Clonal hematopoiesis of indeterminate potential (CHIP), the expansion of leukemogenic mutations in white blood cells, has been associated with increased risk of atherosclerotic cardiovascular diseases, cancer, and mortality. We examined the relationship between individual- and neighborhood-level socioeconomic status (SES) and CHIP and evaluated effect modification by interpersonal and intrapersonal resources. The study population included 10,799 postmenopausal women from the Women's Health Initiative without hematologic malignancy or antineoplastic medication use. Individual- and neighborhood (Census tract)-level SES were assessed across several domains including education, income, and occupation, and a neighborhood-level SES summary -score, which captures multiple dimensions of SES, was generated. Interpersonal and intrapersonal resources were self-reports. CHIP was ascertained based on a prespecified list of leukemogenic driver mutations. Weighted logistic regression models adjusted for covariates were used to estimate risk of CHIP as an odds ratio (OR) and 95% confidence interval (95% CI). The interval-scale neighborhood-level SES summary -score was associated with a 3% increased risk of CHIP: OR (95% CI) = 1.03 (1.00–1.05), = .038. Optimism significantly modified that estimate, such that among women with low/medium and high levels of optimism, the corresponding ORs (95% CIs) were 1.03 (1.02–1.04) and 0.95 (0.94–0.96), < .001. Our findings suggest that reduced risk of somatic mutation may represent a biological pathway by which optimism protects contextually advantaged but at-risk women against age-related chronic disease and highlight potential benefits of long-term, positive psychological interventions.

中文翻译：

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与心血管疾病和死亡风险增加相关的个人和社区社会经济状况和体细胞突变：妇女健康倡议的横断面分析

不确定潜能克隆造血（CHIP），即白细胞中白血病突变的扩展，与动脉粥样硬化性心血管疾病、癌症和死亡率的风险增加有关。我们研究了个人和社区层面的社会经济地位 (SES) 与 CHIP 之间的关系，并评估了人际和内部资源的影响修正。研究人群包括来自妇女健康倡议的 10,799 名绝经后妇女，她们没有患有血液恶性肿瘤或没有使用抗肿瘤药物。对个人和社区（人口普查区）层面的 SES 进行了跨教育、收入和职业等多个领域的评估，并生成了涵盖 SES 多个维度的社区层面 SES 总结分数。人际和人际资源是自我报告。 CHIP 是根据预先指定的致白血病驱动突变列表确定的。使用针对协变量调整的加权逻辑回归模型以比值比 (OR) 和 95% 置信区间 (95% CI) 来估计 CHIP 风险。区间尺度邻里级 SES 总结分数与 CHIP 风险增加 3% 相关：OR (95% CI) = 1.03 (1.00–1.05), = .038。乐观情绪显着改变了这一估计，因此在乐观程度低/中和高的女性中，相应的 OR (95% CI) 分别为 1.03 (1.02–1.04) 和 0.95 (0.94–0.96)，< .001。我们的研究结果表明，体细胞突变风险降低可能代表了一种生物学途径，通过这种途径，乐观情绪可以保护处于有利环境但处于危险之中的女性免受与年龄相关的慢性病的侵害，并强调长期积极心理干预的潜在益处。