Early Life Determinants of Accelerated Pubertal Development in Adolescent Girls

青春期女孩青春期加速发育的早期决定因素

• 批准号: 8443286
• 负责人: Ai Kubo
• 金额: $ 19.7万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8443286
• 关键词: Affect; Age; Anthropometry; Biometry; Birth; Body Composition; Body fat; Breast; California; Cancer Etiology; Central obesity; Child; Childhood; Classification Scheme; Cohort Studies; Colon; Complement; Computerized Medical Record; Data; Databases; Daughter; Development; Doctor of Philosophy; Documentation; Early Intervention; Electronics; Endocrinology; Endometrium; Environment; Estrogens; Event; Exposure to; Fat Body; Female Adolescents; Future; Gestational Diabetes; Goals; Health; Health Planning; Hormones; Human; Hyperglycemia; Infant; Insulin; Insulin Resistance; Intervention; Leptin; Life; Link; Malignant Neoplasms; Mammary Gland Parenchyma; Measures; Mediating; Medical Records; Menarche; Mentors; Mentorship; Metabolic; Metabolic syndrome; Metabolism; Mothers; Obesity; Outcome; Ovary; Participant; Pattern; Perinatal Exposure; Physical activity; Play; Polycystic Ovary Syndrome; Population; Positioning Attribute; Postmenopause; Pregnancy; Premenopause; Prevalence; Prevention strategy; Prospective Studies; Proxy; Puberty; Registries; Reporting; Research; Risk; Risk Factors; Role; Sexual Maturation; Staging; Time; Time Factors; Time Study; Training; United States; Variant; Visit; Vulnerable Populations; Weight Gain; Woman; base; cancer epidemiology; cancer prevention; cancer risk; career; cohort; design; early onset; experience; girls; glucose metabolism; glucose tolerance; health disparity; high risk; indexing; innovation; intergenerational; malignant breast neoplasm; mammary gland development; member; modifiable risk; multidisciplinary; nutrition; obesity in children; offspring; postnatal; prenatal; prevent; programs; pubertal timing; racial and ethnic; racial/ethnic difference; reproductive; responsible research conduct; skills; transmission process; trend

DESCRIPTION (provided by applicant): Dr. Kubo's long-term career goal is to understand early-life determinants of cancer risk factors that relate to obesity and metabolic dysregulation, and to identify high-risk sub-populations that can benefit from early intervention strategies. Her primary research aim is to examine whether factors such as intrauterine exposure to maternal gestational diabetes (GDM), excessive gestational weight gain, obesity, and rapid infant weight gain increase the risk of accelerated pubertal onset in adolescent girls, an important breast and reproductive cancer risk factor. Her secondary aim is to explore the causes of the observed racial/ethnic differences in timing of puberty. No previous studies have examined these associations. These research goals will take advantage of electronic health data that are available in Kaiser Permanente Northern California (KPNC), a large integrated health plan that covers about 450,000 girls. Two specific approaches are proposed: 1. Linkage of mothers' and daughters' electronic health data in an on-going prospective study of predictors of sexual maturation in adolescent girls (U01 ES/CA019435) (Study 1); and, 2. Establishment of a new cohort of 20,000 multiethnic mother-daughter pairs using the electronic databases within KPNC (Study 2). Study 1 will utilize data from the CYGNET study (PI: Lawrence H. Kushi, ScD), which has been following 444 girls annually since 2005 with extensive information on pubertal development and anthropometric measures. The KPNC GDM and Pregnancy Glucose Tolerance Registry (Director: Assiamira Ferrara, MD, PhD) will be linked to the CYGNET data to accomplish study 1. In addition, the Registry will be used to establish a new cohort of mother-daughter pairs. This will allow Dr. Kubo gain experience and skills in establishing and follow a cohort based on KPNC electronic medical record data, and to explore racial/ethnic differences in pubertal onset. Electronic documentation of Tanner stage (an established five-stage classification scheme to assess pubertal development) from routine pediatric visits has recently been implemented at KPNC, and this availability on a large and diverse pediatric population makes this study unique and innovative. The candidate's research goals will be complemented with formal, mentored training through coursework and tailored tutorials in pediatric endocrinology, intergenerational transmission of metabolic dysregulation, advanced biostatistics, cancer prevention and health disparities, and responsible conduct of research. KPNC's Division of Research is an ideal environment for the proposed training because it provides unique and extensive electronic databases, access to data from a large, multiethnic membership, and internationally-recognized multidisciplinary experts. The planned scientific training and mentorship will build on the candidate's previous training in nutrition and cancer epidemiology, and uniquely position her to attain her goals. The proposed studies will provide crucial skills in establishing a new cohort, providing a platform for Dr. Kubo to develop successful R01 research to further elucidate early life determinants of pubertal onset and other cancer risk factors.

描述（由申请人提供）：Kubo博士的长期职业目标是了解与肥胖和代谢失调相关的癌症风险因素的早期决定因素，并确定可以从早期干预策略中受益的高风险亚种群。她的主要研究目的是检查诸如宫内妊娠糖尿病（GDM）之类的因素是否是否会增加妊娠体重增加，肥胖和快速婴儿体重增加的因素是否会增加青春期女孩加速青春期发作的风险，这是一个重要的乳腺癌和生殖性癌症风险因素。她的次要目的是探讨青春期时机上观察到的种族/种族差异的原因。以前没有研究检查这些关联。这些研究目标将利用Kaiser Permanente North California（KPNC）可用的电子健康数据，这是一项庞大的综合健康计划，覆盖了约450,000名女孩。提出了两种具体方法：1。在对青少年女孩的性成熟预测指向的前瞻性研究中，母亲和女儿的电子健康数据的联系（U01 ES/CA019435）（研究1）；以及2。建立新的队列，由KPNC中的电子数据库建立20,000个多种族的母女对（研究2）。研究1将利用Cygnet研究（PI：Lawrence H. Kushi，SCD）中的数据，该数据自2005年以来每年遵循444名女孩，并提供有关青春期发展和人体测量指标的广泛信息。 KPNC GDM和妊娠葡萄糖耐量注册表（主任：Assiamira Ferrara，MD，PhD）将与Cygnet数据联系起来，以完成研究1。此外，该注册将用于建立新的母女对。这将允许Kubo博士在建立和遵循基于KPNC电子病历数据的队列方面获得经验和技能，并探索青春期发作的种族/种族差异。最近在KPNC实施了Tanner阶段的电子文献（一种既定的五阶段分类计划，以评估常规的儿科访问），并且在大型多样化的儿科人群中的这种可用性使这项研究使得这项研究变得独特而创新。候选人的研究目标将通过课程工作以及小儿内分泌学，代谢失调，先进的生物统计学，预防癌症和健康差异以及负责任的研究的正式指导培训以及量身定制的教程。 KPNC的研究部门是拟议培训的理想环境，因为它提供了独特而广泛的电子数据库，从大型多民族会员资格中获取数据以及国际认可的多学科专家。计划中的科学培训和指导将建立在候选人以前在营养和癌症流行病学方面的培训，并独特地定位她以实现自己的目标。拟议的研究将在建立新的队列方面提供至关重要的技能，为Kubo博士提供了一个成功的R01研究的平台，以进一步阐明青春期发作和其他癌症危险因素的早期生命决定因素。