Liu Sze Yan, Kawachi Ichiro
1 Harvard Center for Population and Development Studies, Boston, MA, USA.
2 Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Public Health Rep. 2017 Mar/Apr;132(2):220-230. doi: 10.1177/0033354916689613. Epub 2017 Feb 1.
Chronic stress from experiencing discrimination can lead to long-term changes in psychological and physiologic responses, including shorter leukocyte telomere length. We examined the association between leukocyte telomere length and variations in the association by race or type of discrimination.
Our study consisted of 3868 US-born non-Hispanic black (hereinafter, black) and non-Hispanic white (hereinafter, white) adult participants from the 2008 Health and Retirement Study biomarker sample with complete sociodemographic and discrimination information. We examined major lifetime unfair treatment and everyday discrimination. Coarsened exact matching matched exposed and unexposed participants on several sociodemographic factors. Coarsened exact matching creates analytic weights for the matched data sets. We applied weighted linear regression to the matched data sets. We conducted 2 subanalyses in which we matched on potential mediators-physical activity, smoking status, and obesity-and examined if racism was associated with shorter telomere length compared with other attributes. All analyses were stratified by race.
We found no difference in telomere length for black and white participants reporting major lifetime unfair treatment (β = 0.09; 95% CI, -0.33 to 0.15) or everyday discrimination (β = 0.04; 95% CI, -0.12 to 0.40). Everyday discrimination was associated with shorter leukocyte telomere length among black people (β = -0.23; 95% CI, -0.44 to -0.01) but not among white people (β = 0.05; 95% CI, -0.01 to 0.10). Matching on potential mediators generally decreased the effect estimate among black people.
Experiencing everyday discrimination was associated with shortened telomere length among older black adults. Further research is needed to understand the adverse physiologic effects of discrimination to create effective interventions.
因遭受歧视而产生的慢性压力会导致心理和生理反应的长期变化，包括白细胞端粒长度缩短。我们研究了白细胞端粒长度与基于种族或歧视类型的关联差异。
我们的研究包括来自2008年健康与退休研究生物标志物样本的3868名在美国出生的非西班牙裔黑人（以下简称黑人）和非西班牙裔白人（以下简称白人）成年参与者，他们拥有完整的社会人口统计学和歧视信息。我们研究了一生中遭受的主要不公平待遇和日常歧视。粗化精确匹配在几个社会人口统计学因素上对暴露组和非暴露组参与者进行匹配。粗化精确匹配为匹配数据集创建分析权重。我们对匹配后的数据集应用加权线性回归。我们进行了两项子分析，在潜在中介因素（身体活动、吸烟状况和肥胖）上进行匹配，并研究与其他属性相比，种族主义是否与端粒长度缩短有关。所有分析均按种族分层。
报告一生中遭受主要不公平待遇的黑人和白人参与者的端粒长度没有差异（β = 0.09；95%可信区间，-0.33至0.15），报告日常歧视的参与者也是如此（β = 0.04；95%可信区间，-0.12至0.40）。日常歧视与黑人的白细胞端粒长度缩短有关（β = -0.23；95%可信区间，-0.44至-0.01），但与白人无关（β = 0.05；95%可信区间，-0.01至0.10）。在潜在中介因素上进行匹配通常会降低黑人中的效应估计值。
日常歧视与老年黑人成年人的端粒长度缩短有关。需要进一步研究以了解歧视的不良生理影响，从而制定有效的干预措施。
