Eact Carolina Univ. Bariatric Surgery Clinical Center

卡罗莱纳大学

基本信息

批准号：
7285956
负责人：
WALTER Julius PORIES
金额：
$ 37.25万
依托单位：
EAST CAROLINA UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-09-30 至 2009-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7285956
关键词：
Admission activity Adverse event African American American Appendix Area Asthma Bariatrics Basic Science Behavioral Behavioral Research Biliopancreatic Diversion Body Composition Body Weight decreased Body mass index Bypass Caring Caucasians Caucasoid Race Charge Chronic Disease Clinical Clinical Research Clinical Trials Collaborations Collection Communicable Diseases Communities Consensus Consent Credentialing Data Data Quality Data Storage and Retrieval Databases Development Disease remission Distal Education Emotional disorder Ethical Issues Ethics Exercise Fostering Funding Gastric Bypass Gastrointestinal tract structure Gastroplasty Gender Greenville Gastric Bypass Guidelines Hormones Human Hypertension Incidence Individual Informed Consent Institution Insulin Insulin Resistance Investigation Leadership Length of Stay Life Lipids Lipolysis Logic Malnutrition Measures Medical Metabolic Metabolism Methods Molecular Morbid Obesity Morbidity - disease rate National Institute of Diabetes and Digestive and Kidney Diseases Non-Insulin-Dependent Diabetes Mellitus Obesity Operating Rooms Operative Surgical Procedures Outcome Patients Pickwickian Syndrome Predisposition Procedures Process Protocols documentation Pseudotumor Cerebri Quality of life Rate Research Research Ethics Resources Safety Silastic Specific qualifier value Standardization Standards of Weights and Measures Stomach Stomach Part Stress Urinary Incontinence Structure Surface Today United States Universities Variant Waiting Lists Woman Work bariatric surgery base concept cost database design economic outcome family management follow-up ghrelin human subject insulin sensitivity interest mortality oxidation prospective tool

项目摘要

DESCRIPTION (provided by applicant): Obesity, the most prevalent, fatal, chronic disease of the 21st Century, is increasing at a rate seen before only with infectious diseases. Morbid obesity, the most severe form, afflicts 23 million Americans. These individuals are not only limited by their bulk but are sharply compromised by life-endangering co-morbidities. Surgery has proven to be an effective therapy. The Greenville gastric bypass operation (GGB), developed at this institution, produces not only durable weight loss greater than 100 Ibs but also induces full remission of type 2 diabetes in 83 percent of patients, control of hypertension in over half, as well as full reversal of such co-morbidities as asthma, Pickwickian syndrome, stress incontinence, and pseudotumor cerebri. The reproducible reversal of type 2 diabetes in GGB patients is a provocative finding and requires further basic research. However, the GGB, like other bariatric procedures, is associated with serious long-term nutritional deficiencies and, in vulnerable individuals, emotional disorders. Generally, there is no consensus about which of the seven common bariatric procedures should be used. There is also considerable variation in surgical outcomes across the US for the same operation due to a lack of standardization of the surgical care. Thus, bariatric surgery is ripe for a collaborative approach to answering both clinical and basic research issues. Our current center efforts include three major areas: 1. Fostering collaboration within the bariatric surgical community to promote clinical, behavioral, and basic research in morbid obesity and its co-morbidities; 2. Clinical studies of the efficacy, efficiency, and safety of two types of gastric bypass operations with an emphasis on differences in outcomes between African-American and Caucasian women. 3. Basic science studies of insulin action and sensitivity in human subjects prior to and after bariatric surgery. In addition, this application includes three proposals for inter-institutional projects: 1. Comparison of the most commonly performed bariatric operations; 2. the mechanism for increased insulin sensitivity after gastric bypass surgery; and 3. the ethics of the informed consent in bariatric surgery. Because East Carolina University has a productive tradition of interdisciplinary clinical, basic science, and behavioral research in morbid obesity as well as a record of national leadership, we submit this application to become one of the Bariatric Surgery Clinical Centers of the NIDDK.

描述（由申请人提供）：肥胖是 21 世纪最普遍、最致命的慢性疾病，其增长速度之快只有传染病才能见到。病态肥胖是最严重的一种形式，困扰着 2300 万美国人。这些人不仅受到体重的限制，而且还受到危及生命的合并症的严重影响。手术已被证明是一种有效的治疗方法。该机构开发的格林维尔胃绕道手术 (GGB) 不仅能实现超过 100 磅的持久体重减轻，还能使 83% 的患者的 2 型糖尿病完全缓解，一半以上的高血压得到控制，并且完全缓解逆转哮喘、匹克威克综合征、压力性尿失禁和假性脑瘤等合并症。 GGB 患者 2 型糖尿病的可重复逆转是一个具有挑战性的发现，需要进一步的基础研究。然而，与其他减肥手术一样，GGB 与严重的长期营养缺乏有关，对于弱势个体来说，还会导致情绪障碍。一般来说，对于应该使用七种常见的减肥手术中的哪一种并没有达成共识。由于手术护理缺乏标准化，美国各地同一手术的手术结果也存在很大差异。因此，减肥手术采用协作方法来解决临床和基础研究问题的时机已经成熟。我们目前中心的工作包括三个主要领域： 1. 促进减肥外科界的合作，以促进病态肥胖及其并发症的临床、行为和基础研究； 2. 两种胃绕道手术的功效、效率和安全性的临床研究，重点关注非洲裔美国女性和白人女性之间的结果差异。 3. 减肥手术前后人体胰岛素作用和敏感性的基础科学研究。此外，该申请还包括三项机构间项目提案： 1. 最常用减肥手术的比较； 2. 胃绕道手术后胰岛素敏感性增加的机制； 3. 减肥手术知情同意的道德规范。由于东卡罗莱纳大学在病态肥胖方面拥有跨学科临床、基础科学和行为研究的富有成效的传统以及国家领导力的记录，因此我们提交此申请，成为 NIDDK 的减肥手术临床中心之一。