Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina.
Department of Biobehavioral Health, The Pennsylvania State University, University Park.
J Gerontol B Psychol Sci Soc Sci. 2021 Feb 17;76(3):583-595. doi: 10.1093/geronb/gbaa027.
To clarify the relationships among race, gender, and socioeconomic status (SES) with C-reactive protein (CRP).
The present study analyzed data from 6,521 Black and White respondents aged 51 and older in the Health and Retirement Study, a nationally representative sample of midlife and older adults, to address two aims. We sought to (i) assess the independent associations between race, gender, and SES with CRP concentrations and (ii) test whether race, gender, and SES interacted to produce unequal CRP concentrations cross-sectionally and over a 4-year follow-up.
The results demonstrated that race, gender, and SES were each independently associated with baseline CRP, but only SES was associated with CRP at follow-up. Furthermore, race, gender, and education interacted to produce differential CRP levels at baseline. There were incremental benefits for each additional level of education for White men and women, but the relationship between education and CRP was more complicated for Black men and women. Compared with other race/gender groups with less than high school, Black women had the highest and Black men had the lowest levels of CRP. There were no apparent benefits to CRP for Black women with college compared with Black women with high school, while Black men with less than high school and college had similar concentrations of CRP.
In clarifying the complexity inherent in CRP disparities, this work contributes to a greater understanding of the biological mechanisms underlying racial disparities in leading causes of morbidity and mortality in the United States.
阐明 C 反应蛋白(CRP)与种族、性别和社会经济地位(SES)之间的关系。
本研究分析了来自健康与退休研究(Health and Retirement Study)的 6521 名年龄在 51 岁及以上的黑人和白人受访者的数据,该研究是中年及以上成年人的全国代表性样本,旨在实现两个目的。我们试图(i)评估种族、性别和 SES 与 CRP 浓度之间的独立关联,(ii)检验种族、性别和 SES 是否相互作用,导致 CRP 浓度在横断面和 4 年随访期间存在不平等。
结果表明,种族、性别和 SES 各自与基线 CRP 独立相关,但只有 SES 与随访时的 CRP 相关。此外,种族、性别和教育相互作用,导致基线时 CRP 水平存在差异。对于白人男性和女性,每增加一个教育水平都有额外的获益,但对于黑人男性和女性,教育与 CRP 之间的关系更为复杂。与其他受教育程度低于高中的种族/性别群体相比,黑人女性的 CRP 水平最高,黑人男性的 CRP 水平最低。与受教育程度低于高中和大学的黑人女性相比,大学学历的黑人女性的 CRP 没有明显获益,而受教育程度低于高中和大学的黑人男性的 CRP 浓度相似。
在阐明 CRP 差异中固有的复杂性方面,这项工作有助于更好地理解美国导致发病率和死亡率主要原因的种族差异背后的生物学机制。