Brewster Glenna S, Houser Madelyn C, Yang Irene, Pelkmans Jordan, Higgins Melinda, Tower-Gilchrist Cristy, Wells Jessica, Quyyumi Arshed A, Jones Dean, B Dunbar Sandra, Carlson Nicole
Nurs Res. 2025;74(1):37-46. doi: 10.1097/NNR.0000000000000783. Epub 2024 Oct 10.
In the United States, Black adults have the highest prevalence of obesity and hypertension, increasing their risk of morbidity and mortality. Caregivers of persons with dementia are also at increased risk of morbidity and mortality due to the demands of providing care. Thus, Black caregivers-who are the second largest group of caregivers of persons with dementia in the United States-have the highest risks for poor health outcomes among all caregivers. However, the physiological changes associated with multiple chronic conditions in Black caregivers are poorly understood.
In this study, metabolomics were compared to the metabolic profiles of Black caregivers with obesity, with or without hypertension. Our goal was to identify metabolites and metabolic pathways that could be targeted to reduce obesity and hypertension rates in this group.
High-resolution, untargeted metabolomic assays were performed on plasma samples from 26 self-identified Black caregivers with obesity, 18 of whom had hypertension. Logistic regression and pathway analyses were employed to identify metabolites and metabolic pathways differentiating caregivers with obesity only and caregivers with both obesity and hypertension.
Key metabolic pathways discriminating caregivers with obesity only and caregivers with obesity and hypertension were butanoate and glutamate metabolism, fatty acid activation/biosynthesis, and the carnitine shuttle pathway. Metabolites related to glutamate metabolism in the butanoate metabolism pathway were more abundant in caregivers with hypertension, while metabolites identified as butyric acid/butanoate and R-(3)-hydroxybutanoate were less abundant. Caregivers with hypertension also had lower levels of several unsaturated fatty acids.
In Black caregivers with obesity, multiple metabolic features and pathways differentiated among caregivers with and without hypertension. If confirmed in future studies, these findings would support ongoing clinical monitoring and culturally tailored interventions focused on nutrition (particularly polyunsaturated fats and animal protein), exercise, and stress management to reduce the risk of hypertension in Black caregivers with obesity.
在美国，成年黑人肥胖和高血压的患病率最高，这增加了他们发病和死亡的风险。痴呆症患者的照料者由于护理需求，发病和死亡风险也会增加。因此，黑人照料者——美国第二大痴呆症患者照料者群体——在所有照料者中健康状况不佳的风险最高。然而，人们对黑人照料者中与多种慢性病相关的生理变化知之甚少。
在本研究中，对有或无高血压的肥胖黑人照料者的代谢组学与代谢谱进行了比较。我们的目标是确定可以作为靶点来降低该群体肥胖和高血压发病率的代谢物和代谢途径。
对26名自我认定为肥胖的黑人照料者的血浆样本进行了高分辨率、非靶向代谢组学分析，其中18人患有高血压。采用逻辑回归和通路分析来确定区分单纯肥胖照料者和肥胖且患有高血压照料者的代谢物和代谢途径。
区分单纯肥胖照料者和肥胖且患有高血压照料者的关键代谢途径是丁酸和谷氨酸代谢、脂肪酸激活/生物合成以及肉碱穿梭途径。在丁酸代谢途径中，与谷氨酸代谢相关的代谢物在患有高血压的照料者中更为丰富，而被鉴定为丁酸/丁酸盐和R-(3)-羟基丁酸盐的代谢物则较少。患有高血压的照料者几种不饱和脂肪酸水平也较低。
在肥胖的黑人照料者中，有和没有高血压的照料者之间存在多种代谢特征和途径差异。如果在未来的研究中得到证实，这些发现将支持正在进行的临床监测以及针对营养（特别是多不饱和脂肪和动物蛋白）、运动和压力管理的文化定制干预措施，以降低肥胖的黑人照料者患高血压的风险。
