ORAL INFECTION IN DIABETES

糖尿病患者的口腔感染

基本信息

批准号：
7960439
负责人：
LYNNAE Karen MILLAR Sauvage
金额：
$ 7.12万
依托单位：
UNIVERSITY OF HAWAII AT MANOA
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：
2009-07-01 至 2010-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7960439
关键词：
14 year old 6 year old Age Asians Birth Weight Blood Clinic Clinical Research Clinical Trials Communities Computer Retrieval of Information on Scientific Projects Database Data Dental Diabetes Mellitus Enrollment Ethnic group Evaluation Exclusion Criteria Exposure to Faculty Female Funding Future Gestational Age Gestational Diabetes Gingival Overgrowth Glucose tolerance test Goals Grant Hawaii Health House Staffs IGF1 gene IGF2 gene Immunoglobulin M Imprisonment Institution Insulin Resistance Insulin-Like Growth Factor I Insulin-Like Growth Factor II Intervention Language Liquid substance Measures Medical Minority Oral Organism Outcome Pacific Island Americans Pacific Islands Patient Recruitments Patients Periodontal Diseases Periodontal Infection Population Postpartum Period Pregnancy Pregnant Women Premature Birth Prenatal care Private Practice Recruitment Activity Research Research Infrastructure Research Personnel Resources Rheumatic Heart Disease Sampling Screening procedure Source Umbilical Cord Blood United States National Institutes of Health Universities Visit Woman diabetic fetal glycemic control maternal serum microbial alkaline proteinase inhibitor non-diabetic oral infection oral pathogen pregnant prevent sample collection

项目摘要

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. There is a high rate of moderate-severe periodontal disease in pregnant API women compared to mainland USA women. Periodontal infections are associated with preterm birth in both gestational diabetic and non-diabetic pregnant women. Although periodontal infection is associated with gestational diabetes and preterm birth in our population, the relationship between periodontal infection and insulin resistance is unknown. Specific Aim 1: To determine whether maternal periodontal disease is associated with a decrease in the levels of insulin-like growth factor-1 in maternal serum and whether IGF1 suppression is an intermediary variable in the association between maternal periodontal status and glycemic control. Specific Aim 2: To determine whether fetal-placental exposure to maternal oral organisms, as measured by fetal cord blood IgM titers to oral pathogens, is associated with a change in the levels of insulin-like growth factor-2 in maternal serum and/or in fetal cord blood at delivery and whether fetal IgM seropositivity and IGF2 levels are intermediary explanatory variables in the association between the maternal periodontal status, maternal glycemic control and birth weight for gestational age. Specific Aim 3: To establish necessary infrastructure and support to conduct a future longitudinal clinical trial from 16 weeks gestational age until 3 months postpartum. A future trial will last 5 years and enroll 1,400 women. Goals include: 1) Orient community clinics, University of Hawaii faculty private practices, house staff clinics, and private practitioners to the study. 2) Optimize patient recruitment and continuation in the study. 3) Establish biologic sample collection and storage for the following: a) Periodontal plaque and fluid samples at 11-15 weeks, delivery and postpartum, b) maternal blood at 11-15 weeks and 35-38 weeks GA, c) cord blood and placental sample collection, d) glucose tolerance testing. We will be studying Asian and Pacific Island women, as gestational diabetes mellitus (GDM) and type 2 diabetes are significant health problems for this minority ethnic group. Females age 14 and older who are pregnant (11 to 15 weeks gestational age) and whose ethnic background includes Asian or Pacific Islander ancestry, will be enrolled. Exclusion criteria follows: 1) Type 1 or 2 diabetes mellitus, 2) rheumatic heart disease, 3)orthodontia that would prevent periodontal evaluation, 4)excessive gingival overgrowth, 5) subjects less than 14 years of age, 6) incarcerated, 7) language barrier unable to speak or understand English. Patients will be recruited from the University of Hawaii prenatal care clinics. Additionally, private medical and dental practitioners in the community will be notified of the study, and will be able to refer patients from their private offices. Subjects will be seen on 6 different occasions during the study interval: 1) Screening and /enrollment: before visit 1 2) Visit 1: 11-15 weeks gestation 3) Visit 2: 24-28 weeks gestation 4) Visit 3: 35-38 weeks gestation 5) Visit 4: Delivery 6) Visit 5: Postpartum 8-16 weeks Data from this and the subsequent RO1 application will enable us to study the mechanisms underlying gestational diabetes, and potentially enable us to develop interventions to prevent the condition, or optimize maternal and fetal outcomes.

该子项目是利用该技术的众多研究子项目之一资源由 NIH/NCRR 资助的中心拨款提供。子项目和研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金，因此可以在其他 CRISP 条目中表示。列出的机构是对于中心来说，它不一定是研究者的机构。与美国大陆女性相比，API 孕妇中中重度牙周病的发病率较高。牙周感染与妊娠期糖尿病和非糖尿病孕妇的早产有关。尽管牙周感染与我国人群中妊娠糖尿病和早产有关，但牙周感染与胰岛素抵抗之间的关系尚不清楚。具体目标 1：确定母体牙周疾病是否与母体血清中胰岛素样生长因子-1 水平降低相关，以及 IGF1 抑制是否是母体牙周状态与血糖控制之间关联的中介变量。具体目标 2：确定胎儿胎盘暴露于母体口腔微生物（通过胎儿脐带血对口腔病原体的 IgM 滴度测量）是否与母体血清和/或中胰岛素样生长因子 2 水平的变化相关。分娩时胎儿脐带血中的 IgM 血清阳性和 IGF2 水平是否是母体牙周状态、母体血糖控制和胎龄出生体重之间关联的中介解释变量。具体目标 3：建立必要的基础设施和支持，以开展未来从胎龄 16 周到产后 3 个月的纵向临床试验。未来的试验将持续 5 年并招募 1,400 名女性。目标包括： 1) 引导社区诊所、夏威夷大学教职员工私人诊所、内部员工诊所和私人医生参与研究。 2) 优化研究中的患者招募和继续。 3) 建立以下生物样本采集和储存：a) 11-15 周、分娩和产后的牙周菌斑和液体样本，b) GA 11-15 周和 35-38 周的母血，c) 脐带血和胎盘样本采集，d) 葡萄糖耐量测试。我们将研究亚洲和太平洋岛屿女性，因为妊娠糖尿病 (GDM) 和 2 型糖尿病是这个少数族裔群体的严重健康问题。年龄 14 岁及以上、怀孕（孕龄 11 至 15 周）且种族背景包括亚洲或太平洋岛民血统的女性将被纳入。排除标准如下：1) 1 型或 2 型糖尿病，2) 风湿性心脏病，3) 会妨碍牙周评估的正畸，4) 牙龈过度生长，5) 小于 14 岁的受试者，6) 被监禁，7)语言障碍无法说或听懂英语。患者将从夏威夷大学产前护理诊所招募。此外，社区的私人医生和牙科医生将收到有关这项研究的通知，并能够从他们的私人办公室转诊患者。在研究期间，受试者将在 6 个不同的场合出现： 1) 筛选和/注册：访视前 1 2) 访视 1：妊娠 11-15 周 3) 第 2 次访视：妊娠 24-28 周 4) 第 3 次访视：妊娠 35-38 周 5) 拜访4：送货 6) 第 5 次访视：产后 8-16 周来自此和随后的 RO1 应用的数据将使我们能够研究妊娠糖尿病的机制，并有可能使我们能够制定干预措施来预防这种情况，或优化母亲和胎儿的结局。