Self-reported racial/ethnic discrimination and bronchodilator response in African American youth with asthma

Autor: Shannon Thyne, Nadine Burke-Harris, Michael A. LeNoir, Myngoc Nguyen, Esteban G. Burchard, Neeta Thakur, Luisa N. Borrell, Sonia Carlson, Celeste Eng
Přispěvatelé: Loukides, Stelios
Rok vydání: 2017
Předmět:
Male
Endotype
Pulmonology
Outcome Assessment
Social Sciences
lcsh:Medicine
Racism
0302 clinical medicine
Sociology
Outcome Assessment
Health Care
Medicine and Health Sciences
Psychology
Ethnicities
030212 general & internal medicine
Young adult
lcsh:Science
10. No inequality
Child
Lung
media_common
African Americans
Multidisciplinary
medicine.diagnostic_test
Racial Discrimination
Drugs
Social Discrimination
Population groupings
16. Peace & justice
Bronchodilator Agents
Infectious Diseases
Mental Health
Respiratory
Population study
Female
Research Article
Spirometry
medicine.medical_specialty
Infectious Disease Control
Adolescent
General Science & Technology
media_common.quotation_subject
Psychological Stress
03 medical and health sciences
Young Adult
Bronchodilators
Clinical Research
Internal medicine
Mental Health and Psychiatry
Behavioral and Social Science
medicine
Humans
Albuterol
Asthma
Pharmacology
Psychological and Psychosocial Issues
business.industry
Tumor Necrosis Factor-alpha
lcsh:R
Case-control study
Urban Health
Biology and Life Sciences
medicine.disease
Black or African American
Health Care
030228 respiratory system
Case-Control Studies
Linear Models
lcsh:Q
San Francisco
Self Report
People and places
business
Demography
Zdroj: PloS one, vol 12, iss 6
PLoS ONE, Vol 12, Iss 6, p e0179091 (2017)
PLoS ONE
Popis: Importance Asthma is a multifactorial disease composed of endotypes with varying risk profiles and outcomes. African Americans experience a high burden of asthma and of psychosocial stress, including racial discrimination. It is unknown which endotypes of asthma are vulnerable to racial/ethnic discrimination. Objective We examined the association between self-reported racial/ethnic discrimination and bronchodilator response (BDR) among African American youth with asthma ages 8 to 21 years (n = 576) and whether this association varies with tumor necrosis factor alpha (TNF-α) level. Materials and methods Self-reported racial/ethnic discrimination was assessed by a modified Experiences of Discrimination questionnaire as none or any. Using spirometry, BDR was specified as the mean percentage change in forced expiratory volume in one second before and after albuterol administration. TNF-α was specified as high/low levels based on our study population mean. Linear regression was used to examine the association between self-reported racial/ethnic discrimination and BDR adjusted for selected characteristics. An interaction term between TNF-α levels and self-reported racial/ethnic discrimination was tested in the final model. Results Almost half of participants (48.8%) reported racial/ethnic discrimination. The mean percent BDR was higher among participants reporting racial/ethnic discrimination than among those who did not (10.8 versus 8.9, p = 0.006). After adjustment, participants reporting racial/ethnic discrimination had a 1.7 (95% CI: 0.36–3.03) higher BDR mean than those not reporting racial/ethnic discrimination. However, we found heterogeneity of this association according to TNF-α levels (p-interaction = 0.040): Among individuals with TNF-α high level only, we observed a 2.78 higher BDR mean among those reporting racial/ethnic discrimination compared with those not reporting racial/ethnic discrimination (95%CI: 0.79–4.77). Conclusions We found BDR to be increased in participants reporting racial/ethnic discrimination and this association was limited to African American youth with TNF-α high asthma, an endotype thought to be resistant to traditional asthma medications. These results support screening for racial/ethnic discrimination in those with asthma as it may reclassify disease pathogenesis.
Databáze: OpenAIRE
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