Diabetes Prevention in the Vitamin D and Omega-3 Trial

维生素 D 和 Omega-3 试验中的糖尿病预防

• 批准号: 8689001
• 负责人: Aruna Das Pradhan
• 金额: $ 43.52万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-15 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8689001
• 关键词: Age; Ancillary Study; Applications Grants; Benefits and Risks; Biological Markers; Boston; Cardiovascular Diseases; Cell physiology; Center for Translational Science Activities; Chicago; Cholecalciferol; Chronic; Clinical; Clinical Sciences; Clinical Trials; Collection; Complement; Data; Databases; Diabetes Mellitus; Diabetes prevention; Diagnosis; Diagnostic; Docosahexaenoic Acids; Dose; Eicosapentaenoic Acid; Enrollment; Equilibrium; European; Evaluation; Food; Funding; General Population; Geographic Locations; Glucose; Glucose tolerance test; Glycosylated Hemoglobin; Glycosylated hemoglobin A; Health Benefit; Homeostasis; Hour; Hypoglycemia; Inflammation; Insulin; Intake; Intervention; Intervention Studies; Link; Marines; Measurement; Measures; Medical Records; Metabolic; Methods; Modeling; No-Observed-Adverse-Effect Level; Non-Insulin-Dependent Diabetes Mellitus; Nutrient; OGTT; Omega-3 Fatty Acids; Pancreas; Parents; Participant; Patient Self-Report; Pharmaceutical Preparations; Physicians; Physiological; Placebos; Population; Prevention; Primary Cancer Prevention; Primary Prevention; Process; Questionnaires; Race; Randomized; Randomized Clinical Trials; Recruitment Activity; Reporting; Research; Research Infrastructure; Risk; Running; Safety; San Francisco; Schedule; Seasons; Site; Skin Pigmentation; Specific qualifier value; Supplementation; Testing; Time; United States Centers for Medicare and Medicaid Services; United States National Institutes of Health; Validation; Visit; Vitamin D; Woman; aged; base; blood glucose regulation; cohort; cost effective; design; diabetes risk; diabetic; double-blind placebo controlled trial; fasting glucose; follow-up; glucose tolerance; improved; indexing; insulin secretion; insulin sensitivity; men; non-diabetic; post intervention; prevent; primary outcome; randomized trial; sex; treatment duration; Age; Ancillary Study; Applications Grants; Benefits and Risks; Biological Markers; Boston; Cardiovascular Diseases; Cell physiology; Center for Translational Science Activities; Chicago; Cholecalciferol; Chronic; Clinical; Clinical Sciences; Clinical Trials; Collection; Complement; Data; Databases; Diabetes Mellitus; Diabetes prevention; Diagnosis; Diagnostic; Docosahexaenoic Acids; Dose; Eicosapentaenoic Acid; Enrollment; Equilibrium; European; Evaluation; Food; Funding; General Population; Geographic Locations; Glucose; Glucose tolerance test; Glycosylated Hemoglobin; Glycosylated hemoglobin A; Health Benefit; Homeostasis; Hour; Hypoglycemia; Inflammation; Insulin; Intake; Intervention; Intervention Studies; Link; Marines; Measurement; Measures; Medical Records; Metabolic; Methods; Modeling; No-Observed-Adverse-Effect Level; Non-Insulin-Dependent Diabetes Mellitus; Nutrient; OGTT; Omega-3 Fatty Acids; Pancreas; Parents; Participant; Patient Self-Report; Pharmaceutical Preparations; Physicians; Physiological; Placebos; Population; Prevention; Primary Cancer Prevention; Primary Prevention; Process; Questionnaires; Race; Randomized; Randomized Clinical Trials; Recruitment Activity; Reporting; Research; Research Infrastructure; Risk; Running; Safety; San Francisco; Schedule; Seasons; Site; Skin Pigmentation; Specific qualifier value; Supplementation; Testing; Time; United States Centers for Medicare and Medicaid Services; United States National Institutes of Health; Validation; Visit; Vitamin D; Woman; aged; base; blood glucose regulation; cohort; cost effective; design; diabetes risk; diabetic; double-blind placebo controlled trial; fasting glucose; follow-up; glucose tolerance; improved; indexing; insulin secretion; insulin sensitivity; men; non-diabetic; post intervention; prevent; primary outcome; randomized trial; sex; treatment duration

DESCRIPTION (provided by applicant): We propose to evaluate the balance of benefits and risks of vitamin D3 (2,000 IU/day) and marine omega-3 fatty acid (eicosapentaenoic acid [EPA] + docosahexaenoic acid [DHA], 1g/day) supplements in reducing risk of T2D in the setting of an NIH-funded large-scale randomized trial, the VITamin D and OmegA-3 TriaL (VITAL). The VITAL trial is a randomized, double-blind, placebo-controlled trial specifically designed to evaluate the efficacy of vitamin D and marine omega-3 fatty acid supplements in the primary prevention of cancer and cardiovascular disease (CVD) among 20,000 U.S. men and women. We will test the hypothesis that vitamin D or omega-3 supplementation reduces the risk of T2D among initially non-diabetic subjects participating in the trial. We will further assess whether and to what extent vitamin D or omega-3 supplementation improves glucose tolerance and insulin sensitivity/secretion in a subset of the cohort undergoing biomarker evaluation for these endpoints. Hence, we propose a cost-effective strategy to evaluate the efficacy of the study interventions for diabetes prevention as well as to provide detailed characterization of the physiologic mechanisms that may impart this benefit. Case validation of incident T2D will require collection of detailed diagnostic information from medical record review and/or supplementary questionnaires completed by the participants' physicians. To complement case validation, additional data on diabetes diagnoses and hypoglycemic medication will be retrieved by linking the trial participants with the Centers for Medicare and Medicaid Services (CMS) database. In our substudy, 1,000 participants without a report of diabetes at baseline recruited at four Clinical and Translational Science Center (CTSC) sites across the U.S. (Boston, Chicago, San Francisco, and Houston) will undergo a standard 2-hour oral glucose tolerance test (OGTT) at baseline (pre- randomization) and at 2 years of follow-up (matched for season, by month). Serial measurements of insulin and glucose homeostasis will thereby be ascertained. Glycated hemoglobin A1c (HbA1c) will also be measured. In summary, we believe that the research infrastructure of the parent VITAL trial will offer us a unique cost-effective opportunity to answer important and timely questions about potential benefits of vitamin D or omega-3 fatty acid supplementation in the prevention of T2D, as well as to identify potential risks. In this proposed ancillary study, we request funds to perform diabetes case validation in the VITAL cohort and serial glucose tolerance testing at baseline and follow-up in a subsample. In order to complete pre-randomization assessment of glucose tolerance among participants at the CTSC sites, it is critically important that this ancillary study be undertaken parallel to the placebo "run-in" enrollment period for the parent VITAL trial, which is scheduled to begin in April 2010.

描述（由申请人提供）：我们建议评估维生素D3（2,000 IU/天）和海洋omega-3脂肪酸（Eicososapentaenoic [EPA] + docosahexaenoic [eicosapentaenoic [eicosapentaenoic + docosahexaenoic [eicososapentaenoic [eicososapentaenoic action + dahecahexaenoic acid）在降低NIH-Fund and-ac and-acte t2d的风险中的补充，以降低NIH-Fundin t2d的风险。 Omega-3试验（生命）。这项重要试验是一项随机，双盲的，安慰剂对照试验，专为评估维生素D和海洋omega-3脂肪酸补充剂在20,000名美国男性和女性中的主要预防癌症和心血管疾病（CVD）中的功效。我们将检验以下假设：维生素D或omega-3补充可降低参与试验的最初非糖尿病受试者的T2D风险。我们将进一步评估补充维生素D或在多大程度上可以改善对这些端点的生物标志物评估的一部分中的葡萄糖耐受性和胰岛素敏感性/分泌。因此，我们提出了一种具有成本效益的策略，以评估研究干预措施预防糖尿病的功效，并提供可能带来这种益处的生理机制的详细表征。事件的病例验证T2D将需要从参与者医师填写的医疗记录审查和/或补充问卷中收集详细的诊断信息。为了补充病例验证，将通过将试验参与者与医疗保险和医疗补助服务中心（CMS）数据库联系起来，以获取有关糖尿病诊断和降血糖药物的其他数据。在我们的物质中，在美国的四个临床和转化科学中心（CTSC）招募的基线招募的1000名参与者（波士顿，芝加哥，芝加哥，旧金山和休斯顿）将在基线（随机化之前（Pre-Pre）进行2年的2小时口服葡萄糖耐受性测试（OGTT）和2年以后（按照2年的时间）进行。因此，将确定胰岛素和葡萄糖稳态的系列测量。还将测量糖化的血红蛋白A1C（HBA1C）。总而言之，我们认为，父母重要试验的研究基础设施将为我们提供一个独特的成本效益机会，以回答有关维生素D或omega-3脂肪酸在预防T2D方面的潜在益处的重要和及时的问题，并确定潜在的风险。在这项拟议的辅助研究中，我们要求资金在基线时在重要的队列和串行葡萄糖耐受性测试中进行糖尿病病例验证，并在子样本中进行随访。为了完成CTSC站点参与者之间的葡萄糖耐量的预先评估，至关重要的是，与计划于2010年4月开始的父母生命试验平行进行这项辅助研究。