Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA.
National Institute of Minority Health and Health Disparities, Bethesda, MD 20892, USA.
Int J Environ Res Public Health. 2020 Jun 24;17(12):4533. doi: 10.3390/ijerph17124533.
Stress leads to physiologic dysfunction and cardiometabolic disease. Allostatic load score (ALS) measures stress-induced cardiovascular, metabolic, and inflammatory biomarkers. We estimated the odds of high ALS by reason for and age at immigration, duration of American residence, number of children, and socioeconomic status in 193 African immigrants (male: 65%, age 41 ± 10 y (mean ± Standard Deviation (SD)), range 22-65 y). ALS was calculated with High-ALS defined as ALS ≥ 3.0 and Low-ALS defined as ALS < 3.0. Oral glucose tolerance tests (OGTT) were performed, the cardiovascular disease (CVD) risk estimated, and TNF-α, an inflammatory cytokine, measured. Logistic regression was used to estimate odds of High-ALS. In the High- and Low-ALS groups, ALS were 4.0 ± 1.2 vs. 1.3 ± 0.7, diabetes prevalence: 14% vs. 4%, CVD risk: 23% vs. 8%, TNF-α levels: 15 ± 9 vs. 11 ± 6 pg/mL, respectively (all ≤ 0.01). Immigrants were more likely to be in the High-ALS group if their reason for immigration was work or asylum/refugee (OR 2.18, = 0.013), their age at immigration was ≥30 y (OR 3.28, < 0.001), their duration of residence in United States was ≥10 y (OR 3.16, = 0.001), or their number of children was ≥3 (OR 2.67, = 0.019). Education, income, health insurance, marital status, and gender did not affect High-ALS odds. Factors adversely influencing allostatic load and cardiometabolic health in African immigrants were age at and reason for immigration, duration of residence in America, and number of children.
压力会导致生理功能障碍和心血管代谢疾病。全身适应综合征评分（ALS）可衡量应激诱导的心血管、代谢和炎症生物标志物。我们在 193 名非洲移民中（男性占 65%，年龄 41 ± 10 岁（平均值 ± 标准差（SD）），年龄范围为 22-65 岁），根据移民原因和年龄、在美国的居住时间、子女数量和社会经济地位来估计 ALS 评分高的几率。ALS 采用高 ALS（ALS≥3.0）和低 ALS（ALS＜3.0）定义。进行口服葡萄糖耐量试验（OGTT），估计心血管疾病（CVD）风险，并测量炎症细胞因子 TNF-α。采用 logistic 回归估计高 ALS 的几率。在高 ALS 和低 ALS 组中，ALS 分别为 4.0 ± 1.2 和 1.3 ± 0.7，糖尿病患病率分别为 14%和 4%，CVD 风险分别为 23%和 8%，TNF-α 水平分别为 15 ± 9 和 11 ± 6 pg/mL（均 ≤ 0.01）。如果移民原因是工作或庇护/难民（比值比 2.18， = 0.013）、移民年龄≥30 岁（比值比 3.28， ＜0.001）、在美国居住时间≥10 年（比值比 3.16， = 0.001）或子女≥3 个（比值比 2.67， = 0.019），移民更有可能处于高 ALS 组。教育、收入、医疗保险、婚姻状况和性别对高 ALS 几率没有影响。年龄和移民原因、在美国的居住时间和子女数量是影响非洲移民全身适应综合征和心血管代谢健康的不利因素。
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