少数民族青年感知的歧视与哮喘及其相关结局具有相关性 GALA II 和SAGE II研究
2017/07/24
背景：哮喘在不同程度上影响少数民族人群,且与民族/种族歧视等相关的心理社会压力有关。我们旨在检测在非洲裔和拉丁裔美国青年中,感知歧视与哮喘及哮喘控制不佳的关系。
方法：我们纳入了来源于拉丁裔美籍中基因-环境和混合因素的研究以及非洲裔美籍、哮喘、基因和环境的研究中年龄在8-21岁的非洲裔美籍(n = 954)、墨西哥裔美籍(n = 1086)、其他拉丁裔美籍(n = 522)和波多黎各岛 (n = 1025)青年。哮喘由内科医生诊断,而哮喘控制的定义来源于国立心、肺和血液研究所的指南。感知民族/种族歧视由歧视经历问卷来评估,重点是在学校、医疗场所和公共场所。我们检测了感知歧视与每一个结局指标之间的相关性,以及社会经济地位(socioeconomic status, SES)和全球非洲血统是否会改变这些关系。
结果：非洲裔美国儿童报道有任何感知的歧视,与从未感知歧视的儿童比较,经历哮喘的比率提高了78% (OR,1.78; 95% CI,1.33-2.39)。同样的，感知了任何歧视的非洲裔美国儿童,与没有感知歧视的同龄人比较,面临哮喘控制不佳的几率增加(OR,1.97;95% CI,1.42-2.76)。这些相关性并未在拉丁裔美国儿童中观察到。我们观察到根据社会经济地位,感知歧视与哮喘之间的相关性存在异质性，即感知歧视在社会经济地位较低的墨西哥裔美国青年(交互效应P=.01)与其他社会经济地位较高的拉丁裔青年(交互效应p=.04)中,其患哮喘的几率增加。
结论：在非洲裔美国青年中感知歧视与哮喘患病增加及哮喘控制更差具有相关性关。社会经济地位加剧了感知歧视在患哮喘的墨西哥裔美国人和其他拉丁裔青年中的影响。
Perceived Discrimination Associated with Asthma and Related Outcomes in Minority Youth: The GALA II and SAGE II Studies
Thakur N, Barcelo NE, Borrell LN, Singh S, Eng C, Davis A, Meade K, LeNoir MA, Avila PC, Farber HJ, Serebrisky D, Brigino-Buenaventura E, Rodriguez-Cintron W, Thyne S, Rodriguez-Santana JR, Sen S, Bibbins-Domingo K, Burchard EG. CHEST 2017; 151(4):804-812
BACKGROUND: Asthma disproportionately affects minority populations and is associated with psychosocial stress such as racial/ethnic discrimination. We aimed to examine the association of perceived discrimination with asthma and poor asthma control in African American and Latino youth.
METHODS: We included African American (n =954), Mexican American (n = 1,086), other Latino (n = 522), and Puerto Rican Islander (n = 1,025) youth aged 8 to 21 years from the Genes-Environments and Admixture in Latino Americans study and the Study of African Americans, Asthma, Genes, and Environments. Asthma was defined by physician diagnosis, and asthma control was defined based on the National Heart, Lung, and Blood Institute guidelines. Perceived racial/ethnic discrimination was assessed by the Experiences of Discrimination questionnaire, with a focus on school, medical, and public settings. We examined the associations of perceived discrimination with each outcome and whether socioeconomic status (SES) and global African ancestry modified these associations.
RESULTS: African American children reporting any discrimination had a 78% greater odds of experiencing asthma (OR, 1.78; 95% CI, 1.33-2.39) than did those not reporting discrimination. Similarly, African American children faced increased odds of poor asthma control with any experience of discrimination (OR, 1.97; 95% CI, 1.42-2.76) over their counterparts not reporting discrimination. These associations were not observed among Latino children. We observed heterogeneity of the association between reports of discrimination and asthma according to SES, with reports of discrimination increasing the odds of having asthma among low-SES Mexican American youth (interaction P = .01) and among high-SES other Latino youth (interaction P = .04).
CONCLUSIONS: Perceived discrimination is associated with increased odds of asthma and poorer control among African American youth. SES exacerbates the effect of perceived discrimination on having asthma among Mexican American and other Latino youth.
方法：我们纳入了来源于拉丁裔美籍中基因-环境和混合因素的研究以及非洲裔美籍、哮喘、基因和环境的研究中年龄在8-21岁的非洲裔美籍(n = 954)、墨西哥裔美籍(n = 1086)、其他拉丁裔美籍(n = 522)和波多黎各岛 (n = 1025)青年。哮喘由内科医生诊断,而哮喘控制的定义来源于国立心、肺和血液研究所的指南。感知民族/种族歧视由歧视经历问卷来评估,重点是在学校、医疗场所和公共场所。我们检测了感知歧视与每一个结局指标之间的相关性,以及社会经济地位(socioeconomic status, SES)和全球非洲血统是否会改变这些关系。
结果：非洲裔美国儿童报道有任何感知的歧视,与从未感知歧视的儿童比较,经历哮喘的比率提高了78% (OR,1.78; 95% CI,1.33-2.39)。同样的，感知了任何歧视的非洲裔美国儿童,与没有感知歧视的同龄人比较,面临哮喘控制不佳的几率增加(OR,1.97;95% CI,1.42-2.76)。这些相关性并未在拉丁裔美国儿童中观察到。我们观察到根据社会经济地位,感知歧视与哮喘之间的相关性存在异质性，即感知歧视在社会经济地位较低的墨西哥裔美国青年(交互效应P=.01)与其他社会经济地位较高的拉丁裔青年(交互效应p=.04)中,其患哮喘的几率增加。
结论：在非洲裔美国青年中感知歧视与哮喘患病增加及哮喘控制更差具有相关性关。社会经济地位加剧了感知歧视在患哮喘的墨西哥裔美国人和其他拉丁裔青年中的影响。
(王刚1 张红萍1 四川大学华西医院中西医结合科呼吸病组 610041 摘译)
（CHEST 2017; 151(4):804-812）
（CHEST 2017; 151(4):804-812）
Perceived Discrimination Associated with Asthma and Related Outcomes in Minority Youth: The GALA II and SAGE II Studies
Thakur N, Barcelo NE, Borrell LN, Singh S, Eng C, Davis A, Meade K, LeNoir MA, Avila PC, Farber HJ, Serebrisky D, Brigino-Buenaventura E, Rodriguez-Cintron W, Thyne S, Rodriguez-Santana JR, Sen S, Bibbins-Domingo K, Burchard EG. CHEST 2017; 151(4):804-812
BACKGROUND: Asthma disproportionately affects minority populations and is associated with psychosocial stress such as racial/ethnic discrimination. We aimed to examine the association of perceived discrimination with asthma and poor asthma control in African American and Latino youth.
METHODS: We included African American (n =954), Mexican American (n = 1,086), other Latino (n = 522), and Puerto Rican Islander (n = 1,025) youth aged 8 to 21 years from the Genes-Environments and Admixture in Latino Americans study and the Study of African Americans, Asthma, Genes, and Environments. Asthma was defined by physician diagnosis, and asthma control was defined based on the National Heart, Lung, and Blood Institute guidelines. Perceived racial/ethnic discrimination was assessed by the Experiences of Discrimination questionnaire, with a focus on school, medical, and public settings. We examined the associations of perceived discrimination with each outcome and whether socioeconomic status (SES) and global African ancestry modified these associations.
RESULTS: African American children reporting any discrimination had a 78% greater odds of experiencing asthma (OR, 1.78; 95% CI, 1.33-2.39) than did those not reporting discrimination. Similarly, African American children faced increased odds of poor asthma control with any experience of discrimination (OR, 1.97; 95% CI, 1.42-2.76) over their counterparts not reporting discrimination. These associations were not observed among Latino children. We observed heterogeneity of the association between reports of discrimination and asthma according to SES, with reports of discrimination increasing the odds of having asthma among low-SES Mexican American youth (interaction P = .01) and among high-SES other Latino youth (interaction P = .04).
CONCLUSIONS: Perceived discrimination is associated with increased odds of asthma and poorer control among African American youth. SES exacerbates the effect of perceived discrimination on having asthma among Mexican American and other Latino youth.
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交通噪音在交通相关空气污染与儿童肺功能的关系中的作用
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酪氨酸激酶抑制剂伊马替尼对重度难治性哮喘患者的作用
