黑人老年人群中 C 反应蛋白升高的相关因素：来自健康与退休研究的证据。
Correlates of Elevated C-Reactive Protein Among Black Older Adults: Evidence From the Health and Retirement Study.
机构信息
Department of Human Development and Family Sciences, University of Delaware, Newark, Delaware, USA.
Department of Community Health Sciences, University of California, Los Angeles, Los Angeles, California, USA.
出版信息
J Gerontol B Psychol Sci Soc Sci. 2022 Nov 23;77(11):1964-1977. doi: 10.1093/geronb/gbac033.
OBJECTIVES
Substantial evidence documents gender and racial disparities in C-reactive protein (CRP), a measure of systemic inflammation, among older adults. Yet, the comparative approaches of these studies may obscure distinct risk and protective factors associated with elevated CRP among older Black Americans. To pinpoint opportunities for intervention, this study utilizes a "within-group approach" to identify the sociodemographic, psychosocial, behavioral, and health-related correlates of elevated CRP among older Black women and men.
METHOD
The sample consisted of 2,420 Black respondents aged 51 and older in the Health and Retirement Study (2006-2016). Gender-stratified, random effects logistic regression models were used to examine correlates of elevated CRP (>3.0 mg/L).
RESULTS
More than 50% of Black women had elevated CRP, and younger age, Medicaid, lower mastery, religiosity, overweight/obesity, physical inactivity, and activities of daily living (ADLs) contributed to elevated CRP among this group. In contrast, elevated CRP was reported among only 37.25% of Black men, for whom financial distress was associated with lower odds of elevated CRP; religiosity, less neighborhood cohesion, current smoking, overweight/obesity, ADLs, and more chronic conditions were associated with greater odds of elevated CRP among this group.
DISCUSSION
Sociodemographic factors had a limited association with elevated CRP among older Black Americans. Rather, a range of psychosocial, behavioral, and health-related factors were more influential determinants of elevated CRP among older Black Americans. Most notably, findings demonstrate distinct correlates of CRP among Black women and men, underscoring the critical need to further evaluate the risk and protective mechanisms undergirding disparities among this aging population.
目的
大量证据表明，在老年人中，C 反应蛋白（CRP）——一种全身性炎症的衡量指标——存在性别和种族差异。然而，这些研究的比较方法可能掩盖了与老年非裔美国人 CRP 升高相关的不同风险和保护因素。为了确定干预的机会，本研究利用“组内方法”来确定与老年非裔美国女性和男性 CRP 升高相关的社会人口统计学、心理社会、行为和与健康相关的因素。
方法
该样本由参加健康与退休研究（2006-2016 年）的 2420 名年龄在 51 岁及以上的黑人受访者组成。使用性别分层、随机效应逻辑回归模型来研究 CRP 升高（>3.0mg/L）的相关因素。
结果
超过 50%的黑人女性 CRP 升高，年龄较小、拥有医疗补助、较低的掌控感、宗教信仰、超重/肥胖、身体不活动和日常生活活动（ADLs）与该组 CRP 升高有关。相比之下，只有 37.25%的黑人男性报告 CRP 升高，经济困境与 CRP 升高的几率降低有关；宗教信仰、邻里凝聚力较低、当前吸烟、超重/肥胖、ADLs 和更多慢性疾病与该组 CRP 升高的几率增加有关。
讨论
社会人口统计学因素与老年非裔美国人 CRP 升高的相关性有限。相反，一系列心理社会、行为和与健康相关的因素是非裔美国老年人 CRP 升高的更重要决定因素。最值得注意的是，研究结果表明 CRP 在黑人女性和男性中存在不同的相关因素，这突显了进一步评估这一老龄化人群中差异背后的风险和保护机制的迫切需要。
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