INSULIN RESISTANCE IN CHILDHOOD

儿童时期的胰岛素抵抗

• 批准号: 6636731
• 负责人: SILVA A ARSLANIAN
• 金额: $ 8.47万
• 依托单位: CHILDREN'S HOSP PITTSBURGH/UPMC HLTH SYS
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-05-01 至 2005-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6636731
• 关键词: African American; acanthosis nigricans; adolescence (12-20); adrenal disorder; adrenocorticotropic hormone; caucasian American; clinical research; dihydrotestosterone; disease /disorder proneness /risk; glucose clamp technique; hormone regulation /control mechanism; hormone therapy; human subject; human therapy evaluation; hyperinsulinism; insulin sensitivity /resistance; longitudinal human study; middle childhood (6-11); noninsulin dependent diabetes mellitus; obesity; polycystic ovary syndrome; pregnenolone; progesterone; racial /ethnic difference; somatotropin

DESCRIPTION (Adapted from the Applicant's Description) This application is for a Midcareer Investigator Award in Patient-Oriented Research for Silva Arsianian, M.D., Associate Professor of Pediatrics University of Pittsburgh, Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children s Hospital of Pittsburgh. The award will serve two purposes: (1) to assist the principal investigator to further develop her research endeavors in investigating insulin resistance in childhood; and (2) more importantly, to provide her with protected time to mentor the future generation of clinician- scientists in patient-oriented research (POR) by providing state-of-the-art clinical research in the multiple aspects of pediatric metabolism and diabetes. Cardiovascular disease is the leading cause of death in the United States. A growing body of evidence points to insulin resistance and the cardiovascular dysmetabolic syndrome (hyperglycemia, hyperinsulinemia, hyperlipidemia and hypertension) as a major risk factor. Dr. Arsianian's research has focused on investigating insulin resistance in childhood with the objective of early intervention/prevention to improve overall health outcome in adulthood. The principal investigator's POR is to investigate hormonal, metabolic, nutritional and environmental causes of insulin resistance in children. For the K24 award the focus of research will be: (1) to continue to investigate racial (Black/White) differences in insulin sensitivity and metabolic partitioning of fat in an effort to determine childhood risk factors for the higher rates of obesity, Type 2 diabetes and CVD in African-Americans; (2) to assess, longitudinally, the effects of dihydrotestosterone (DHT), a nonaromatizable androgen in prepubertal boys to determine the role of androgen vs growth hormone in insulin resistance of puberty; and (3) to investigate the relationship of hyperinsulinemia and hyperandrogenenua, cross-sectionally and longitudinally, in female children with hyperandrogenisnt The clinical research tools include insulin-glucose clamp experiments, stable isotope methodologies, indirect calorimetry, assessment of body composition and body fat topography, assessment of physical fitness and activity and assessment of free-living energy expenditure. Future directions in POR include: (1) Family- based behavioral lifestyle treatment of pediatric obesity; (2) multi center investigation of the emerging epidemic of obesity-related Type 2 diabetes in children, especially African-American and Latino; (3) development of noninvasive methods, p31 NMR spectroscopy to study muscle energy metabolism in children; (4) intervention/prevention strategies for childhood obesity. Early identification in childhood of precursors of adult morbidity will form the basis to fulfill the objectives of "Healthy People 2000." The mentoring component of this award will insure that the new generation of clinician- scientists will be fully prepared for an academic/investigative career in POR in pediatrics to carry to the next millennium

描述（改编自申请人的描述）此应用程序是 Silva 获得以患者为导向的研究中的职业生涯中期研究员奖 Arsianian，医学博士，匹兹堡大学儿科副教授， 儿科内分泌、代谢和糖尿病科， 匹兹堡儿童医院。该奖项有两个目的：（1） 协助主要研究者进一步开展其研究工作 研究儿童时期的胰岛素抵抗； (2) 更重要的是， 为她提供受保护的时间来指导下一代临床医生- 科学家通过提供最先进的技术进行以患者为导向的研究（POR） 儿科代谢多个方面的临床研究 糖尿病。 心血管疾病是美国的首要死因。一个 越来越多的证据表明胰岛素抵抗和心血管疾病 代谢障碍综合征（高血糖、高胰岛素血症、高脂血症和 高血压）作为主要危险因素。 Arsianian 博士的研究重点是 研究儿童期的胰岛素抵抗，目的是尽早发现胰岛素抵抗 干预/预防以改善成年期的整体健康结果。 主要研究者的 POR 是研究激素、代谢、 儿童胰岛素抵抗的营养和环境原因。为了 K24奖的研究重点将是：（1）继续调查 胰岛素敏感性和代谢的种族（黑人/白人）差异 脂肪的划分，以确定儿童时期的危险因素 非裔美国人肥胖、2 型糖尿病和心血管疾病的发病率较高； (2) 至 纵向评估双氢睾酮 (DHT) 的作用 青春期前男孩的不可芳香化雄激素以确定雄激素的作用 与生长激素在青春期胰岛素抵抗中的关系； (3) 调查 高胰岛素血症和高雄激素血症的关系，横断面和 纵向来看，患有高雄激素血症的女童的临床 研究工具包括胰岛素-葡萄糖钳实验、稳定同位素 方法论、间接量热法、身体成分和身体评估 脂肪分布图、体能和活动评估以及 自由生活的能量消耗。 POR 的未来方向包括： (1) Family- 基于行为生活方式的儿童肥胖治疗； (2)多中心 与肥胖相关的 2 型糖尿病的新流行调查 儿童，尤其是非裔美国人和拉丁裔儿童； (3) 发展 非侵入性方法，p31 NMR 波谱研究肌肉能量代谢 孩子们; (4)儿童肥胖的干预/预防策略。 在儿童期早期识别成人发病的先兆 是实现“人民健康2000”目标的基础。辅导 该奖项的一部分将确保新一代临床医生- 科学家将为 POR 的学术/研究生涯做好充分准备 儿科学将延续到下一个千年