Predictors of Nephropathy in Type 2 Diabetes

2 型糖尿病肾病的预测因子

• 批准号: 7459007
• 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 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7459007
• 关键词: Accounting; Affect; Albuminuria; Alcohol consumption; Angiotensins; Antioxidants; Award; Biological Markers; Blindness; Blood; Blood Vessels; Blood specimen; C-reactive protein; Cardiovascular Diseases; Carotene; Cholesterol; Clinical; Collection; Coronary; Coronary heart disease; Creatinine; Development; Diabetes Mellitus; Diabetic Nephropathy; Diagnosis; Dialysis patients; Diet; Dietary intake; Doctor of Medicine; Doctor of Philosophy; End stage renal failure; Epidemiologic Methods; Epidemiologist; Faculty; Fatty acid glycerol esters; Fiber; Foundations; Functional disorder; Future; Glomerular Filtration Rate; High Density Lipoproteins; Hospitals; Hyperlipidemia; Hypertension; Inflammatory; Injury; Intake; Kidney; Kidney Diseases; Life Style; Link; Lipids; Low-Density Lipoproteins; Master of Public Health; Measures; Medicine; Microalbuminuria; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Nurses' Health Study; Obesity; Participant; Personal Satisfaction; Pharmaceutical Preparations; Physical activity; Plasma; Play; Protein C; Proteins; Rate; Regression Analysis; Renal function; Reporting; Research; Research Personnel; Risk; Risk Factors; Role; Sampling; Scientist; Serum; Smoke; Specimen; Supplementation; Time; Training; Triglycerides; United States; Unsaturated Fats; Urine; Vascular Proliferation; Vitamin A; Vitamins; Woman; blood glucose regulation; career; cigarette smoking; cohort; diabetic; experience; follow-up; instructor; medical schools; mortality; nutritional epidemiology; prospective; saturated fat; type I diabetic; Accounting; Affect; Albuminuria; Alcohol consumption; Angiotensins; Antioxidants; Award; Biological Markers; Blindness; Blood; Blood Vessels; Blood specimen; C-reactive protein; Cardiovascular Diseases; Carotene; Cholesterol; Clinical; Collection; Coronary; Coronary heart disease; Creatinine; Development; Diabetes Mellitus; Diabetic Nephropathy; Diagnosis; Dialysis patients; Diet; Dietary intake; Doctor of Medicine; Doctor of Philosophy; End stage renal failure; Epidemiologic Methods; Epidemiologist; Faculty; Fatty acid glycerol esters; Fiber; Foundations; Functional disorder; Future; Glomerular Filtration Rate; High Density Lipoproteins; Hospitals; Hyperlipidemia; Hypertension; Inflammatory; Injury; Intake; Kidney; Kidney Diseases; Life Style; Link; Lipids; Low-Density Lipoproteins; Master of Public Health; Measures; Medicine; Microalbuminuria; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Nurses' Health Study; Obesity; Participant; Personal Satisfaction; Pharmaceutical Preparations; Physical activity; Plasma; Play; Protein C; Proteins; Rate; Regression Analysis; Renal function; Reporting; Research; Research Personnel; Risk; Risk Factors; Role; Sampling; Scientist; Serum; Smoke; Specimen; Supplementation; Time; Training; Triglycerides; United States; Unsaturated Fats; Urine; Vascular Proliferation; Vitamin A; Vitamins; Woman; blood glucose regulation; career; cigarette smoking; cohort; diabetic; experience; follow-up; instructor; medical schools; mortality; nutritional epidemiology; prospective; saturated fat; type I diabetic

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型糖尿病的肾病是最普遍的肾脏疾病之一，是美国终末期肾脏疾病的主要原因，目前的所有透析患者中​​约有50％。尽管已经确定了一些预测糖尿病性肾病的发育和进展，包括高血压，葡萄糖控制不良和吸烟，但潜在的可修改饮食危险因素以及脂质和炎症生物标志物的作用也可能起重要作用。 我们建议研究通过估计的肾小球滤过率（GFR）衡量的蛋白尿的前瞻性危险因素和肾功能的逐渐下降，780名患有2型糖尿病的女性是护士健康研究的参与者。我们假设，通过肾小球内皮微血管功能障碍的机制，饱和脂肪的饮食摄入量更高，脂质的脂肪水平升高与较高的蛋白尿和较低的GFR相关，而较高的非饱和脂肪，纤维，纤维和较高的体育活动水平与蛋白尿素水平较低的饮食摄入更高的饮食摄入相关。 该提案的目的是使用多变量回归分析，调整诸如A1C，高血压，吸烟，肥胖和血管紧张素抑制药物的使用，以识别2型糖尿病中肾病的独立饮食和生物标志物风险因素。 该提案的具体目的是： 特定目的＃1：评估2型糖尿病中可改变的饮食和生活方式因素的关系以及蛋白尿和GFR的变化。 特定目标＃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。 该K08奖的候选人是M.D. Julie Lin，M.P.H.，Brigham and Hospital of Brigham and Hospital的肾脏科医生，也是哈佛医学院的医学教练。在营养流行病学领域领先的领先研究人员的弗兰克·胡（Frank Hu）博士的指导下，她正在寻求进一步的培训和经验。该项目建议将为候选人作为肾脏研究的独立且成功的临床科学家的未来职业提供基础。