Disparities in lung function trajectories among tobacco-exposed individuals

Thorax · 2026-01-06 · 1 citations

Background The relationship of social determinants of health (SDOH), environmental exposures and medical history to lung function trajectories is underexplored. A better understanding of these relationships could inform preventive strategies for lung health. Methods We analysed data from COPDGene, a US longitudinal, observational study. Participants were tobacco-exposed (≥10 pack-years of smoking) non-Hispanic Black and non-Hispanic White adults aged 45–80 years. We analysed 2990 males and 2945 females, using Bayesian trajectory modelling on post-bronchodilator forced expiratory volume in one second (FEV 1 ) and forced vital capacity (FVC). We applied multinomial logistic regression to assess the association of SDOH, environmental exposures and medical history with lung function trajectories. Measurements and main results Six trajectories were identified within each sex. Non-Hispanic Black race was more prevalent in trajectories characterised by lower FEV1 and FVC values (ie, lower lung function trajectories) compared with non-Hispanic White adults. In adjusted models, non-Hispanic Black race, residence in the Southeastern USA, lifetime asthma and a father with COPD were associated with significantly higher odds of the lowest trajectory (ie, trajectory six vs the reference trajectory) for both sexes. Higher income and private insurance showed inverse associations with lower lung function trajectories. The Social Vulnerability Index socioeconomic theme (based on census-level poverty, unemployment, income and educational attainment) was associated with the lowest trajectory in males. Conclusions Significant disparities in lung function trajectories exist between non-Hispanic Black adults and non-Hispanic White adults. Individual- and community-level factors are associated with lower lung function trajectory in people exposed to tobacco.

Beyond the genome: intergenerational inheritance through epigenetics and other pathways

Epigenomics · 2025-10-01

The American Association of Anthropological Genetics (AAAG) paired with the American Association of Biological Anthropology (AABA) to put on a symposium at the 94th Annual AAABA meeting entitled, "Beyond the genome: Intergenerational inheritance through epigenetics and other pathways." The symposium was held at the Marriott Waterfront in Baltimore, Maryland, on 14 March 2025, and was organized by Dr. Amy Non. The symposium's 13 speakers covered topics including the value of unique study designs and rare ecological settings, contributions of animal models, mechanisms beyond traditional epigenetics, such as microchimerism, microbiomes, and bioactive molecules in milk. Speakers also addressed ethical considerations of studies of intergenerational inheritance, including misconceptions and overhype. The discussed approaches help address ongoing challenges in the field of epigenetics, including how to demonstrate lasting effects across generations, identify causal associations with early life exposures, and ensure accurate interpretation of findings.

Epigenetics in persons living with HIV: trauma, coping, and <i>FKBP5</i> and <i>SLC6A4</i> methylation

Epigenomics · 2025-03-11 · 2 citations

AIM: People living with HIV (PLWH) have an increased risk for lifetime trauma and mental health difficulties. However, no studies have evaluated stress-related genes in relation to early-life adversity, lifetime trauma, or post-traumatic stress disorder (PTSD) in PLWH. METHODS: = 48 at both time points). Exploratory regression analyses were conducted with DNAm in relation to trauma exposure, mental health symptoms, and coping strategies. RESULTS: = 0.0103). Various coping strategies were also associated with sites in both genes across time points, e.g. self-blame and substance use. CONCLUSION: Our findings generate intriguing hypotheses linking mental health symptoms and DNA methylation, to be replicated with larger samples.

Obstetric views on reduced preterm birth rates early in the COVID-19 pandemic

Social Science & Medicine · 2025-12-04

A significant decrease in preterm births occurred during the first few months of the COVID-19 lockdown across the U.S. and in other high-income countries, particularly among medically induced births, or artificially initiated births. This unexpected phenomenon raised speculation that the reduction was influenced by changes in obstetric care or hospital policy shaped by the pandemic. Reductions in spontaneous preterm births also occurred and may have been related to reductions in stress, fewer infectious exposures, and less daily exertions due to the ability for some to work at home in early months of quarantine. There is currently no clear explanation for the short-term reduction in preterm births, but it is clear that obstetric practices were altered during the early pandemic, which may have impacted birth outcomes. To gain more insight into potential shifts in clinical perspectives and reproductive care practices during the pandemic that may have influenced preterm births, fifteen semi-structured interviews of prenatal caregivers working during lockdown in the U.S. were conducted in 2023-2024 and analyzed in this qualitative study. Many clinicians hypothesized that the decrease of in-person prenatal visits led clinicians to miss critical indicators for preterm inductions that could have reduced the rate of preterm births. However, clinicians offered an alternative, but not mutually exclusive, hypothesis suggesting that clinical practices were overmedicalizing pregnancy pre-pandemic. These perspectives on the impacts of reduced prenatal care warrant further discussion on risk tolerances around pregnancy, the current structure of U.S. obstetric healthcare, and effects on birth outcomes.

The Long-Term Effects of Cost-Related Nonadherence on COPD Outcomes and Progression in the COPDGene Study Cohort

Chronic Obstructive Pulmonary Diseases Journal of the COPD Foundation · 2025-01-01

Background: Chronic obstructive pulmonary disease (COPD) is a progressive disease with a high prevalence and cost burden on the health care system. Overall, adherence to prescribed therapies is low and associated with worse outcomes. Objective: Cost-related nonadherence (CRN) is a type of nonadherence that could be addressed through policy. We evaluated the long-term association of CRN on COPD outcomes in a well-profiled cohort. Methods: We identified 2521 participants with baseline COPD who answered the social and economic questionnaire in the COPD Genetic Epidemiology study cohort. Of these, 408 participants endorsed experiencing CRN. Multivariable regression models were utilized to assess the association of experiencing CRN and COPD outcomes including functional status, health status, and progression of disease. Results: Experiencing CRN is associated with worse functional status by the 6-minute walk distance, symptom burden by the COPD Assessment Test score, and health status by the St George’s Respiratory Questionnaire. Longitudinal analysis revealed an association of CRN with faster lung function decline and an increased risk of COPD exacerbations. Conclusion: Policy changes to address out-of-pocket medication costs may improve COPD outcomes and potentially lead to long-term cost savings.

The eighth annual US DOHAD meeting: promising approaches in epigenetics research of early life exposures

Epigenomics · 2025-01-28 · 2 citations

The U.S. Developmental Origins of Health and Disease (DOHaD) meeting is an annual conference of primarily U.S. scientists who study early life programming of health and disease. The eighth annual symposium, entitled "Exploring Translational DOHaD Science: From Cells to Communities" was held at the Rizzo Conference Center in Chapel Hill, North Carolina, from October 14 to 16, 2024. The meeting was organized by US-DOHaD President Danielle Christifano and Vice President Kaela Varberg, and other Society Council Members. This year's meeting had record attendance, with 158 attendees from diverse disciplines, and featured 10 keynote speakers, 11 platform talks, and 84 poster presentations. Four major topics were covered: 1) Early nutrition and developmental outcomes, 2) Prenatal origins of child health, 3) Developmental impacts of toxicant exposures, and 4) Metabolic origins of health. Overall, the presented research highlighted the value of studying epigenetic effects of dietary and toxic exposures early in life. Various strategies emerged to address challenges facing the field, such as harnessing the power of nationwide longitudinal birth cohorts, new methods to integrate epigenetic and environmental data across various levels, and the emerging potential of organoids to identify the causal impact of early life exposures.

Sex Ratio at Birth in Northern Ireland During the <scp>COVID</scp>‐19 Pandemic: A Comparison With Published Data From the Republic of Ireland, England and Wales

American Journal of Human Biology · 2025-06-27

OBJECTIVES: The COVID-19 pandemic has been linked in several countries to fluctuations in the proportion of male live births/total live births, known as the sex ratio at birth (SRB). This study investigates how the pandemic influenced SRB patterns in Northern Ireland compared to published data from neighboring regions, including the Republic of Ireland with which it shares an open land border, and England and Wales, across the sea. METHODS: Monthly live birth data for Northern Ireland from 2015 to 2021 were obtained from the Northern Ireland Statistics and Research Agency. A time series analysis predicted the SRB for 2020 using data from 2015 to 2019. Predicted and observed SRB values were compared for 2020. RESULTS: In August 2020, 5 months after the pandemic declaration, the SRB fell significantly to 49.13%, the period's lowest, below the 95% prediction interval (50.09%-51.85%). In December 2020, 9 months after the declaration, the SRB rose to 54.48%, exceeding the prediction interval (49.75%-51.57%). This overall SRB pattern resembled that in England and Wales but differed from the Republic of Ireland. CONCLUSION: The decline in SRB in August 2020, occurring 3-5 months after the pandemic declaration, suggests the pandemic disproportionately affected male fetuses in Northern Ireland. The rise in December, 9 months after the declaration, may relate to increased sexual activity in March 2020 following lockdown in a subset of the population. Northern Ireland's SRB pattern aligns more with England and Wales than the Republic of Ireland, indicating that socio-political ties in the United Kingdom may be more influential for pandemic response than geographical proximity.

Clinicians’ perspectives on race-specific guidelines for hypertensive treatment

Social Science & Medicine · 2024-05-05 · 5 citations

Were fewer boys born in the United States during the early months of the COVID‐19 pandemic? A test of the Trivers–Willard hypothesis

Evolutionary Anthropology Issues News and Reviews · 2024-07-25 · 2 citations

The Trivers-Willard hypothesis predicts that mammalian parents in poor environmental conditions will favor the offspring sex with more reliable chance of reproductive success, which in humans is females. Three months following the onset of the COVID-19 pandemic in South Africa, England, and Wales, there were significant decreases in the sex ratio at birth (SRB) (male births/total live births). We analyzed this ratio with a seasonal autoregressive moving average model, and a logistic regression, using nationwide natality data for all singleton births in the United States from 2015 to 2021 (n = 25,201,620 total births). We identified no significant change in the sex ratio in either analysis. Rather, we observed marked differences in the sex ratio by maternal characteristics of race/ethnicity, age, and education, with more vulnerable groups having lower sex ratios. These findings suggest the SRB may be an important marker of reproductive vulnerability for disadvantaged groups in the United States.

Integrating genetic and socioeconomic data to predict the progression of nonalcoholic fatty liver disease

American Journal of Biological Anthropology · 2024-05-22 · 8 citations

OBJECTIVES: Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease globally, with an estimated prevalence exceeding 25%. Variants in the PNPLA3 and HSD17B13 genes have been a focus of investigations surrounding the etiology and progression of NAFLD and are believed to contribute to a greater burden of disease experienced by Hispanic Americans. However, little is known about socioeconomic factors influencing NAFLD progression or its increased prevalence among Hispanics. MATERIALS AND METHODS: We cross-sectionally analyzed 264 patients to assess the role of genetic and socioeconomic variables in the development of advanced liver fibrosis in individuals at risk for NAFLD. RESULTS: Adjusting for age, sex, body mass index, and PNPLA3 genotype, lacking a college degree was associated with 3.3 times higher odds of advanced fibrosis (95% confidence interval [CI]: 1.21-8.76, p = 0.019), an effect comparable to that of possessing the major PNPLA3 risk variant. Notably, the effect of PNPLA3 genotype on advanced fibrosis was attenuated to nonsignificance following adjustment for education and other socioeconomic markers. The effect of the protective HSD17B13 variant, moreover, diminished after adjustment for education (odds ratio [OR]: 0.39 [95% CI: 0.13-1.16, p = 0.092]), while lower education continued to predict advanced fibrosis following multivariable adjustment with an OR of 8.0 (95% CI: 1.91-33.86, p = 0.005). DISCUSSION: Adjusting for education attenuated the effects of genotype and Hispanic ethnicity on liver fibrosis, suggesting that social factors-rather than genes or ethnicity-may be driving disease severity within some populations. Findings reveal the importance of including socioenvironmental controls when considering the role of genetics or ethnicity in complex disease.