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Psychoneuroendocrinology. 2019 Aug;106:122-128. doi: 10.1016/j.psyneuen.2019.03.021. Epub 2019 Mar 25.

An investigation of racial/ethnic and sex differences in the association between experiences of everyday discrimination and leukocyte telomere length among patients with coronary artery disease.

Author information

1
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
2
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
3
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA.
4
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Atlanta VA Medical Center, Decatur, GA, USA.
5
Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
6
Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA.
7
Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
8
Atlanta VA Medical Center, Decatur, GA, USA; Departments of Psychiatry and Behavioral Sciences and Radiology, Emory University School of Medicine, Atlanta, GA, USA.
9
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
10
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: tene.t.lewis@emory.edu.

Abstract

Leukocyte telomere length (LTL) may be sensitive to psychosocial stressors such as discrimination. An inclusive examination of experiences of discrimination on LTL across racial/ethnic and sex groups is currently lacking. Baseline data were obtained from 369 White and African American patients with coronary artery disease (CAD) in the Mental Stress Ischemia Mechanisms and Prognosis Study. LTL was measured from peripheral blood leukocytes by quantitative polymerase chain reaction and calculated in kilobase pairs. Discrimination was measured using the 10-item Everyday Discrimination Scale (EDS). Responses were rated using 4-point Likert scales ranging from never = 1 to often = 4 and summed. Regression models were stratified by race/ethnicity and sex to estimate associations between discrimination and LTL. Each 10-unit increase in experiences of everyday discrimination was associated with an average of .20 fewer kilobase pairs (or 200 base pairs) among both African American women (β = -0.19; 95% CI: -0.35, -0.04; p-value: 0.02) and White women (β = -0.19; 95% CI: -0.37, -0.01; p-value: 0.04), after adjusting for basic demographic factors. Results were similar after further adjusting for behavioral, disease, and psychosocial risk factors (depression and stress). There were no significant associations between experiences of everyday discrimination and LTL for White men or African American men. Overall, experiences of discrimination were associated with shorter LTL among women and not in men. Discrimination may be a potential source of stress associated with shorter LTL among women with CAD. Future studies should explore longitudinal associations between everyday experiences of discrimination and telomere length and also with adverse cardiovascular outcomes.

KEYWORDS:

Discrimination; Leukocyte telomere length; Psychosocial stressors; Women

PMID:
30978531
PMCID:
PMC6655339
[Available on 2020-08-01]
DOI:
10.1016/j.psyneuen.2019.03.021

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