Predictors of Nephropathy in Type 2 Diabetes

2 型糖尿病肾病的预测因素

• 批准号: 6942960
• 负责人: JULIE LIN
• 金额: $ 13.39万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6942960
• 关键词: albuminuria; alcoholic beverage consumption; antioxidants; biomarker; blood lipid; clinical research; diabetic nephropathy; dietary fiber; dietary lipid; dietary proteins; disease /disorder proneness /risk; glomerular filtration rate; high density lipoproteins; human subject; kidney function; lifestyle; noninsulin dependent diabetes mellitus; nutrient intake activity; questionnaires; renal glomerulus; saturated fatty acids; statistics /biometry; unsaturated fatty acids

DESCRIPTION (provided by applicant): Nephropathy from Type 2 diabetes mellitus is one of the most prevalant kidney diseases and is the leading cause of end-stage renal disease in the United States, accounting or approximately 50% of all dialysis patients currently. Although some predictors for the development and progression of diabetic nephropathy have been identified, including hypertension, poor glucose control, and cigarette smoking, the role of potential modifiable dietary risk factors, as well as lipid and inflammatory biomarkers, may also play important roles. We propose to study prospectively risk factors for albuminuria and progressive decline in renal function as measured by estimated glomerular filtration rate (GFR) 780 women with Type 2 diabetes who are participants in the Nurses' Health Study. We hypothesize that higher dietary intake of saturated fats and elevated serum levels of lipids are associated with higher levels of albuminuria and lower GFR through a mechanism of glomerular endothelial microvascular dysfunction, whereas higher dietary intake of unsaturated fats, fiber, and higher levels of physical activity are associated with lower levels of albuminuria and higher GFR. The objective of this proposal is to use multivariable regression analysis, adjusting for such factors as A1C, hypertension, smoking, obesity, and angiotensin-inhibition medication use, to identify independent dietary and biomarker risk factors for nephropathy in Type 2 diabetes. The specific aims of this proposal are: Specific Aim #1: Assess the relation of modifiable dietary and lifestyle factors and change in albuminuria and GFR in Type 2 diabetes. Specific Aim #2: Assess the relation of lipid and inflammatory biomarkers and change in albuminuria and GFR in Type 2 diabetes. The candidate for this K08 award is Julie Lin, M.D., M.P.H., a nephrologist on the faculty of the Brigham and Women's Hospital and an Instructor in Medicine at Harvard Medical School. She is seeking further training and experience in advanced epidemiologic methods under the guidance of Gary Curhan, M.D., a well-known renal epidemiologist, and Frank Hu, M.D., Ph.D., a leading investigator in the field of nutritional epidemiology. This project proposal will provide the foundation for the candidate's future career as an independent and successful clinical scientist in renal research.

描述（由申请人提供）： 2 型糖尿病肾病是最常见的肾脏疾病之一，也是美国终末期肾病的主要原因，约占目前所有透析患者的 50%。尽管已经确定了糖尿病肾病发生和进展的一些预测因素，包括高血压、血糖控制不良和吸烟，但潜在的可改变饮食危险因素以及脂质和炎症生物标志物也可能发挥重要作用。 我们建议对参与护士健康研究的 780 名患有 2 型糖尿病的女性进行前瞻性研究，通过估计肾小球滤过率 (GFR) 来测量蛋白尿和肾功能进行性下降的危险因素。我们假设，通过肾小球内皮微血管功能障碍的机制，较高的饱和脂肪饮食摄入量和较高的血清脂质水平与较高水平的蛋白尿和较低的肾小球滤过率相关，而较高的不饱和脂肪、纤维饮食摄入量和较高的体力活动水平与较低水平的蛋白尿和较高的 GFR 相关。 该提案的目的是利用多变量回归分析，调整 A1C、高血压、吸烟、肥胖和血管紧张素抑制药物使用等因素，以确定 2 型糖尿病肾病的独立饮食和生物标志物危险因素。 该提案的具体目标是： 具体目标#1：评估 2 型糖尿病中可改变的饮食和生活方式因素与蛋白尿和 GFR 变化之间的关系。 具体目标#2：评估 2 型糖尿病中脂质和炎症生物标志物的关系以及蛋白尿和 GFR 的变化。 K08 奖的候选人是 Julie Lin，医学博士、公共卫生硕士，她是布莱根妇女医院的肾脏病专家，也是哈佛医学院的医学讲师。她正在著名肾脏流行病学家 Gary Curhan 医学博士和营养流行病学领域领先研究者 Frank Hu 医学博士、哲学博士的指导下寻求高级流行病学方法的进一步培训和经验。该项目提案将为候选人未来作为独立且成功的肾脏研究临床科学家的职业生涯奠定基础。