Iodine Nutrition and Thyroid Disease During Pregnancy and Lactation

妊娠期和哺乳期的碘营养与甲状腺疾病

• 批准号: 8638052
• 负责人: Angela Mei-Tin Leung
• 金额: $ 12.87万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8638052
• 关键词: Academic Medical Centers; Address; Advisory Committees; Affect; Appointment; Area; Award; Biological Markers; Biostatistical Methods; Boston; Breast; Breast Feeding; Caucasoid Race; Childhood; Clinical; Clinical Investigator; Clinical Research; Clinical Research Curriculum Award; Country; Cross-Sectional Studies; Data; Databases; Development Plans; Diabetic Diet; Dietary Iodine; Discipline of obstetrics; Educational process of instructing; Endocrine; Endocrinology; Environment; Environmental Exposure; Epidemiologic Methods; Epidemiology; Exposure to; Faculty; Fellowship; Female of child bearing age; First Pregnancy Trimester; Fostering; Funding; Future; Grant; Guidelines; Health; Hour; Human Milk; Hypothyroidism; Infant; Infant Health; Ingestion; Institutes; Intake; Interdisciplinary Study; Iodine; Knowledge; Laboratories; Lactation; Los Angeles; Master of Science; Measures; Medicine; Mental Retardation; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Mothers; NCI Scholars Program; National Health and Nutrition Examination Survey; National Research Service Awards; Outcome; Perchlorates; Perinatal; Physiology; Population; Population Database; Postpartum Women; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Prenatal Nutrition; Public Health; Public Health Schools; Publications; Regression Analysis; Research; Research Personnel; Research Project Grants; Research Training; Residencies; SECTM1 gene; Serum; Site; Standardization; Testing; Thiocyanates; Thyroid Diseases; Thyroid Function Tests; Thyroid Gland; Thyroid Hormones; Time; Training; Training Programs; Trust; United States National Institutes of Health; Universities; Urine; Variant; Woman; Women' s Health; Work; World Health Organization; career; career development; cigarette smoking; college; design; experience; fetal; hatching; infant nutrition; instructor; interest; iodine deficiency syndrome; meetings; member; neurodevelopment; nutrition; pregnant; premature; prenatal; professor; programs; reproductive; screening; secondary outcome; skills; sodium-iodide symporter; symposium; uptake; urinary

DESCRIPTION (provided by applicant): My research experience began with laboratory projects at Occidental College in Los Angeles. During my residency and fellowship training at Boston University Medical Center (BUMC), I undertook several clinical research projects with Drs. Lewis Braverman and Elizabeth Pearce. In June 2009, I completed a clinical and research fellowship in the Section of Endocrinology, Diabetes, and Nutrition at Boston University Medical Center (BUMC), the last 2 years of which were supported by an NIH T32 National Research Service Award. I completed the BUMC Clinical Research Training (CREST) program (an NIH K30 Clinical Research Curriculum Award) from 2007-2009. In July 2009, I became a junior faculty member at Boston University, a Clinical and Translational Institute (CTSI) site, (BU-BRIDGE). I received a Master of Science in Epidemiology degree at the Boston University School of Public Health in January 2010. I have had 5 original research publications related to the topics of the current proposal, including 3 as first author. I am supported by a Charles A. King Trust Postdoctoral Fellowship Award and an NIH K12 Building Interdisciplinary Research Careers in Women's Health (BIRCWH) grant at Boston University. The BIRCWH scholars program promotes career development of young investigators through mentored research, monthly research meetings, academic guidance, and national research presentations. During the K23 award period, my career development plans include participation in research-oriented seminars, presenting at national endocrine meetings, attending BUMC didactic conferences, teaching activities, and formal coursework at BUMC. I have assembled a research advisory committee who will assess my progress and provide ongoing guidance as I pursue my research plan. The skills and mentorship I will obtain through the BIRCWH and K23 awards will allow me to develop future research hypotheses aimed at specific strategies of achieving adequate iodine nutrition and normal thyroid function during pregnancy and lactation. This work will then prepare me to embark on the design and implementation of an R01 award aimed at specific strategies to achieve universal adequate iodine nutrition and normal thyroid function during pregnancy and lactation. Environment I am currently an Instructor of Medicine in the Section of Endocrinology, Diabetes, and Nutrition (Shalender Bhasin, MD; Chief) at BUMC, where the majority of my current appointment is devoted to research. The Section is comprised of 45 full-time faculty members (including one of the largest thyroid groups in the country with 7 fulltime MD faculty) and boasts over 12 million dollars in research funding, an NIH training grant, and several program and center projects. My mentor on this proposal is Dr. Lewis Braverman, Professor of Medicine at BUMC and an accomplished mentor to over 60 fellows in various aspects of thyroid physiology over his nearly 50-year career. My co-mentor is Dr. Elizabeth Hatch, Associate Professor of Epidemiology at Boston University School of Public Health, who has extensive experience and research interests in prenatal and childhood exposures relating to adverse reproductive outcomes. Research Iodine deficiency is debilitating, prevalent, and the leading cause of mental retardation worldwide. Dietary iodine is necessary for thyroid hormone synthesis. Normal thyroid function is particularly important during pregnancy and lactation, as maternal thyroid hormone levels are crucial for proper fetal and infant neurodevelopment. The impact of breast milk iodine levels on infant thyroid function is unknown. In addition, environmental exposures to perchlorate and cigarette smoke (which is metabolized to thiocyanate) decrease iodine uptake into the lactating breast, thereby further impairing iodine availability to the infant and potentially directly affecting infant thyroid function. The broad objective of this proposal is to test the hypotheses that: 1) hypothyroidism during pregnancy is associated with premature birth and other adverse obstetric/perinatal outcomes, and 2) breast milk perchlorate and thiocyanate levels, by their inhibition of NIS, decrease breast milk iodine levels (which fluctuate in relationship to dietary iodine ingestion), and are associated with infant hypothyroidism. The results of this research will have important public health implications for thyroid function screening among pregnant women and adequate maternal iodine nutrition during pregnancy and lactation. Specific Aim 1 will be a database review studying the relationships between maternal hypothyroidism during pregnancy and obstetric/perinatal outcomes. Specific Aim 2 will be an interventional assessment of an iodine load on the effects and timing of peak breast milk iodine levels in postpartum women. Specific Aim 3 will be a cross-sectional study of maternal and infant iodine intake, maternal and infant perchlorate and cigarette smoke (thiocyanate) exposures, and infant thyroid function. The pursuit of these projects, in conjunction with formal coursework in biostatistical and epidemiological methods, is intended to foster my career as an independent academic clinical investigator in thyroid disease as it relates to women's and infant health.

描述（由申请人提供）：我的研究经验始于洛杉矶西方学院的实验室项目。在波士顿大学医学中心（BUMC）的居住和奖学金培训期间，我与DRS进行了一些临床研究项目。刘易斯·布拉弗曼（Lewis Braverman）和伊丽莎白·皮尔斯（Elizabeth Pearce）。 2009年6月，我在波士顿大学医学中心（BUMC）完成了内分泌，糖尿病和营养部门的临床和研究奖学金，其中最后两年得到了NIH T32国家研究服务奖的支持。我完成了2007 - 2009年的BUMC临床研究培训（CREST）计划（NIH K30临床研究课程奖）。 2009年7月，我成为波士顿大学的初级教职员工，临床和转化研究所（CTSI）站点（BU-BRIDGE）。我于2010年1月在波士顿大学公共卫生学院获得了流行病学学位硕士学位。我有5个与当前提案主题有关的原始研究出版物，其中包括3个作为第一作者。 我得到了Charles A. King Trust博士后奖学金奖和波士顿大学妇女健康（BIRCWH）Grant的NIH K12建筑跨学科研究职业的支持。 BIRCWH学者计划通过指导的研究，每月研究会议，学术指导和国家研究演讲来促进年轻研究人员的职业发展。在K23奖项期间，我的职业发展计划包括参加以研究为导向的研讨会，参加国家内分泌会议，参加BUMC的BUMC教学，教学活动和BUMC的正式课程。我已经组建了一个研究咨询委员会，该委员会将评估我的进度并在进行研究计划时提供持续的指导。我将通过BIRCWH和K23奖获得的技能和指导能力将使我能够开发未来的研究假设，旨在在怀孕和哺乳期间实现足够的碘营养和正常甲状腺功能的特定策略。然后，这项工作将使我准备着旨在在怀孕和哺乳期间实现适当的碘营养和正常甲状腺功能的特定策略的R01奖项的设计和实施。环境我目前是BUMC内分泌，糖尿病和营养（MD Shalender Bhasin，MD;首席）的医学讲师，我目前的大部分任命都专门用于研究。该部分由45名全职教职员工组成（包括该国最大的甲状腺组织之一，拥有7个全职MD教职员工），并拥有超过1200万美元的研究资金，NIH培训补助金以及几个计划和中心项目。我对这项建议的导师是BUMC医学教授Lewis Braverman博士，也是甲状腺生理学各个方面的60多名研究员的良好导师。我的同事是波士顿大学公共卫生学院流行病学副教授伊丽莎白·哈奇（Elizabeth Hatch）博士，他在产前和儿童期与不良生殖结果有关的经验和研究兴趣。研究碘的缺乏症是使全球智力低下的智障，流行和主要原因。饮食碘对于甲状腺激素合成是必需的。正常的甲状腺功能在怀孕和哺乳期间尤为重要，因为母体甲状腺激素水平对于适当的胎儿和婴儿神经发育至关重要。母乳碘水平对婴儿甲状腺功能的影响尚不清楚。此外，环境暴露于高氯酸盐和香烟烟雾（已代谢为硫氰酸盐）减少碘在泌乳乳房中的吸收，从而进一步损害了婴儿的碘可用性，并可能直接影响婴儿甲状腺功能。 该提案的广泛目的是检验：1）怀孕期间的甲状腺功能减退症与过早的出生和其他不良产科/围产期结局有关，以及2）母乳，甲氯酸盐和硫氰酸酯水平，通过抑制NIS的抑制作用，降低母乳碘的水平（与饮食中的饮食相关性相关），并与饮食中的含量相关联。这项研究的结果将对孕妇的甲状腺功能筛查具有重要的公共卫生影响，并在怀孕和哺乳期间提供足够的母体碘营养。具体目标1将是一个数据库审查，研究孕妇甲状腺功能减退症与产科/围产期结局之间的关系。具体目标2将是对碘负载对产后女性峰碘水平的影响和时机的介入评估。具体的目标3将是对母亲和婴儿碘摄入，孕产妇和婴儿高氯酸盐和香烟烟雾（硫代）暴露以及婴儿甲状腺功能的横断面研究。对这些项目的追求以及生物统计学和流行病学方法的正式课程，旨在促进我作为甲状腺疾病的独立学术临床研究者的职业，因为这与妇女和婴儿健康有关。