{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:06:00Z","timestamp":1789841160252,"version":"4.0.1"},"reference-count":30,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Metabolic syndrome (MetS) is a common health condition that predisposes individuals to cardiovascular disease (CVD) and disproportionately affects Black and other racially and ethnically minoritized people. Concurrently, Black individuals also report more exposure to racial discrimination compared with White individuals; however, the role of discrimination in the development of MetS over time and associated mediators in these pathways remain underexplored.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the association between racial discrimination and MetS in rural Black individuals transitioning from late adolescence into early adulthood and to identify potential mediating pathways.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This longitudinal cohort study included Black adolescents enrolled in the Strong African American Families Healthy Adults (SHAPE) Project between June 2009 and May 2021. Families resided in rural counties of Georgia, where poverty rates are among the highest in the nation. Analyses included 322 of the 500 participants who originally enrolled in SHAPE and who were eligible to participate. Guardians provided information about socioeconomic disadvantage. Analyses were conducted in April 2023.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Youths reported exposure to racial discrimination annually from ages 19 to 21 years.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n MetS was the main health outcome and was measured at ages 25 and 31 years. MetS was diagnosed according to the International Diabetes Federation guidelines, which requires central adiposity (ie, waist circumference \u226594 cm for males and \u226580 cm for females) and at least 2 of the 4 additional components: signs of early hypertension (ie, systolic blood pressure \u2265130 mm Hg or diastolic blood pressure \u226585 mm Hg); elevated triglyceride levels (ie, &amp;gt;150 mg\/dL); elevated fasting glucose level (ie, \u2265100 mg\/dL); or lowered high-density lipoprotein levels (ie, &amp;lt;40 mg\/dL in men and &amp;lt;50 mg\/dL in women). At age 25 years, markers of inflammatory activity (ie, soluble urokinase plasminogen activator receptor [suPAR]) and sleep problems were collected to consider as potential mediators.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In 322 participants (210 [65.2%] female) ages 19 to 21 years, more frequent exposure to racial discrimination was associated with higher suPAR levels (\n b<\/jats:italic>\n \u2009=\u20090.006; 95% CI, 0.001-0.011;\n P<\/jats:italic>\n \u2009=\u2009.01) and more sleep problems at age 25 years (\n b<\/jats:italic>\n \u2009=\u20090.062; 95% CI\n ,<\/jats:italic>\n 0.028-0.097;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) as well as a 9.5% higher risk of MetS diagnosis at age 31 years (odds ratio [OR], 1.10; 95% CI, 1.01-1.20;\n P<\/jats:italic>\n \u2009=\u2009.03). Both suPAR (\n b<\/jats:italic>\n \u2009=\u20090.015; 95% CI, 0.002-0.037) and sleep problems (\n b<\/jats:italic>\n \u2009=\u20090.020; 95% CI, 0.002-0.047) at age 25 years were significant indirect pathways. No significant interactions between sex and discrimination emerged.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This study suggests that racial discrimination in late adolescence is associated with MetS among Black young adults through biobehavioral pathways. Thus, health interventions for MetS in Black adults will need to contend with sleep behaviors and inflammatory intermediaries as well as address and reduce exposure to racial discrimination to narrow disparities and promote health equity.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.5288","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T11:00:49Z","timestamp":1713438049000},"page":"e245288","source":"Crossref","is-referenced-by-count":19,"title":["Racial Discrimination and Metabolic Syndrome in Young Black Adults"],"prefix":"10.1001","volume":"7","author":[{"given":"Nia","family":"Heard-Garris","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois"},{"name":"Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, Illinois"},{"name":"Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children\u2019s Research Institute, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, Illinois"},{"name":"Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyi","family":"Yu","sequence":"additional","affiliation":[{"name":"Center for Family Research, University of Georgia, Athens"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gene","family":"Brody","sequence":"additional","affiliation":[{"name":"Center for Family Research, University of Georgia, Athens"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine B.","family":"Ehrlich","sequence":"additional","affiliation":[{"name":"Center for Family Research, University of Georgia, Athens"},{"name":"Department of Psychology, University of Georgia, Athens"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory E.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"issue":"24","key":"zoi240214r1","doi-asserted-by":"publisher","first-page":"2526","DOI":"10.1001\/jama.2020.4501","article-title":"Trends in the prevalence of metabolic syndrome in the United States, 2011-2016.","volume":"323","author":"Hirode","year":"2020","journal-title":"JAMA"},{"key":"zoi240214r2","doi-asserted-by":"publisher","DOI":"10.5888\/pcd14.160287","article-title":"Metabolic syndrome prevalence by race\/ethnicity and sex in the United States, National Health and Nutrition Examination Survey, 1988-2012.","volume":"14","author":"Moore","year":"2017","journal-title":"Prev Chronic Dis"},{"key":"zoi240214r3","doi-asserted-by":"publisher","year":"2009","journal-title":"Circulation","DOI":"10.1161\/CIRCULATIONAHA.109.192644"},{"issue":"9468","key":"zoi240214r4","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.1016\/S0140-6736(05)66378-7","article-title":"The metabolic syndrome.","volume":"365","author":"Eckel","year":"2005","journal-title":"Lancet"},{"issue":"2","key":"zoi240214r5","doi-asserted-by":"publisher","first-page":"786","DOI":"10.3390\/ijms23020786","article-title":"Metabolic syndrome: updates on pathophysiology and management in 2021.","volume":"23","author":"Fahed","year":"2022","journal-title":"Int J Mol Sci"},{"key":"zoi240214r7","doi-asserted-by":"publisher","author":"Agbonlahor","journal-title":"J Racial Ethn Health Disparities","DOI":"10.1007\/s40615-023-01561-1"},{"issue":"1","key":"zoi240214r8","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1002\/imhj.2019.40.issue-1","article-title":"Considering the role of early discrimination experiences and the parent-child relationship in the development of disruptive behaviors in adolescence.","volume":"40","author":"Savell","year":"2019","journal-title":"Infant Ment Health J"},{"issue":"7","key":"zoi240214r9","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1080\/13557858.2019.1613517","article-title":"Developmental timing of initial racial discrimination exposure is associated with cardiovascular health conditions in adulthood.","volume":"26","author":"Cuevas","year":"2021","journal-title":"Ethn Health"},{"issue":"2","key":"zoi240214r10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-1765","article-title":"The impact of racism on child and adolescent health.","volume":"144","author":"Trent","year":"2019","journal-title":"Pediatrics"},{"key":"zoi240214r11","doi-asserted-by":"publisher","DOI":"10.1016\/j.appdev.2019.101068","article-title":"Daily multidimensional racial discrimination among Black US American adolescents.","volume":"66","author":"English","year":"2020","journal-title":"J Appl Dev Psychol"},{"issue":"5","key":"zoi240214r12","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1037\/a0028847","article-title":"Cumulative socioeconomic status risk, allostatic load, and adjustment: a prospective latent profile analysis with contextual and genetic protective factors.","volume":"49","author":"Brody","year":"2013","journal-title":"Dev Psychol"},{"issue":"7624","key":"zoi240214r13","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"335","author":"von Elm","year":"2007","journal-title":"BMJ"},{"issue":"2","key":"zoi240214r14","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1177\/00957984960222002","article-title":"The schedule of racist events: a measure of racial discrimination and a study of its negative physical and mental health consequences.","volume":"22","author":"Landrine","year":"1996","journal-title":"J Black Psychol"},{"key":"zoi240214r15","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.socscimed.2012.11.031","article-title":"A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people.","volume":"95","author":"Priest","year":"2013","journal-title":"Soc Sci Med"},{"issue":"2","key":"zoi240214r17","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1016\/j.bpsgos.2022.02.008","article-title":"Discrimination and inflammation in adolescents of color.","volume":"3","author":"Chen","year":"2022","journal-title":"Biol Psychiatry Glob Open Sci"},{"key":"zoi240214r18","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1016\/j.ijcard.2015.03.041","article-title":"Soluble urokinase plasminogen activator receptor as a prognostic marker of all-cause and cardiovascular mortality in a Black population.","volume":"184","author":"Botha","year":"2015","journal-title":"Int J Cardiol"},{"issue":"9","key":"zoi240214r19","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.008194","article-title":"Predicting mortality in African Americans with type 2 diabetes mellitus: soluble urokinase plasminogen activator receptor, coronary artery calcium, and high-sensitivity C-reactive protein.","volume":"7","author":"Hayek","year":"2018","journal-title":"J Am Heart Assoc"},{"issue":"7","key":"zoi240214r20","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1210\/er.2008-0024","article-title":"The metabolic syndrome.","volume":"29","author":"Cornier","year":"2008","journal-title":"Endocr Rev"},{"issue":"1","key":"zoi240214r21","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1080\/00273170701341316","article-title":"Addressing moderated mediation hypotheses: theory, methods, and prescriptions.","volume":"42","author":"Preacher","year":"2007","journal-title":"Multivariate Behav Res"},{"issue":"1","key":"zoi240214r23","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1097\/PSY.0000000000000516","article-title":"Everyday discrimination and metabolic syndrome incidence in a racially\/ethnically diverse sample: study of women\u2019s health across the nation.","volume":"80","author":"Beatty Moody","year":"2018","journal-title":"Psychosom Med"},{"issue":"1","key":"zoi240214r24","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1097\/PSY.0000000000000350","article-title":"Perceived ethnic discrimination and the metabolic syndrome in ethnic minority groups: the healthy life in an urban setting study.","volume":"79","author":"Ikram","year":"2017","journal-title":"Psychosom Med"},{"issue":"11","key":"zoi240214r25","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1136\/archdischild-2020-318875","article-title":"Racial discrimination and socioemotional and sleep problems in a cross-sectional survey of Australian school students.","volume":"105","author":"Priest","year":"2020","journal-title":"Arch Dis Child"},{"issue":"2","key":"zoi240214r26","doi-asserted-by":"publisher","first-page":"477","DOI":"10.5665\/sleep.5468","article-title":"Racial discrimination and ethnic disparities in sleep disturbance: the 2002\/03 New Zealand Health Survey.","volume":"39","author":"Paine","year":"2016","journal-title":"Sleep"},{"issue":"1","key":"zoi240214r27","doi-asserted-by":"publisher","first-page":"147","DOI":"10.5665\/sleep.3326","article-title":"Discrimination, other psychosocial stressors, and self-reported sleep duration and difficulties.","volume":"37","author":"Slopen","year":"2014","journal-title":"Sleep"},{"key":"zoi240214r28","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.sleep.2015.01.012","article-title":"Discrimination and sleep: a systematic review.","volume":"18","author":"Slopen","year":"2016","journal-title":"Sleep Med"},{"issue":"5","key":"zoi240214r29","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1038\/nrendo.2009.23","article-title":"Effects of poor and short sleep on glucose metabolism and obesity risk.","volume":"5","author":"Spiegel","year":"2009","journal-title":"Nat Rev Endocrinol"},{"issue":"6","key":"zoi240214r30","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsy057","article-title":"Agreement between self-reported and objectively measured sleep duration among White, Black, Hispanic, and Chinese adults in the United States: Multi-Ethnic Study of Atherosclerosis.","volume":"41","author":"Jackson","year":"2018","journal-title":"Sleep"},{"key":"zoi240214r22","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach","author":"Hayes","year":"2022","edition":"3rd ed"},{"key":"zoi240214r6","unstructured":"National Heart, Lung, and Blood Institute. Metabolic syndrome\u2014causes and risk factors. Published May 18, 2022. Accessed July 1, 2023. https:\/\/www.nhlbi.nih.gov\/health\/metabolic-syndrome\/causes"},{"key":"zoi240214r16","doi-asserted-by":"crossref","unstructured":"Stewart? A, Sherbourne? CD, eds. Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Duke University Press; 1992. Accessed July 28, 2023. https:\/\/www.rand.org\/pubs\/commercial_books\/CB361.html","DOI":"10.7249\/CB361"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2817815\/heardgarris_2024_oi_240214_1712855441.57586.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T11:00:53Z","timestamp":1713438053000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2817815"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,18]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.5288","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,18]]}}}