Sleep-Related Determinants of Gestational Diabetes

妊娠期糖尿病的睡眠相关决定因素

• 批准号: 8928654
• 负责人: Bilgay Izci Balserak
• 金额: $ 24.04万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-03 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8928654
• 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' s Health; Wrist; actigraphy; adverse outcome; base; behavior measurement; blood glucose regulation; career; congenital anomaly; cytokine; diabetes control; diabetes management; diaries; experience; fetal; innovation; interest; modifiable risk; new technology; novel; parity; programs; receptor

ABSTRACT 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.

抽象的 在怀孕期间，睡眠障碍很常见。超过四分之一的孕妇患睡眠 - 呼吸无序。许多孕妇的睡眠质量和连续性较差。越来越多的证据 从对普通人群的研究表明，睡眠呼吸呼吸，睡眠时间短和差 睡眠质量（包括慢波睡眠减少）与增加的风险独立相关 代谢综合征，2型糖尿病和胰岛素抵抗。怀孕的初步研究发现 这些问题之间的类似，类似的关系（自我报告的睡眠呼吸呼吸和短暂 睡眠持续时间）和妊娠糖尿病（GDM）。我们还发现中度/重度睡眠 呼吸暂停和白天小睡都与怀孕期间高血糖有关。因此，睡觉 干扰可能构成GDM的一类新型可修改风险因素。 GDM与 不良母亲的结果，也是2型糖尿病，心血管疾病和肥胖症的预测指标 在母亲和孩子中。 拟议研究的目的是（1）评估怀孕期间慢波睡眠的变化以及 获得高级培训（K99阶段）和（2）来研究睡眠障碍的独立关联 在病例对照研究（R00期）中具有妊娠糖尿病的特征。 在K99指导阶段，将使用档案多聚会数据数据确定慢波睡眠的变化 在第一和第三孕妇中从孕妇那里聚集。在此期间，Actraphic培训 睡眠持续时间和生物标志物评估的评估将基于我先前的经验 脑电图（EEG）分析和评估睡眠的行为和主观特性。 在R00阶段，将进行病例对照研究以确定睡眠的独立关联 GDM的干扰和睡眠特征，招募140例和280个对照（1：2匹配年龄， 来自大学医院的妇产科服务的种族，平等和体重指数（BMI）） 宾夕法尼亚州（HUP）和宾夕法尼亚医院（PAH）。数据将从家庭中收集 多摄影学，睡眠日记，腕部动作法和问卷调查。对于探索目的，血清样品 睡眠前后将收集。对病例状态视而不见的技术人员，BMI将执行所有睡眠 得分。