Abstract P2089: Sex Differences In Racism And Renal Injury Biomarker Association In African Americans

Abstract

Among the general population of African Americans (AAs) the risk for kidney disease is approximately 4-fold greater than Caucasians. However, the risk for kidney disease can be as high as 10-fold greater among hypertensive young African American (AA) males. The reason for this disparity remains elusive, but environmental stress has been identified as a contributor to disease risk among Blacks. Male (n=78) and female (n=91) AAs were administered the perceived racism scale (PRS) to investigate the relationship between perceived racism and biomarkers of stress (cortisol), hypertension (systolic and diastolic blood pressure; SBP/DBP, respectively), obesity (body mass index, BMI), and diabetes (CRP, and C peptide). Resting heart rate (HR) and BMI were measured; a blood sample collected to measure cortisol as well as C reactive protein (CRP) and C peptide (both biomarkers of diabetes); and urine was collected for measuring albumin to creatinine ratio (A:C, index of renal injury). There were no sex differences in age (36 ± 2 vs 33 ± 2), SBP (127± 13 vs 124 ± 2), DBP (72 ± 1 vs 69 ± 1), but A:C was higher in males (28 ± 12 vs 21 ± 4; p<0.003; males vs females, respectively). Males had higher job domain PRS scores (20 ± 2 vs 14 ± 1, p<0.01 male vs female, respectively) and PRS was positively correlated with cortisol (r=0.54, p<0.05) in males only. Furthermore, job PRS was positively correlated with biomarkers of obesity (BMI: r=0.419, p<0.004), hypertension (SBP, DBP: r=0.521, r=0.480; p<0.002, <0.009, respectively), and diabetes (C peptide: r=0.468, p<0.03) in males but not females. Interestingly, job PRS scores (r=0.498, p<0.005) as well as hypertension (SBP/DBP: r=0.398, r=0.611; p<0.03, p<0.001, respectively) and diabetes (CRP: r=0.812, p<0.001) biomarkers were positively correlated with A:C in males but not females. These findings support the idea that the increased risk for kidney injury in young hypertensive AA males results from environmental stress of racism that activates biological pathways leading to cardiovascular and kidney disease. More studies are needed to identify the underlying pathways between perceived racism and promotion of cardiometabolic disease.