From the National Center for Primary Care, Morehouse School of Medicine, Atlanta, GA (PB, CL, AG); Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA (PB); Department of Family Medicine, Morehouse School of Medicine, Atlanta, GA (AG).
J Am Board Fam Med. 2020 Nov-Dec;33(6):832-841. doi: 10.3122/jabfm.2020.06.200008.
To provide a potential biological, mechanistic link for the well-established association between primary care access and reduced mortality, this study sought to measure the impact of having a usual source of health care on leukocyte telomere length (LTL).
Our study population included 3202 participants aged 50 to 84 years from National Health and Nutrition Examination Survey 1999 to 2001.
Cross-sectional Study. LTLs between people with and without a usual source of care were compared using unadjusted and adjusted linear regression models. Fully adjusted models accounted for demographic characteristics, health conditions, and health behaviors.
After controlling for individual factors, health conditions, and health behaviors, people who had a usual source of health care had significantly longer LTL (β = 89.8 base pairs, -value = .005) compared with those without a usual source of care; corresponding to approximately 7 years of life.
Having a usual source of health care is associated with longer LTL among older adults. This study provides a potential biologic link for the noted association between primary care access and reduced mortality that has been observed at the individual and population level.
为初级保健的可及性与死亡率降低之间的既定关联提供潜在的生物学、机制联系，本研究旨在测量拥有常规医疗来源对白细胞端粒长度（LTL）的影响。
我们的研究人群包括来自 1999 年至 2001 年国家健康和营养调查的 3202 名年龄在 50 至 84 岁的参与者。
横断面研究。使用未经调整和调整后的线性回归模型比较有和没有常规医疗来源的人群之间的 LTL。完全调整的模型考虑了人口统计学特征、健康状况和健康行为。
在控制了个体因素、健康状况和健康行为后，与没有常规医疗来源的人群相比，有常规医疗来源的人群的 LTL 明显更长（β=89.8 个碱基对，P 值=0.005）；相当于大约 7 年的寿命。
拥有常规医疗来源与老年人的 LTL 较长有关。本研究为在个体和人群层面观察到的初级保健可及性与死亡率降低之间的关联提供了潜在的生物学联系。
