Epidemiology of Diabetes Complications (EDC) Phase II: renewal

糖尿病并发症流行病学 (EDC) 第二阶段：更新

基本信息

批准号：
8004724
负责人：
TREVOR J. ORCHARD
金额：
$ 1.58万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-12-23 至 2010-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8004724
关键词：
Achievement Address Advanced Glycosylation End Products Affect Age Antioxidants Binding Blood Glucose Blood Glucose Self-Monitoring Blood Vessels Brain Cardiology Cardiovascular system Centers for Disease Control and Prevention (U.S.)Childhood Clinic Clinical Collaborations Complex Complication Complications of Diabetes Mellitus Coronary Arteriosclerosis Coronary heart disease Country Creatinine clearance measurement Data Defense Mechanisms Development Devices Diabetes Mellitus Diabetes prevention Diagnosis Disease Documentation Employee Strikes Epidemiology Event Exposure to Fluorescence Fluorescence Spectrometry Follow-Up Studies Funding General Population Genotype Glomerular Filtration Rate Glycosylated hemoglobin A Grant Haptoglobins Health Healthcare Hemoglobin Hemoglobin concentration result Immune response Impaired Renal Function Incidence Individual Inflammatory Insulin Insulin Resistance Insulin-Dependent Diabetes Mellitus Insurance Insurance Carriers Investigation Kidney Diseases Knowledge Life Expectancy Life Insurance Magnetic Resonance Imaging Measurement Measures Mediator of activation protein Menopausal Status Menopause Modeling Morbidity - disease rate Natural History Nested Case-Control Study Neuropathy Non-Insulin-Dependent Diabetes Mellitus Participant Pathogenesis Patients Pattern Pediatric Hospitals Peer Review Phase Population Study Postmenopause Pregnancy Pregnancy loss Prevalence Prevention approach Progress Reports Proteomics Public Health Publications Recording of previous events Registries Reporting Research Research Infrastructure Research Personnel Risk Risk Estimate Risk Factors Risk Marker Role Self Care Series Sister Skin Specimen Stress Surveys Testing Time Variant Women&apos s Health adipokines adiponectin age effect base calcification cohort coronary artery calcification cytokine disability follow-up genetic analysis high risk improved insight instrument insulin dependent diabetes mellitus onset mortality novel strategies phase 2 study prospective public health relevance response stressor success urinary

项目摘要

DESCRIPTION (provided by applicant): Unlike type 2 diabetes, where prevention is possible, type 1 diabetes is currently neither preventable nor curable and its incidence continues to rise approximately 3% per year. Thus, the continuing investigation of type 1 diabetes complications remains imperative. The Epidemiology of Diabetes Complications (EDC) study has examined the prevalence and incidence of and risk factors contributing to the diabetes complications for 20 years. The study population is a well defined cohort of childhood onset type 1 diabetes identified from the Children's Hospital of Pittsburgh Registry (diagnosis: 1950-80). All 658 participants attending a clinical exam at study entry (1986-88) have been subsequently followed for up to 20 years, leading to over 114 peer reviewed publications. A number of striking preliminary observations made during the last phase of the study have given rise to questions and hypotheses this renewal aims to address. These include the increasingly complex interaction between various pro- and anti-glycoxidative and inflammatory cytokines, as well as the rapidly changing natural history of complications which provides further insight into the interrelationships of, and specific risk factors for, complications, and renders historic data outdated for health care and insurance purposes. The current application, therefore, focuses on further assessment of complication development for a total follow up period of 25 years, thus allowing reasonably stable estimates of complication development over 40 years duration of childhood onset type 1 diabetes. This gives the opportunity to document morbidity risk and to estimate life expectancy in the modern era, i.e. for those diagnosed in 1965-80 and who have had more than half their diabetes duration since the availability of HbA1c testing and self monitoring of blood glucose. The roles of glycemic, oxidative and inflammatory stress, and the host's responses they invoke, on complication development will be another major focus along with women's health issues and continuing a number of collaborations. Finally, we will evaluate skin advanced glycosylation end products using a new instrument and how they relate to complication risk. This will be facilitated by continuing the annual surveys and, at 25 years of follow up, a full examination. PUBLIC HEALTH RELEVANCE: The significance of this application lies in the ability to provide, in a large type 1 diabetes cohort, documentation of morbidity risk and estimates of life expectancy in the modern era of HbA1c testing and self monitoring of blood glucose, whereas the availability of stored specimen offers the opportunity to address the role of stress (glycemic, oxidative and/or inflammatory) and the host's response it provokes, in the pathogenesis of vascular complications. This application also addresses women's health issues and evaluates new instruments in their ability to predict complication risk. As currently type 1 diabetes is neither preventable nor curable, the continuing investigation of its complications remains imperative and the present study may both further our knowledge of the natural history of complications and also point to novel approaches to prevention and management.

描述（由申请人提供）：与2型糖尿病不同，在可能的情况下，1型糖尿病目前既无法预防也无法治愈，并且其发病率每年继续上升约3％。因此，对1型糖尿病并发症的持续研究仍然必须进行。糖尿病并发症（EDC）研究的流行病学研究了20年来导致糖尿病并发症的危险和危险因素的患病率和发生率和危险因素。研究人群是从匹兹堡登记处确定的1型糖尿病的童年发病群体定义明确（诊断：1950-80）。所有658名参加临床考试在研究条目（1986-88）的参与者随后遵循了20年，导致了超过114个同行评审的出版物。在研究的最后阶段进行了许多引人注目的初步观察，这引起了问题和假设，这种续签旨在解决。其中包括各种促和抗糖性和炎症性细胞因子之间日益复杂的相互作用，以及并发症的迅速变化的自然历史，这些自然病史将进一步深入了解并发症，并发症的特定风险因素，以及使历史数据的历史数据超过了医疗保健和保险目的。因此，当前的应用集中在25年的总随访期内进一步评估并发症发育，从而可以在40年的儿童期1型糖尿病持续时间内对并发症发育的合理估计。这有机会记录发病率的风险并估计现代时代的预期寿命，即1965 - 80年被诊断出的人，并且自HBA1C测试和对血糖的自我监测以来，他们的糖尿病持续时间超过一半以上。血糖，氧化和炎症性压力以及宿主的反应在并发症发展中的作用将是妇女的健康问题以及继续进行许多合作的另一个重点。最后，我们将使用一种新仪器以及它们与并发症风险的关系来评估皮肤先进的糖基化终端产品。这将通过继续年度调查来促进，并在25年的随访中进行全面检查。公共卫生相关性：该应用的重要性在于能够以大型1型糖尿病队列提供发病率风险的文档，并在现代HBA1C测试和对血糖的自我监测中的预期寿命估计以及预期的寿命估计，而储存的标本的可用性可应对压力（或氧化）的作用（或氧化不足）的作用（氧化和/氧化血管并发症的发病机理。该应用程序还解决了妇女的健康问题，并评估了他们预测并发症风险的能力的新工具。由于目前1型糖尿病既无法预防，也无法治愈，因此对其并发症的持续研究仍然必须进行，目前的研究可能会进一步进一步了解我们对并发症的自然史的了解，也指出了新颖的预防和管理方法。