A gender and culturally specific approach to reduce NAFLD in Mexican American men

减少墨西哥裔美国男性 NAFLD 的性别和文化特定方法

• 批准号: 10307086
• 负责人: David O. Garcia
• 金额: $ 13.33万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-01-07 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10307086
• 关键词: Adherence; Affect; Alleles; Arizona; Attitude; Behavior; Belief; Body Weight; Body Weight decreased; Body mass index; Categories; Characteristics; Consumption; Counseling; County; Data; Data Set; Development; Diet; Dietary Sugars; Disclosure; Disease; Disease Management; Environment; Evaluation; FDA approved; Fatty acid glycerol esters; Foundations; Frequencies; Gender; Genes; Genetic; Genetic Predisposition to Disease; Genotype; Goals; Guidelines; Health; Health behavior; Hispanic; Incidence; Intervention; Interview; Knowledge; Life Style; Life Style Modification; Literature; Liver; Mentored Research Scientist Development Award; Mentors; Mentorship; Metabolic; Methodology; Mexican Americans; Modeling; Monitor; National Institute on Minority Health and Health Disparities; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Obesity associated cancer; Obesity associated disease; Outcome; Participant; Pathogenicity; Pathway interactions; Pharmacologic Substance; Phenotype; Phospholipase; Physical activity; Play; Population; Positioning Attribute; Precancerous Conditions; Predisposition; Prevention therapy; Primary carcinoma of the liver cells; Proteins; Qualitative Research; Reporting; Research; Research Design; Research Methodology; Resources; Risk; Risk Factors; Role; Severities; Structure; Subgroup; Therapeutic Intervention; Time; Training; Universities; Weight maintenance regimen; Work; behavior change; black men; burden of illness; cancer risk; cardiometabolism; career; carrier status; cohort; design; diabetes prevention program; dietary; disorder risk; elastography; high risk; high risk population; imaging biomarker; improved; intervention delivery; lifestyle intervention; male; men; non-alcoholic fatty liver disease; non-invasive imaging; obese person; patient engagement; physical inactivity; programs; recruit; risk variant; satisfaction; skill acquisition; skills; social culture; statistics; stem; sugar; sweetened beverage; therapeutically effective; therapy design; weight loss intervention

ABSTRACT Effective therapeutic interventions are needed to stem the alarming increases in non-alcoholic fatty liver disease (NAFLD) in Mexican-American men, an understudied population at greater risk for the development of hepatocellular carcinoma (HCC). Primary lifestyle risk factors for NAFLD include physical inactivity and sugar- sweetened beverage consumption, characteristics that are highly evidenced in Mexican-American men. The risk of NAFLD is further increased in Mexican-American men by a greater frequency (up to 55%) of the risk allele at the PNPLA3 (patatin-like phospholipase domain-containing protein) gene. This allele confers a substantially greater susceptibility to NAFLD and HCC. In the absence of FDA-approved pharmaceutical agents, lifestyle modification, including weight loss initiated by improvements in dietary and physical activity behavior, is the recommended therapy for the prevention and treatment of NAFLD. Lifestyle interventions targeting modest weight loss (approximately 5% body weight) have been shown to result in significant reductions in liver fat. However, evidence regarding the effects of a lifestyle intervention designed exclusively for Mexican-American men at greater risk for NAFLD is not currently available. Dr. David Garcia has an excellent foundation in lifestyle interventions that has positioned him well to advance toward his goal of reducing obesity-related disease burden in Mexican-American males. The goal of this NIMHD K01 Mentored Research Scientist Development Award is to provide Dr. Garcia with an in-depth understanding of metabolic and pathogenic pathways and risk factors of obesity-related cancers and related diseases, with a specific focus on NAFLD and HCC in Mexican-American men. He also will gain training in non-invasive imaging biomarkers (e.g., transient elastography) for the evaluation and management of disease state and risk factors. Lastly, he will advance his knowledge and skill development in research methodologies (e.g., quantitative analysis and qualitative inquiry) that informs on the design and tailoring of a culturally-specific study to reduce the burden of NAFLD. With the mentorship of Dr. Cynthia Thomson and Dr. Michael Fallon, co-mentors, and collaborators; for the proposed project Dr. Garcia intends to 1) use an available dataset from the Cameron County Hispanic Cohort (CCHC) to assess risk for NAFLD, including the influence of phenotypic factors (lifestyle behaviors) in Mexican-American men; 2) evaluate the knowledge, attitudes, and beliefs of obesity-related cancer risk, with an emphasis on NAFLD and HCC risk in Mexican-American men; and 3) assess the feasibility, acceptability, and preliminary efficacy of a NAFLD-specific weight loss intervention tailored for Mexican-American men. The training plan and research strategy in this K01 application will afford Dr. Garcia the time, resources, and mentorship necessary to achieve his career goal which is enthusiastically endorsed by University of Arizona leaders and an extremely appropriate and supportive research environment.

抽象的 需要有效的治疗干预措施来阻止非酒精性脂肪肝的惊人增加 墨西哥裔美国男性患有 NAFLD 疾病（NAFLD），这是一个尚未得到充分研究的人群，该人群罹患 NAFLD 的风险更大 肝细胞癌（HCC）。 NAFLD 的主要生活方式风险因素包括缺乏身体活动和糖分 甜饮料的消费，这一特征在墨西哥裔美国男性中得到了充分体现。这 墨西哥裔美国男性患 NAFLD 的风险进一步增加，风险频率更高（高达 55%） PNPLA3（含patatin样磷脂酶结构域的蛋白质）基因的等位基因。该等位基因赋予 对 NAFLD 和 HCC 的易感性显着提高。在没有 FDA 批准的药品的情况下 药物、生活方式改变，包括通过改善饮食和身体活动来减轻体重 行为，是预防和治疗 NAFLD 的推荐疗法。生活方式干预 以适度减轻体重（约体重的 5%）为目标已被证明可以带来显着的效果 肝脏脂肪减少。然而，有关专门设计的生活方式干预措施效果的证据 目前还没有针对 NAFLD 风险较高的墨西哥裔美国男性的研究。大卫·加西亚博士有一个 生活方式干预方面的良好基础使他能够很好地实现他的目标 减少墨西哥裔美国男性与肥胖相关的疾病负担。 NIMHD K01 指导的目标 研究科学家发展奖旨在让加西亚博士对代谢有深入的了解 以及肥胖相关癌症和相关疾病的致病途径和危险因素，特别关注 墨西哥裔美国男性 NAFLD 和 HCC 的研究。他还将接受非侵入性成像生物标志物方面的培训 （例如瞬时弹性成像）用于评估和管理疾病状态和危险因素。最后，他 将促进他在研究方法方面的知识和技能发展（例如定量分析和 定性调查），为特定文化研究的设计和定制提供信息，以减轻 非酒精性脂肪肝。在共同导师和合作者 Cynthia Thomson 博士和 Michael Fallon 博士的指导下； 对于拟议的项目，加西亚博士打算 1) 使用来自卡梅伦县西班牙裔的可用数据集 队列 (CCHC) 评估 NAFLD 风险，包括表型因素（生活方式行为）的影响 墨西哥裔美国男性； 2）评估肥胖相关癌症风险的知识、态度和信念， 强调墨西哥裔美国男性的 NAFLD 和 HCC 风险； 3）评估可行性、可接受性， 以及针对墨西哥裔美国男性的 NAFLD 特定减肥干预措施的初步效果。这 此 K01 应用程序中的培训计划和研究策略将为 Garcia 博士提供时间、资源和 实现他的职业目标所必需的指导，得到了亚利桑那大学的热情支持 领导者和极其合适和支持性的研究环境。