Sleep-Related Determinants of Gestational Diabetes

妊娠期糖尿病的睡眠相关决定因素

基本信息

批准号：
8452659
负责人：
Bilgay Izci Balserak
金额：
$ 9万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-04-03 至 2014-05-15
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8452659
关键词：
Affect Age Award Behavior assessment Biological Markers Blinded Body mass index Cardiovascular Diseases Case-Control Studies Cesarean section Characteristics Child Clinical Investigator Clinical Skills Data Development Discipline Discipline of obstetrics Electroencephalography Evaluation First Pregnancy Trimester Future General Population Gestational Diabetes Goals Health Home environment Hospitals Hyperglycemia Infection Inflammatory Insulin Resistance Interdisciplinary Study Interleukin-6 International Intervention Knowledge Learning Measures Medicine Mentors Metabolic Metabolic syndrome Metabolism Modeling Mothers Napping Neonatal Neonatal Hypoglycemia Non-Insulin-Dependent Diabetes Mellitus Obesity Outcome Pathway interactions Patient Self-Report Pennsylvania Phase Polyhydramnios Polysomnography Population Study Pre-Eclampsia Pregnancy Pregnancy in Diabetics Pregnant Women Premature Labor Prevention Property Questionnaires Race Recruitment Activity Reporting Research Risk Risk Factors Role Sampling Serum Services Sleep Sleep Apnea Syndromes Sleep Disorders Sleep disturbances Slow-Wave Sleep Snoring Techniques Third Pregnancy Trimester Time Training Training Activity Trauma United States University Hospitals Weight Gain Woman Women&apos s Health Wrist actigraphy adverse outcome base behavior measurement blood glucose regulation career cytokine diabetes control diabetes management diaries experience fetal innovation interest modifiable risk new technology novel parity programs receptor

项目摘要

DESCRIPTION (provided by applicant): Sleep disturbances are common during pregnancy. Over a quarter of pregnant women develop sleep- disordered breathing. Many pregnant women experience poor sleep quality and continuity. Growing evidence from studies of the general population shows that sleep-disordered breathing, short sleep duration and poor sleep quality (including reduced slow wave sleep) are independently associated with increased risk of metabolic syndrome, type 2 diabetes and insulin resistance. Preliminary studies in pregnancy have found a similar, analogous relationship between these problems (self-reported sleep-disordered breathing and short sleep duration) and gestational diabetes mellitus (GDM). We have also found that a moderate/severe sleep apnea and daytime napping are both associated with hyperglycemia during pregnancy. Thus, sleep disturbances may constitute a class of novel MODIFIABLE risk factors for GDM. GDM is associated with adverse maternal-fetal outcomes and is also a predictor of type 2 diabetes, cardiovascular disease and obesity in both mother and child. The aims of the proposed study are (1) to evaluate changes in slow wave sleep during pregnancy as well as obtain advanced training (K99 phase) and (2) to investigate the independent association of sleep disturbances and characteristics with gestational diabetes in a case-control study (R00 phase). In the K99 mentored phase, slow wave sleep changes will be determined using archival polysomnography data gathered from pregnant women in their first and third trimesters. During this time, training in actigraphic evaluation of sleep duration and assessment of biomarkers will build upon my prior experience with electroencephalography (EEG) analysis and assessment of behavioral and subjective properties of sleep. In the R00 phase, a case-control study will be conducted to determine the independent association of sleep disturbances and sleep characteristics with GDM, recruiting 140 cases and 280 controls (1:2 match for age, race, parity and body mass index (BMI)) from the obstetrics services at the Hospital of the University of Pennsylvania (HUP) and at the Pennsylvania Hospital (PAH). Data will be collected from home-based polysomnography, sleep diary, wrist actigraphy and questionnaires. For the exploratory aim, serum samples before and after sleep will be collected. A technician blinded to case status and BMI will perform all sleep scoring.

描述（由申请人提供）：睡眠障碍在怀孕期间很常见。超过四分之一的孕妇会出现睡眠不足的呼吸。许多孕妇的睡眠质量和连续性较差。对普通人群的研究的越来越多的证据表明，睡眠障碍，睡眠时间短，睡眠质量较差（包括慢波睡眠减少）与代谢综合征，2型糖尿病和胰岛素抵抗的风险独立相关。怀孕的初步研究发现这些问题（自我报告的睡眠呼吸和短睡眠持续时间）与妊娠糖尿病（GDM）之间存在类似的类似关系。我们还发现，怀孕期间中度/重度睡眠呼吸暂停和白天小睡都与高血糖有关。因此，睡眠障碍可能构成GDM的一类新型可修改风险因素。 GDM与不良的母亲结局有关，也是母亲和儿童中2型糖尿病，心血管疾病和肥胖症的预测指标。拟议研究的目的是（1）评估怀孕期间慢波睡眠的变化，并获得高级训练（K99阶段）和（2）在病例对照研究（R00期）中研究睡眠障碍和特征与妊娠糖尿病的独立关联。在K99指导阶段，将使用从孕妇中收集的第一和第三个三体孕妇收集的档案多聚会数据来确定慢波睡眠的变化。在此期间，对睡眠持续时间和生物标志物评估的积极评估培训将基于我先前对脑电图（EEG）分析（EEG）分析的经验和对睡眠行为和主观特性的评估。在R00阶段，将进行一项病例对照研究，以确定睡眠障碍和睡眠特征与GDM的独立关联，招募140例和280例对照（1：2匹配年龄，种族，种族，平等和体重指数（BMI）（BMI）与宾夕法尼亚大学（Pennsylvania）医院的妇产科服务（HUP）和PENNSSSYIA（PHAN）（PHAN）（PHAN）（PHAN）（PHAN）（PHAN）（PHAN）（PHAN）（PER）（PER）（PER）（PER）（PER）（PER）数据将从基于家庭的多个术语，睡眠日记，腕部行为和问卷调查中收集。对于探索目的，将收集睡眠前后的血清样品。对病例状态视而不见的技术人员，BMI将执行所有睡眠评分。