Immigrant assimilation and BMI and waist size: A longitudinal examination among hispanic and chinese participants in the multi‐ethnic study of atherosclerosis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99611/1/oby20104.pd

Association of Sleep Duration and Quality With Alterations in the Hypothalamic-Pituitary Adrenocortical Axis: The Multi-Ethnic Study of Atherosclerosis (MESA)

Context: Short sleep duration and poor sleep quality are associated with cardiovascular outcomes. One mechanism proposed to explain this association is altered diurnal cortisol secretion. Objective: The objective of the study was to examine the associations of sleep duration and sleep quality with diurnal salivary cortisol levels. Design: This was a cross-sectional analysis using data from examination 5 (2010–2012) of the Multi-Ethnic Study of Atherosclerosis. Actigraphy-based measures of sleep duration and efficiency were collected over 7 days, and salivary cortisol samples were collected over 2 days from participants aged 54–93 years (n = 600 with analyzable data). Results: Shorter average sleep duration (<6 h/night) was associated with less pronounced late decline in cortisol [2.2% difference in slope; 95% confidence interval (CI) 0.8–3.7; P ≤ .01] and less pronounced wake-to-bed slope (2.2% difference; 95% CI 1.0–3.4; P ≤ .001) compared with longer sleep duration (≥6 h/night). Lower sleep efficiency (<85%) was associated with less pronounced early decline in cortisol (29.0% difference in slope; 95% CI 4.1–59.7; P < .05) compared with higher sleep efficiency (≥85%). Subjects reporting insomnia had a flatter cortisol awakening response (−16.1% difference in slope; 95% CI −34.6 to −0.1; P < .05) compared with those not reporting insomnia. Conclusions: Shorter sleep duration, lower sleep efficiency, and insomnia are associated with alterations in diurnal cortisol levels consistent with changes in hypothalamic-pituitary-adrenal regulation

Factorial Invariance, Scale Reliability, and Construct Validity of the Job Control and Job Demands Scales for Immigrant Workers: The Multi-Ethnic Study of Atherosclerosis.

Immigrants have a different social context from those who stay in their home country or those who were born to the country that immigrants now live. Cultural theory of risk perception suggests that social context influences one's interpretation of questionnaire items. We examined psychometric properties of job control and job demand scales with US- and foreign-born workers who preferred English, Spanish, or Chinese (n = 3,114, mean age = 58.1). Across all groups, the job control scale had acceptable Cronbach's alpha (0.78-0.83) and equivalent factor loadings (DeltaCFI < 0.01). Immigrants had low alpha (0.42-0.65) for the job demands scale regardless of language, education, or age of migration. Two job-demand items had different factor loadings across groups. Among immigrants, both scales had inconsistent associations with perceived job stress and self-rated health. For a better understanding of immigrants' job stress, the concept of job demands should be expanded and immigrants' expectations for job control explored.http://deepblue.lib.umich.edu/bitstream/2027.42/78336/1/FujishiroLandsbergis2010_J Immigr Minor Health.pd

Diurnal salivary cortisol is associated with body mass index and waist circumference: The multiethnic study of atherosclerosis

Objective: Neuroendocrine abnormalities, such as activation of the hypothalamic‐pituitary‐adrenal (HPA) axis, are associated with obesity; however, few large‐scale population‐based studies have examined HPA axis and markers of obesity. We examined the cross‐sectional association of the cortisol awakening response (CAR) and diurnal salivary cortisol curve with obesity. Design and Methods: The Multiethnic Study of Atherosclerosis Stress Study includes 1,002 White, Hispanic, and Black men and women (mean age 65 ± 9.8 years) who collected up to 18 salivary cortisol samples over 3 days. Cortisol profiles were modeled using regression spline models that incorporated random parameters for subject‐specific effects. Cortisol curve measures included awakening cortisol, CAR (awakening to 30‐min postawakening), early decline (30 min to 2‐h postawakening), late decline (2‐h postawakening to bedtime), and the corresponding areas under the curve (AUC). Body mass index (BMI) and waist circumference (WC) were used to estimate adiposity. Results: For the entire cohort, both BMI and WC were negatively correlated with awakening cortisol ( P < 0.05), AUC during awakening rise, and early decline and positively correlated to the early decline slope ( P < 0.05) after adjustments for age, race/ethnicity, gender, diabetes status, socioeconomic status, β‐blockers, steroids, hormone replacement therapy, and smoking status. No heterogeneities of effects were observed by gender, age, and race/ethnicity. Conclusions: Higher BMI and WC are associated with neuroendocrine dysregulation, which is present in a large population sample, and only partially explained by other covariates.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97249/1/20047_ftp.pd

Association of salivary cortisol circadian pattern with cynical hostility: multi-ethnic study of atherosclerosis

OBJECTIVE: To determine if cynical hostility is associated with alterations in diurnal profiles of cortisol. Hostility has been linked to cardiovascular disease but the biological mechanisms mediating this association remain unknown. METHODS: Up to 18 measures of salivary cortisol taken over 3 days were obtained from each of 936 participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Cynical hostility was measured using an eight-item subscale of the Cook-Medley Hostility Scale. Cortisol profiles were modeled using regression spline models that incorporated random parameters for subject-specific effects. Models were adjusted for race, sex, age, socioeconomic position, and lifestyle factors. The association of cynical hostility with key features of the cortisol diurnal profile, both in the full sample and important subsamples, was examined. RESULTS: Waking cortisol levels as well as the extent of the morning surge in cortisol levels did not differ significantly across tertiles of cynical hostility. Respondents in the lowest tertile of cynical hostility experienced a 22% sharper decline in salivary cortisol (age- and sex-adjusted slope of -0.49 microg/dL per hour) than respondents in the highest tertile (-0.40 microg/dL per hour, p for difference = .0004). Intertertile differences in these parameters remained unaltered after further adjustment for potential confounders. This pattern of differences in cortisol diurnal profile tended to be related in a dose-response way to level of cynical hostility, and persisted in stratified analyses. Conclusions: Cynical hostility is associated with the declining phase of the awakening cortisol response. The implications of this for cardiovascular and other health outcomes remain to be determined.http://deepblue.lib.umich.edu/bitstream/2027.42/78520/1/RanjitDiezRoux2009_PsychosomMed.pd

Acculturation Is Associated With Hypertension in a Multiethnic Sample

Background: Hypertension varies in prevalence among race/ethnic groups in the United States. Within-ethnic group differences associated with acculturation have been less frequently examined. We studied the association of three measures of acculturation (language spoken at home, place of birth, and years living in the US) with hypertension in a population sample of 2619 white, 1898 African American, 1,494 Hispanic, and 803 Chinese participants in the Multiethnic Study of Atherosclerosis. Methods: Multivariate Poisson regression was used to estimate the association between the acculturation variables and hypertension. Results: Birthplace outside the US and speaking a non-English language at home were each associated with a lower prevalence of hypertension after adjustment for age, gender, and socioeconomic status (prevalence ratio [95% confidence intervals] 0.82 (0.77–0.87) for non-US born versus US born and 0.80 (0.74–0.85) for those not speaking English at home versus speakers of English at home, both P < .001). For participants born outside of the US, each 10-year increment of years in the US was associated with a higher prevalence of hypertension after adjustment for age, gender, and socioeconomic status (P for trend < .01). The associations between acculturation variables and hypertension were weakened after adjustment for race/ethnic category and risk factors for hypertension. Compared to US-born Hispanics, those born in Mexico or South America had lower prevalence of hypertension, but those born in the Caribbean and Central America had higher prevalence of hypertension. Conclusions: Acculturation and place of birth are associated with hypertension in a multiethnic sample.http://deepblue.lib.umich.edu/bitstream/2027.42/57776/1/Acculturation is associated with hypertension in a multiethnic sample.pd

Change in waist circumference with longer time in the United States among Hispanic and Chinese immigrants: the modifying role of the neighborhood built environment

We examined whether living in neighborhoods supportive of healthier diets and more active lifestyles may buffer immigrants against the unhealthy weight gain that is purported to occur with longer length of US residence

Life-course socioeconomic positions and subclinical atherosclerosis in the multi-ethnic study of atherosclerosis

A major limitation of past work on the social patterning of atherosclerosis has been the reliance on measures of neighborhood or individual-level socioeconomic position (SEP) assessed at a single point in time in adulthood. Risk of chronic disease is thought to accumulate throughout the life-course, so the use of a measure for a single point in time may result in inaccurate estimates of the social patterning of subclinical disease. Using data from the US Multi-Ethnic Study of Atherosclerosis (MESA), we examined the relation between childhood SEP [CSEP] (father or caretaker's education), adulthood SEP [ASEP] (a summary score of income, education, and wealth), and 20-year average exposure to neighborhood poverty [NSEP] (residential addresses geocoded and linked to census data) and the prevalence of subclinical atherosclerosis, as assessed by common carotid intimal-medial thickness (IMT) in mid to late adulthood. Participants were 45-84 years of age at baseline and were sampled from six study sites in the United States. After adjustment for age, CSEP and ASEP were both inversely and independently associated with IMT in men. All three indicators CSEP, ASEP, and NSEP were inversely and independently associated with IMT in women. Associations were somewhat reduced after adjustment for cardiovascular risk factors, suggesting that these factors may play a mediating role. There was evidence of heterogeneity in effects of NSEP by gender, and in the effects of ASEP and NSEP by race/ethnicity. Our results contribute to the growing body of work that shows that SEP at multiple points in the life-course, and at the individual and neighborhood level, contributes to the development of atherosclerosis.http://deepblue.lib.umich.edu/bitstream/2027.42/61830/1/Lifecourse socioeconomic positions and subclinical atherosclerosis in the multi-ethnic study of atherosclerosis.pd

Socioeconomic and race/ethnic differences in daily salivary cortisol profiles: the multi-ethnic study of atherosclerosis.

It has often been hypothesized that stress and its biological consequences mediate the relationship between low socioeconomic status (SES) or minority status and poor cardiovascular disease outcomes. The objective of this study was to determine if daily cortisol patterns, a biomarker of the stress response, differ by race/ethnicity and socioeconomic status. Data were collected from 935 Black, White and Hispanic adults age 48-90 years old. Salivary cortisol samples were collected six times per day over 3 days: at awakening, 30min later, at 1000h, noon, 1800h and at bedtime. Blacks and Hispanics had lower levels of wake-up cortisol and less steep early declines, while Blacks had flatter and Hispanics steeper late day declines relative to Whites. Similarly the low socioeconomic status group also had lower levels of wake-up cortisol and less steep decline during the early part of the day. These patterns remained after adjustment for health behaviors and psychosocial factors. This study finds an association between salivary cortisol and race/ethnicity and SES in a multi-ethnic study population. Further work is needed to determine the health consequences of these differences.http://deepblue.lib.umich.edu/bitstream/2027.42/78335/1/HajatDiezRoux2010_Psychoneuroendo..pd

Air pollution and the microvasculature: A cross-sectional assessment of in vivo retinal images in the population-based multi-ethnic study of atherosclerosis (MESA)

10.1371/journal.pmed.1000372PLoS Medicine711