生物年龄中介了黑人感知到的邻里问题对心力衰竭风险的影响。
Biological Age Mediates the Effects of Perceived Neighborhood Problems on Heart Failure Risk Among Black Persons.
机构信息
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Departments of Psychiatry and Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
出版信息
J Racial Ethn Health Disparities. 2023 Dec;10(6):3018-3030. doi: 10.1007/s40615-022-01476-3. Epub 2022 Dec 5.
OBJECTIVE
We assessed whether biological age, measured by the epigenetic clock GrimAge, mediates the association of objective and subjective neighborhood disadvantage with incident HF among Black persons.
METHODS
Participants were 1448 self-reported Black adults (mean age (standard deviation, SD) = 64.3 (5.5)) dually enrolled in two community-based cohorts in Jackson, Mississippi, the ARIC and JHS cohorts, who were free of HF as of January 1, 2000. Incident HF events leading to hospitalization through December 31, 2017, were classified using ICD-9 discharge codes of HF. Multilevel age- and sex-adjusted Cox causal mediation models were used to examine whether biological age (at the person and neighborhood level) mediated the effects of objective (the National Area Deprivation Index, ADI) and subjective (perceived neighborhood problems) neighborhood disadvantage on incident HF.
RESULTS
A total of 334 incident hospitalized HF events occurred over a median follow-up of 18.0 years. The total effect of the ADI and perceived neighborhood problems (SD units) on HF was hazard ration (HR) = 1.26 and 95% confidence interval (CI) 0.98-1.56 and HR = 1.26 and 95% CI 1.10-1.41, respectively. GrimAge mediated a majority of the effect of perceived neighborhood problems on HF (person-level indirect effect HR = 1.07; 95% CI 1.02-1.12 and neighborhood-level indirect effect HR = 1.18; 95% CI 1.03-1.34), with the combined indirect effect explaining 94.8% of the relationship. The combined indirect effect of ADI on incident HF was comparable but not statistically significant.
CONCLUSIONS
Subjective neighborhood disadvantage may confer an increased risk of HF among Black populations.
目的
我们评估了表观遗传时钟 GrimAge 测量的生物年龄是否在客观和主观邻里劣势与黑人人群中心力衰竭（HF）事件之间起中介作用。
方法
参与者为 1448 名自报为黑人的成年人（平均年龄（标准差，SD）=64.3（5.5）），他们同时参加了密西西比州杰克逊市的两个基于社区的队列，即 ARIC 和 JHS 队列，截至 2000 年 1 月 1 日，他们均无 HF。通过 HF 的 ICD-9 出院代码对导致住院的 HF 事件进行分类。使用多水平年龄和性别调整的 Cox 因果中介模型来检验生物年龄（个体和邻里水平）是否介导客观（国家区域剥夺指数，ADI）和主观（感知邻里问题）邻里劣势对 HF 事件的影响。
结果
在中位数为 18.0 年的随访中，共发生了 334 例 HF 住院事件。ADI 和感知邻里问题（标准差单位）对 HF 的总效应为危害比（HR）=1.26，95%置信区间（CI）为 0.98-1.56 和 HR=1.26，95% CI 为 1.10-1.41。GrimAge 介导了感知邻里问题对 HF 的大部分影响（个体水平间接效应 HR=1.07；95% CI 1.02-1.12 和邻里水平间接效应 HR=1.18；95% CI 1.03-1.34），综合间接效应解释了两者关系的 94.8%。ADI 对 HF 事件的综合间接效应相当，但无统计学意义。
结论
主观邻里劣势可能会增加黑人人群中心力衰竭的风险。
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