Inflammatory factors and diabetes risk in health disparities populations

National Institute On Minority Health And Health Disparities

Investigators

Linked publications & trials

Abstract

The mission of our research is to discern the complex relationship between social determinants of health and inflammation in explaining health disparities in chronic disease occurrence. We are using population data to understand (1) how inflammation may explain the association between social determinants of health and disease, and (2) how social determinants of health modify the relationship between inflammation and disease. Additional studies are focused on understanding the social factors that inform positive healthcare behaviors in young adults with chronic diseases. Project 1. Quantifying systemic inflammation and its association with visceral obesity in US adults. Expending adiposity has been linked to chronic inflammation, which plays a central role in the progression of metabolic diseases such as diabetes. Using a novel systemic inflammation index compiled from clinical laboratory test, we are examining the association between systemic inflammation and sagittal abdominal diameter, an anthropologic measure of visceral obesity. We examined multiple waves of National Health and Nutrition Examination Survey (NHANES) data, with respondents providing biological and survey data. Demographics, self-reported diabetic status and medication use, blood glucose levels, and 6 measures of metabolic risk factors for diabetes mellitus were measured. Overall, we found that the mean systemic inflammation index was greater in persons classified as prediabetic than non-diabetic and greater in those with diabetes compared to prediabetics. Mean systemic inflammation index also varied significantly across sex and race/ethnicity. Collectively, these findings suggest that controlling systemic inflammation can reduce the risk of developing diabetes. Project 2. Differences in Quality Monitoring Practices Among Adult Diabetics in the United States Despite recent expansions in access to care, health disparities in chronic disease persists in the United States. A possible mechanism for this persistence is the disparity in access to quality care across populations. We are using pooled data from multiple cohorts of the National Health and Nutrition Examination Survey in weighted, linear regression analyses to assess differences in quality of care among adult with diabetes. Estimates are adjusted for glycemic control and social determinants of health to assess physician-monitoring and self-monitoring practices and control of diabetes. Project 3. Association between social support in adolescence and the development of positive healthcare behaviors during young adulthood among US Adults with chronic diseases Using data from the National Longitudinal Study of Adolescent to Adult Health we examined the association between social support during adolescence and healthy behaviors during adulthood among individuals with chronic diseases. Social support was defined as the level of perceived care from parents, teachers, and peers. Multivariable logistic regression, adjusting for sociodemographics, was used to estimate the association between social support during adolescence and healthcare utilization during early adulthood. No correlation was found between the support felt during adolescence and the development of positive health behaviors during young adulthood, indicating factors like social support are not the sole determination in the development of positive health behaviors. Future studies including other support constructs; information and instructional, are needed for a more complete picture of the impact of social support on later health behavior.