Cardiovascular Disease and Diabetic Nephropathy

心血管疾病和糖尿病肾病

基本信息

批准号：
7390376
负责人：
RAJNISH MEHROTRA
金额：
$ 13.38万
依托单位：
LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-04-01 至 2010-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7390376
关键词：
African American Albumins California Cardiovascular Diseases Characteristics Clinical Trials Complications of Diabetes Mellitus Coronary Angiography Country Creatinine Data Development Plans Diabetic Nephropathy Dialysis procedure Disease Outcome Electron Beam Electron Beam Tomography Enrollment Epidemic Ethnic Origin Ethnic group Event Figs - dietary Goals Grant Health Healthcare High Prevalence Hispanics Homocysteine Homocystine Individual Intervention Interview Leptin Measures Medical Mexican Americans Minority Groups Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino Outcome Participant Patients Peripheral Vascular Diseases Physical Dialysis Plasma Population Prevalence Rate Recruitment Activity Research Design Research Personnel Retinal Diseases Risk Risk Factors Role Score Severities Socioeconomic Status Specific qualifier value Telephone Testing Time United States Urine X-Ray Computed Tomography base calcification cardiovascular disorder risk career cohort comparative coronary artery calcification design diabetic ethnic difference ethnic minority population follow-up improved mortality novel programs socioeconomics

African American Albumins California Cardiovascular Diseases Characteristics Clinical Trials Complications of Diabetes Mellitus Coronary Angiography Country Creatinine Data Development Plans Diabetic Nephropathy Dialysis procedure Disease Outcome Electron Beam Electron Beam Tomography Enrollment Epidemic Ethnic Origin Ethnic group Event Figs - dietary Goals Grant Health Healthcare High Prevalence Hispanics Homocysteine Homocystine Individual Intervention Interview Leptin Measures Medical Mexican Americans Minority Groups Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino Outcome Participant Patients Peripheral Vascular Diseases Physical Dialysis Plasma Population Prevalence Rate Recruitment Activity Research Design Research Personnel Retinal Diseases Risk Risk Factors Role Score Severities Socioeconomic Status Specific qualifier value Telephone Testing Time United States Urine X-Ray Computed Tomography base calcification cardiovascular disorder risk career cohort comparative coronary artery calcification design diabetic ethnic difference ethnic minority population follow-up improved mortality novel programs socioeconomics

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项目摘要

DESCRIPTION (provided by applicant): Hispanics are the largest ethnic minority group in the country and MA constitute almost 80% of Hispanics in California. MA have a high prevalence of type 2 diabetes and a higher risk for diabetic nephropathy (DN). Paradoxically, data including our own suggest that CVD burden may be lower in MA than non-Hispanic Whites (NHW). We seek to define the CVD burden (coronary artery calcification, CAC) and its determinants in a high-risk sub-group of non-dialyzed diabetics with DN (125 MA, 125 NHW), in order to test three hypotheses: 1) Among individuals with DN, the CAC scores in MA are lower and progress more slowly, than among NHW; 2) The socioeconomic status (SES) of MA individuals with DN is significantly lower than of NHW; and 3) Among individuals with DN, MA have a lower all-cause and CVD mortality. Ten routinely measured, two additional CVD risk factors (homocysteine, leptin) and three SES variables, pre-specified for primary analyses, will be ascertained at baseline, 12 and 24 months. CAC will be ascertained by electron beam computerized tomography at baseline and 24 months. The relationship of CVD risk factors and SES variables that vary by ethnicity will be tested for their contribution to ethnic differences in CAC. The entire cohort will be followed from enrollment till the end of the grant period to ascertain ethnic differences in all-cause and CVD mortality; a high event rate in this population provides power to test the hypotheses thus proposed. A rigorous plan for complete follow-up is proposed. Thus, this study will define for the first time the comparative atherosclerotic burden in MA and NHW with DN and the potential role of several CVD risk factors. It will test the novel hypothesis that despite medical and SES factors that might increase the risk for CVD mortality in MA, the opposite may be true. Identifying health-care disparities will permit us to design targeted interventions to improve the health of ethnic minorities. Recognition of factors associated with the lower CVD risk among MA or the higher risk among NHW may help develop therapies that may potentially reduce the CVD burden among patients with DN. The applicant has institutional support and a career development plan including obtaining a Masters in Clinical Investigation, to achieve his career goals.

描述（由申请人提供）：西班牙裔是该国最大的少数民族群体，MA占加利福尼亚州西班牙裔的80％。 MA患有2型糖尿病的患病率很高，糖尿病性肾病（DN）的风险更高。矛盾的是，包括我们自己的数据表明，MA中的CVD负担可能低于非西班牙裔白人（NHW）。我们试图定义CVD负担（冠状动脉钙化，CAC）及其在具有DN的非二聚糖糖尿病的高风险子组中的决定因素（125 MA，125 NHW），以测试三个假设：1）在患有DN的个体中，MA的CAC得分较低，在MA中的CAC得分较低，比NHW更慢。 2）具有DN的MA个体的社会经济地位（SES）明显低于NHW； 3）在患有DN的个体中，MA的全原因和CVD死亡率较低。将在基线12和24个月时确定十个常规测量的测量，这是两个额外的CVD风险因素（同型半胱氨酸，瘦素）和三个SES变量，预先指定用于主要分析。 CAC将通过基线和24个月的电子束计算机断层扫描来确定。 CVD风险因素和SES变量因种族而异的关系的关系将经过测试，以表明其对CAC种族差异的贡献。从入学人数到赠款期结束到确定全因和CVD死亡的种族差异；该人群中的高事件率提供了测试所提出的假设的能力。提出了一项严格的计划，以进行完整的随访。因此，这项研究将首次定义MA和NHW中DN的比较动脉粥样硬化负担，以及几种CVD危险因素的潜在作用。它将检验一个新的假设，即尽管医学和SES因素可能会增加MA中CVD死亡率的风险，但情况可能相反。确定医疗保健差异将使我们能够设计有针对性的干预措施以改善少数民族的健康。认识到与MA之间的CVD风险较低或NHW中较高风险相关的因素可能有助于开发疗法，从而有可能减轻DN患者的CVD负担。申请人拥有机构支持和职业发展计划，包括获得临床调查的硕士学位，以实现其职业目标。