Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Twin Cities, Minnesota.
Am J Epidemiol. 2019 Apr 1;188(4):656-663. doi: 10.1093/aje/kwy282.
Not much is known about brain structural change in younger populations and minorities. The cross-sectional relationship between depressive symptomatology and racial discrimination with structural measures of brain tissue volume was investigated using magnetic resonance images of 710 participants in the Coronary Artery Risk Development in Young Adults CARDIA Study in 2010. Those reporting depressive symptoms and racial discrimination had lower total brain matter volume compared with those who reported neither (-8.8 mL, 95% confidence interval (CI): -16.4, -1.2), those who reported depressive symptoms only (-10.9 mL, 95% CI: -20.4, -1.4), and those who reported racial discrimination only (-8.6 mL, 95% CI: -16.5, -0.8). Results were similar for total normal white matter. There were 103% higher odds (odds ratio = 2.03, 95% CI: 1.32, 3.14) of being in the highest quartile of white matter hyperintensities in those with depressive symptoms only compared to those without. Although tests for interaction by race were not statistically significant, sensitivity analyses stratified by race revealed inverse associations with total brain matter and total white matter volumes only among black participants with combined depressive symptomatology and experience of racial discrimination, and positive associations only among white participants with depressive symptoms with presence of white matter hyperintensities, suggesting future studies may focus on race.
目前对于年轻人和少数族裔的大脑结构变化知之甚少。本研究使用 2010 年“冠状动脉风险发展中的年轻人(CARDIA)研究”中的 710 名参与者的磁共振成像数据,调查了抑郁症状与种族歧视与脑组织体积结构测量指标之间的横断面关系。与既无抑郁症状又无种族歧视报告的参与者相比,报告抑郁症状和种族歧视的参与者的总脑实质体积较小(-8.8 毫升,95%置信区间(CI):-16.4,-1.2),仅报告抑郁症状的参与者(-10.9 毫升,95% CI:-20.4,-1.4),仅报告种族歧视的参与者(-8.6 毫升,95% CI:-16.5,-0.8)。总正常白质的结果相似。与无抑郁症状的参与者相比,仅报告抑郁症状的参与者发生脑白质高信号最高四分位数的可能性高 103%(优势比=2.03,95% CI:1.32,3.14)。虽然按种族进行交互检验的结果无统计学意义,但按种族分层的敏感性分析显示,仅在抑郁症状和种族歧视经历相结合的黑人参与者中,与总脑实质和总白质体积呈负相关,而在仅存在抑郁症状的白人参与者中,与脑白质高信号呈正相关,表明未来的研究可能需要关注种族差异。