demonstrated to reflect the biological age and function of renal allografts. Epigenetic factors control gene expression and activity in response to environmental perturbations. They also have roles in highly conserved signalling pathways that modulate ageing, including the mTOR and insulin/insulin-like growth factor signalling pathways, and regulation of sirtuin activity. Nutrition, the gut microbiota, inflammation and environmental factors, including psychosocial and lifestyle stresses, provide potential mechanistic links between the epigenetic landscape of ageing and renal dysfunction. Approaches to modify the renal epigenome via nutritional intervention, targeting the methylome or targeting chromatin seem eminently feasible, although caution is merited owing to the potential for intergenerational and transgenerational effects.
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Affiliation(s)
- Paul G Shiels
- Section of Epigenetics, Institute of Cancer Sciences, Wolfson Wohl Translational Research Centre, University of Glasgow, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1QH, UK
| | - Dagmara McGuinness
- Section of Epigenetics, Institute of Cancer Sciences, Wolfson Wohl Translational Research Centre, University of Glasgow, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1QH, UK
| | - Maria Eriksson
- Department of Biosciences and Nutrition (BioNut), H2, Eriksson, Novum 141, 83 Huddinge, Sweden
| | - Jeroen P Kooman
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastrich, Netherlands
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska University Hospital, Huddinge, Karolinska Institutet, SE-14157 Stockholm, Sweden
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Landy R, Head J, Richards M, Hardy R. The effect of life course socioeconomic position on crystallised cognitive ability in two large UK cohort studies: a structured modelling approach. BMJ Open 2017; 7:e014461. [PMID: 28576891 PMCID: PMC5541359 DOI: 10.1136/bmjopen-2016-014461] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This study systematically compared accumulation, sensitive period, critical period and social mobility models relating life course socioeconomic position (SEP) and adult crystallised cognitive ability, which has not been comprehensively investigated. DESIGN Two prospective cohort studies. PARTICIPANTS Five thousand three hundred and sixty-two participants in the Medical Research Council National Survey of Health and Development (NSHD) Birth Cohort Study and 10 308 participants in the Whitehall II Occupational Cohort Study. MEASURES Childhood SEP was measured by father's occupational SEP, early adulthood SEP by educational qualifications and adult SEP by own occupational SEP. Each life course model was compared with a saturated model. RESULTS Using multiple imputation to account for missing data, the sensitive period model, which contained childhood, early adulthood and adult SEP terms, with different coefficients, provided the best fit for both men and women in the NSHD and Whitehall II cohorts. Early adulthood SEP had the largest coefficient in NSHD women, whereas for NSHD men early adulthood and adult SEP had similar coefficients. In Whitehall II adult SEP had the largest effect size for both men and women. CONCLUSIONS Sensitive period with all three time periods was the most appropriate life course models for adult crystallised cognitive ability in both cohorts, including an effect of childhood SEP. It is important to directly compare the life course models to determine which is the most appropriate.
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Affiliation(s)
- Rebecca Landy
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine, Queen Mary University of London, London, UK
| | - Jenny Head
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
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Abstract
OBJECTIVE Identifying the life course health effects of childhood adversity is a burgeoning area of research, particularly in relation to cardiovascular disease (CVD). However, adversity measurement varies widely across studies, which may hamper our ability to make comparisons across studies and identify mechanisms linking adversity to CVD. The purposes of this review are to summarize adversity measurement approaches in the context of CVD, identify gaps, and make recommendations for future research. METHODS PubMed and PsycINFO searches were conducted through June 2016. Studies were selected if CVD end point or predisease risk markers were investigated in association with a measure of childhood adversity. Forty-three studies were reviewed. A meta-analysis was not conducted because of the variation in exposures and outcomes assessed. RESULTS Adversity measurement was heterogeneous across studies. Metrics included different sets of adverse events, relational factors, and socioeconomic indicators. Thirty-seven percent measured childhood adversity prospectively, 23% examined a CVD end point, and 77% treated adversity as an unweighted summary score. Despite the heterogeneity in measurement, most studies found a positive association between childhood adversity and CVD risk, and the association seems to be dose-response. CONCLUSIONS The literature on childhood adversity and CVD would benefit from improving consistency of measurement, using weighted adversity composites, modeling adversity trajectories over time, and considering socioeconomic status as an antecedent factor instead of a component part of an adversity score. We suggest conceptual and analytic strategies to enhance, refine, and replicate the observed association between childhood adversity and CVD risk.
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Ariansen I, Mortensen LH, Graff-Iversen S, Stigum H, Kjøllesdal MKR, Næss Ø. The educational gradient in cardiovascular risk factors: impact of shared family factors in 228,346 Norwegian siblings. BMC Public Health 2017; 17:281. [PMID: 28356092 PMCID: PMC5372258 DOI: 10.1186/s12889-017-4123-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 02/09/2017] [Indexed: 11/16/2022] Open
Abstract
Background Various indicators of childhood socioeconomic position have been related to cardiovascular disease (CVD) risk in adulthood. We investigated the impact of shared family factors on the educational gradient in midlife CVD risk factors by assessing within sibling similarities in the gradient using a discordant sibling design. Methods Norwegian health survey data (1980–2003) was linked to educational and generational data. Participants with a full sibling in the health surveys (228,346 individuals in 98,046 sibships) were included. Associations between attained educational level (7–9 years, 10–11 years, 12 years, 13–16 years, or >16 years) and CVD risk factor levels in the study population was compared with the corresponding associations within siblings. Results Educational gradients in risk factors were attenuated when factors shared by siblings was taken into account: A one category lower educational level was associated with 0.7 (95% confidence interval 0.6 to 0.8) mm Hg higher systolic blood pressure (27% attenuation), 0.4 (0.4 to 0.5) mmHg higher diastolic blood pressure (30%), 1.0 (1.0 to 1.1) more beats per minute higher heart rate (21%), 0.07 (0.06 to 0.07) mmol/l higher serum total cholesterol (32%), 0.2 (0.2 to 0.2) higher smoking level (5 categories) (30%), 0.15 (0.13 to 0.17) kg/m2 higher BMI (43%), and 0.2 (0.2 to 0.2) cm lower height (52%). Attenuation increased with shorter age-difference between siblings. Conclusion About one third of the educational gradients in modifiable CVD risk factors may be explained by factors that siblings share. This implies that childhood environment is important for the prevention of CVD. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4123-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Inger Ariansen
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, PO box 4404, Oslo, N-0403, Norway.
| | - Laust Hvas Mortensen
- Section of Social Medicine, University of Copenhagen, PO box 2099, Copenhagen, K 1014, Denmark
| | - Sidsel Graff-Iversen
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, PO box 4404, Oslo, N-0403, Norway.,Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway
| | - Hein Stigum
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, PO box 4404, Oslo, N-0403, Norway.,Institute of Health and Society, University of Oslo, PO box 1130, Oslo, 0318, Norway
| | | | - Øyvind Næss
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, PO box 4404, Oslo, N-0403, Norway.,Institute of Health and Society, University of Oslo, PO box 1130, Oslo, 0318, Norway
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Wickrama KAS, Bae D, O'Neal CW. Explaining the Association between Early Adversity and Young Adults' Diabetes Outcomes: Physiological, Psychological, and Behavioral Mechanisms. J Youth Adolesc 2017; 46:2407-2420. [PMID: 28144816 DOI: 10.1007/s10964-017-0639-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 01/20/2017] [Indexed: 11/27/2022]
Abstract
Previous studies have documented that early adversity increases young adults' risk for diabetes resulting in morbidity and comorbidity with adverse health conditions. However, less is known about how inter-related physiological (e.g., body mass index [BMI]), psychological (e.g., depressive symptoms), and behavioral mechanisms (e.g., unhealthy eating and sedentary behavior) link early adversity to young adults' diabetes outcomes, although these mechanisms appear to stem from early stressful experiences. The current study tested the patterning of these longitudinal pathways leading to young adults' diabetes using a nationally representative sample of 13,286 adolescents (54% female) over a period of 13 years. The findings indicated that early adversity contributed to elevated BMI, depressive symptoms, and stress-related health behaviors. The impact of these linking mechanisms on hierarchical diabetes outcomes (i.e., prediabetes and diabetes) remained significant after taking their associations with each other into account, showing that these mechanisms operate concurrently. The findings emphasize the importance of early detection for risk factors of young adults' diabetes in order to minimize their detrimental health effects.
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Affiliation(s)
- Kandauda A S Wickrama
- Department of Human Development and Family Science, The University of Georgia, Athens, GA, USA
| | - Dayoung Bae
- Center for Family Research, The University of Georgia, 1095 College Station Road, Athens, GA, 30602, USA.
| | - Catherine Walker O'Neal
- Department of Human Development and Family Science, The University of Georgia, Athens, GA, USA
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