Social determinants of health linked to faster genetic aging

科学家们已经知道，心血管健康可能受到包括一个人的社区在内的健康社会决定因素的影响, education, access to healthy foods and economic stability. But new research offers a clue as to why: accelerated biological aging.

For the new study, researchers considered epigenetic age acceleration. 表观遗传学研究着眼于环境如何影响DNA的读取方式，并为一个人的生活经历如何改变基因的工作方式提供了一种潜在的解释. Unlike chronological age, epigenetic age is a measure of those changes in cells, tissues and organ systems.

Researchers analyzed the health data of 2,932名黑人和白人参与了年轻人冠状动脉风险发展的研究, or CARDIA, which began in the mid-1980s. 参与者平均年龄为45岁，在十几岁或二十多岁时加入了CARDIA.

To measure cardiovascular risk, 研究人员检查了一个人的冠状动脉钙水平——向心脏供血的血管中斑块的数量——和左心室质量指数, 测量心脏左心室的厚度和效率.

During their seventh year of participation, 研究人员测量了这些人健康的某些社会决定因素:居住种族隔离, neighborhood poverty levels, food insecurity, difficulty paying for basic necessities or health care, and the education level of participants or their parents.

Researchers found that by the 25th year of participation, 所有测量的社会决定因素都与心脏心室肌肉增厚有关. 食品不安全、难以支付基本必需品和医疗保健费用也与冠状动脉钙水平升高有关.

Next, researchers examined DNA in blood samples for epigenetic changes, or whether social factors may be associated with the age acceleration of genes. 有几个因素被发现有显著的影响:32%的教育和心肌厚度之间的关系可以用表观遗传衰老来解释. 对于居住种族隔离，这一关系为24%，而对于社区贫困，这一关系为21%.

研究结果表明，表观遗传变化可能部分解释了社会因素影响心肌厚度的原因, lead researcher Havisha Pedamallu said.

“表观遗传年龄加速占教育和心血管健康恶化之间关系的30%以上，这是一个非常重要的发现," said Pedamallu, 他是芝加哥西北大学范伯格医学院医学和公共卫生专业的学生. “我们开始表明，社会不利因素可能会导致直接的生物学变化."

The findings 在本月早些时候在费城举行的美国心脏协会科学会议上，这些研究结果被认为是初步的，直到完整的结果发表在同行评议的杂志上.

Pedamallu说，这些结果为未来的DNA研究铺平了道路，以探索导致心脏病恶化的基因组变化.

“能够识别我们体内发生的机制对于寻找新的检测方法将是非常重要的, treatment and early intervention," she said. "I really hope that more studies can push our medical system, 我们的政府和社会要更好地认识到健康的社会决定因素，并付出更多努力使其成为医疗保健的优先事项."

Pedamallu said the study was limited because it didn't show cause and effect, and it also looked at a limited number of social determinants of health. Because the field of epigenetics continues to evolve, more accurate test methods may be developed in the future, she said.

Dr. Mario Sims, a professor of social medicine, population and public health at the University of California, Riverside School of Medicine, 称这项研究是“对在常规诊所就诊中无法诊断的疾病进行的一项有趣的研究”, 皮肤下发生的事情会对下游的心血管健康产生连锁反应."

"I think it shows that clinicians, 医疗服务提供者和公共卫生从业人员需要找到将这些社会风险变量纳入其诊断的方法," said Sims, who was not involved in the research. “我们必须从整体的角度(包括社会决定因素)诊断一个人是否患有心脏病。, not just from a behavioral or clinical risk standpoint."

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