Department of Family Medicine, Charles R Drew University of Medicine and Science, 1731 E. 120th, Los Angeles, CA, 90059, USA.
Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 2846 SPH I, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
J Urban Health. 2019 Aug;96(4):632-643. doi: 10.1007/s11524-019-00360-6.
Psychological stressors such as violence victimization are known contributors to obesity. However, moderators and mediators of this association have not been studied, although they might offer pathways for intervention or prevention. Using a sample of African American young adults, this study tested: (1) the moderating effect of sex on the effect of violence victimization on trajectories of body mass index (BMI), and (2) the mediating effect of dehydroepiandrosterone (DHEA) on this association. This 13-year longitudinal study followed 73 male and 80 female African American young adults who lived in an urban area from 1999 to 2012 when the youth were 20-32 years old. The independent variable was violence victimization measured in 1999 and 2000. The dependent variable was BMI measured in 2002 and 2012. The mediator was DHEA measured in 2001 and 2002. Multilevel path analysis was used to test if males and females differed in violence victimization predicting change in BMI (Model I) and the mediating effect of DHEA change on the above association (Model II). The results of Model I suggested that the change in violence victimization from 1999 to 2000 predicted change in BMI from 2002 to 2012 for females, but not males. Based on Model II, the DHEA change from 2000 to 2001 for females fully mediated the association between violence victimization from 1999 to 2000 and increases in BMI from 2002 to 2012. Our findings suggest that violence victimization in urban areas contributes to the development of obesity among African American female young adults and change in DHEA mediates this link. Violence prevention may have important implications for obesity prevention of African American young women who live in unsafe urban areas. This study also suggests that DHEA may be involved in the violence victimization-obesity link for African American women.
心理压力源，如暴力受害，是肥胖的已知促成因素。然而，尽管它们可能提供了干预或预防的途径，但这种关联的调节因子和中介因子尚未得到研究。本研究使用了一组非裔美国年轻成年人的样本，检验了以下两点：（1）性别对暴力受害对身体质量指数（BMI）轨迹的影响的调节作用；（2）脱氢表雄酮（DHEA）在这种关联中的中介作用。这项为期 13 年的纵向研究跟踪了 73 名男性和 80 名女性非裔美国年轻成年人，他们从 1999 年到 2012 年居住在城市地区，当时年轻人 20-32 岁。自变量是在 1999 年和 2000 年测量的暴力受害。因变量是在 2002 年和 2012 年测量的 BMI。中介变量是在 2001 年和 2002 年测量的 DHEA。多水平路径分析用于检验男性和女性在暴力受害预测 BMI 变化方面是否存在差异（模型 I）以及 DHEA 变化对上述关联的中介作用（模型 II）。模型 I 的结果表明，1999 年至 2000 年暴力受害的变化预测了 2002 年至 2012 年女性 BMI 的变化，但对男性没有预测。基于模型 II，女性 2000 年至 2001 年 DHEA 的变化完全中介了 1999 年至 2000 年暴力受害与 2002 年至 2012 年 BMI 增加之间的关联。我们的研究结果表明，城市地区的暴力受害导致非裔美国年轻女性肥胖的发展，而 DHEA 的变化则介导了这种联系。在不安全的城市地区生活的非裔美国年轻女性中，预防暴力可能对预防肥胖具有重要意义。本研究还表明，DHEA 可能参与了非裔美国女性的暴力受害与肥胖之间的联系。
