Are Overweight Children with T1DM at Increased Risk of Cardiovascular Disease?

患有 T1DM 的超重儿童患心血管疾病的风险会增加吗？

• 批准号: 7631138
• 负责人: INGRID M LIBMAN
• 金额: $ 13.02万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-06-15 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7631138
• 关键词: Adult; Age; Anthropometry; Area; Atherosclerosis; Blood Pressure; Blood Tests; Body mass index; Cardiovascular Diseases; Carotid Arteries; Center for Translational Science Activities; Central obesity; Child; Childhood; Clinical; Cross-Sectional Studies; DEXA; Data; Development; Development Plans; Diabetes Mellitus; Disease Marker; Dyslipidemias; Endocrinologist; Epidemiology; Euglycemic Clamping; Fasting; Glucose Clamp; Goals; Hour; Hypertension; Immune; Insulin; Insulin Resistance; Insulin-Dependent Diabetes Mellitus; Life; Lipids; Measurement; Measures; Mediating; Mentorship; Metabolic; Metabolic syndrome; Microalbuminuria; Morbidity - disease rate; Obesity; Onset of illness; Overweight; Pediatrics; Physicians; Physiologic pulse; Population; Prevalence; Questionnaires; Recruitment Activity; Research; Research Personnel; Risk; Risk Factors; Risk Marker; Role; Scientist; Surrogate Markers; Syndrome; Techniques; Testing; Thick; Time; Training; Ultrasonography; United States; Universities; Weight; Work; Youth; abstracting; base; cardiovascular disorder risk; cardiovascular risk factor; career development; in vivo; insulin sensitivity; interest; intima media; mortality; obesity in children; patient oriented; patient oriented research; population based; professor; programs

DESCRIPTION (provided by applicant): Dr. Ingrid Libman is a pediatric endocrinologist with previous training in epidemiology who is currently an Assistant Professor in Pediatrics at the University of Pittsburgh. The candidate's long term goal is to become an academic physician and independent clinical scientist expanding her training from the area of population based epidemiology of childhood diabetes mellitus (DM) to patient oriented and interventional research, with particular focus on the impact of obesity on type 1 diabetes mellitus (T1 DM), in particular on the development of cardiovascular disease (CVD). This interest developed during the last years when Dr. Libman identified an increase in the prevalence of obesity in this population, usually considered not to be overweight. The consequences of this increase are currently not known. Under the mentorships of Drs. Silva Arslanian, Dorothy Becker, Ronald LaPorte and Bradley Keller, Dr. Libman proposes a comprehensive career development plan composed of training in the use of the hyperinsulinemic-euglycemic clamp to assess insulin resistance, measurement of early CVD markers such as carotid ultrasonography to measure intima media thickness and pulse wave velocity and carefully selected course work in clinical patient-oriented research. The research plan is a three year cross sectional study of three groups of children: overweight children with T1DM, non-overweight children with T1DM and overweight children with no DM in order to compare early risk markers of CVD. This study will also assess the role of insulin resistance, measured by the use of the hyperinsulinemic-euglycemic clamp technique in the first two groups, and validate an insulin resistance syndrome score, consisting of clinical parameters which could potentially be used in clinical and population-based studies. This study will recruit 120 children between the ages of 12 and 18 years who will attend the Pediatric Clinical Translational Research Center (PCTRC) for 24 hours to undergo questionnaire, body anthropometry, blood pressure, fasting blood tests, whole body DEXA, carotid ultrasonography and in the groups with diabetes, an hyper insulinemic-euglycemic clamp. Objectives of the study are to 1) test the hypothesis that overweight children with T1 DM have more markers of early atherosclerosis compared to those with T1DM who are not overweight and to those equally overweight with no diabetes and this is mediated by factors which constitute the metabolic syndrome and 2) assess the role of insulin resistance. (End of Abstract)

描述（由申请人提供）：Ingrid Libman 博士是一位儿科内分泌学家，曾接受过流行病学培训，目前是匹兹堡大学儿科助理教授。候选人的长期目标是成为一名学术医生和独立临床科学家，将她的培训范围从基于人群的儿童糖尿病 (DM) 流行病学领域扩展到以患者为导向的干预研究，特别关注肥胖对 1 型糖尿病的影响糖尿病（T1 DM），特别是心血管疾病（CVD）的发展。这种兴趣是在过去几年中发展起来的，当时利布曼博士发现这一人群中肥胖症的患病率有所增加，而这些人群通常被认为不是超重。目前尚不清楚这种增加的后果。在博士的指导下。 Silva Arslanian、Dorothy Becker、Ronald LaPorte 和 Bradley Keller、Libman 博士提出了一项全面的职业发展计划，包括使用高胰岛素-正常血糖钳评估胰岛素抵抗的培训、测量早期 CVD 标志物（如颈动脉超声检查来测量内膜）介质厚度和脉搏波速度以及在以患者为导向的临床研究中精心挑选的课程作业。该研究计划是一项为期三年的横断面研究，对象为三组儿童：超重的 T1DM 儿童、非超重的 T1DM 儿童和超重的非糖尿病儿童，以比较 CVD 的早期风险标志物。这项研究还将评估胰岛素抵抗的作用，通过在前两组中使用高胰岛素-正常血糖钳夹技术来测量，并验证胰岛素抵抗综合征评分，包括可能用于临床和人群的临床参数。基础研究。这项研究将招募120名年龄在12岁至18岁之间的儿童，他们将在儿科临床转化研究中心（PCTRC）进行24小时的问卷调查、人体测量、血压、空腹血液检查、全身DEXA、颈动脉超声检查和在糖尿病组中，进行高胰岛素-正常血糖钳夹试验。本研究的目的是 1) 检验以下假设：与未超重的 T1DM 儿童和同样超重但未患糖尿病的儿童相比，患有 T1 DM 的超重儿童具有更多早期动脉粥样硬化标志物，这是由构成代谢性糖尿病的因素介导的。综合征和2）评估胰岛素抵抗的作用。 （摘要完）