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路易斯安那州东南部女性创伤后应激中表观遗传年龄加速和差异:NIMHD 社会表观基因组学计划。

Epigenetic Age Acceleration and Disparities in Posttraumatic Stress in Women in Southeast Louisiana: NIMHD Social Epigenomics Program.

机构信息

Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia.

Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, Georgia.

出版信息

JAMA Netw Open. 2024 Jul 1;7(7):e2421884. doi: 10.1001/jamanetworkopen.2024.21884.

Abstract

IMPORTANCE

Disasters experienced by an entire community provide opportunities to understand individual differences in risk for adverse health outcomes over time. DNA methylation (DNAm) differences may help to distinguish individuals at increased risk following large-scale disasters.

OBJECTIVE

To examine the association of epigenetic age acceleration with probable posttraumatic stress disorder (PTSD) and PTSD symptom severity in women.

DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study examined data from participants in the Women and Their Children's Health cohort, who were characterized longitudinally following the Deepwater Horizon oil spill (DHOS) in 2010 and through numerous hurricanes in the Gulf Coast region of the US. Wave 1 occurred August 6, 2012, through June 26, 2014, and wave 2 occurred September 2, 2014, through May 27, 2016. Data were analyzed between August 18 and November 4, 2023. Address-based sampling was used to recruit women aged 18 to 80 years and residing in 1 of the 7 Louisiana parishes surrounding the DHOS-affected region. Recruitment consisted of 2-stage sampling that (1) undersampled the 2 more urban parishes to maximize probability of participant oil exposure and (2) proportionally recruited participants across census tracts in the 5 other parishes closest to the spill.

EXPOSURE

Posttraumatic stress subsequent to the DHOS.

MAIN OUTCOME AND MEASURES

Epigenetic age acceleration was measured by DNAm assayed from survey wave 1 blood samples. Posttraumatic stress disorder was assessed using the PTSD Checklist for DSM-5 at survey wave 2, and lifetime trauma exposure was assessed using the Life Events Checklist for DSM-5. General linear models were used to examine the association between wave 1 DNAm age and wave 2 probable PTSD diagnosis and symptom severity.

RESULTS

A total of 864 women (mean [SD] age, 47.1 [12.0] years; 328 Black [38.0%], 19 American Indian [2.2%], 486 White [56.3%], and 30 of other racial groups, including uknown or unreported [3.5%]) were included. Black and American Indian participants had a higher age acceleration at wave 1 compared with White participants (β = 1.64 [95% CI, 1.02-2.45] and 2.34 [95% CI, 0.33-4.34], respectively), and they had higher PTSD symptom severity at wave 2 (β = 7.10 [95% CI, 4.62-9.58] and 13.08 [95% CI, 4.97-21.18], respectively). Epigenetic age acceleration at wave 1 was associated with PTSD symptom severity at wave 2 after adjusting for race, smoking, body mass index, and household income (β = 0.38; 95% CI, 0.11-0.65).

CONCLUSIONS AND RELEVANCE

In this cohort study, epigenetic age acceleration was higher in minoritized racial groups and associated with future PTSD diagnosis and severity. These findings support the need for psychoeducation about traumatic responses to increase the likelihood that treatment is sought before years of distress and entrenchment of symptoms and comorbidities occur.

摘要

重要性

整个社区经历的灾难为了解个体随时间推移对不良健康结果的风险差异提供了机会。DNA 甲基化(DNAm)差异可能有助于区分大规模灾难后风险增加的个体。

目的

研究表观遗传年龄加速与女性创伤后应激障碍(PTSD)和 PTSD 症状严重程度的关联。

设计、地点和参与者:这项前瞻性队列研究检查了妇女及其子女健康队列参与者的数据,这些参与者在 2010 年深水地平线石油泄漏(DHOS)后以及美国墨西哥湾沿岸地区的多次飓风中进行了纵向特征描述。第 1 波发生在 2012 年 8 月 6 日至 2014 年 6 月 26 日,第 2 波发生在 2014 年 9 月 2 日至 2016 年 5 月 27 日。数据分析于 2023 年 8 月 18 日至 11 月 4 日进行。基于地址的抽样用于招募年龄在 18 至 80 岁之间且居住在受 DHOS 影响地区周围的路易斯安那州 7 个教区之一的女性。招募包括 2 阶段抽样,(1)对 2 个较城市化的教区进行抽样不足,以最大限度地提高参与者石油暴露的可能性,(2)根据距离泄漏点最近的 5 个教区的人口普查区比例招募参与者。

暴露

DHOS 后的创伤后应激。

主要结果和测量

通过第 1 波血液样本的 DNAm 检测来测量表观遗传年龄加速。第 2 波使用 DSM-5 PTSD 清单评估 PTSD,使用 DSM-5 生活事件清单评估终生创伤暴露。使用一般线性模型检查第 1 波 DNAm 年龄与第 2 波可能的 PTSD 诊断和症状严重程度之间的关联。

结果

共纳入 864 名女性(平均[标准差]年龄,47.1[12.0]岁;328 名黑人[38.0%],19 名美国印第安人[2.2%],486 名白人[56.3%],30 名其他种族群体,包括未知或未报告[3.5%])。与白人参与者相比,黑人(β=1.64 [95%CI,1.02-2.45])和美国印第安人(β=2.34 [95%CI,0.33-4.34])参与者在第 1 波的年龄加速更高,并且在第 2 波的 PTSD 症状严重程度更高(β=7.10 [95%CI,4.62-9.58]和 13.08 [95%CI,4.97-21.18])。在调整种族、吸烟、体重指数和家庭收入后,第 1 波的表观遗传年龄加速与第 2 波的 PTSD 症状严重程度相关(β=0.38;95%CI,0.11-0.65)。

结论和相关性

在这项队列研究中,少数族裔群体的表观遗传年龄加速更高,并且与未来的 PTSD 诊断和严重程度相关。这些发现支持需要进行创伤反应的心理教育,以增加在出现多年痛苦和症状根深蒂固以及合并症发生之前寻求治疗的可能性。

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