Pathobiology and Reversibility of Prediabetes in a Biracial Cohort

混血儿群体中糖尿病前期的病理学和可逆性

基本信息

批准号：
9276660
负责人：
SAMUEL DAGOGO-JACK, M.D., D.Sc.
金额：
$ 60.63万
依托单位：
UNIVERSITY OF TENNESSEE HEALTH SCI CTR
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-04-01 至 2020-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9276660
关键词：
Adherence African American Back Behavioral Biochemical Biochemistry Blood Pressure Blood Vessels Body Composition Caucasians Characteristics Cohort Studies Data Dependency Diabetes Mellitus Energy Metabolism Enrollment Epidemic Ethnic Origin Euglycemic Clamping Event Funding Glucose Goals Impairment Incidence Individual Insulin Intervention Knowledge Lead Lipids Measures Metabolic Metabolism Microalbuminuria Microvascular Dysfunction Natural History Neuropathy Non-Insulin-Dependent Diabetes Mellitus OGTT Obesity Parents Participant Pattern Peripheral Vascular Diseases Persons Phenotype Physical activity Physiological Play Population Prediabetes syndrome Public Health Race Request for Proposals Research Project Grants Retinal Diseases Risk Risk Factors Role Testing Time adipokines aged biobehavior biracial blood glucose regulation cardiometabolic risk cohort cost diabetes prevention program endothelial dysfunction ethnic disparity follow-up healthy weight high risk insulin secretion lifestyle intervention novel nutrition offspring parent grant prevent public health relevance racial disparity restoration

项目摘要

DESCRIPTION (provided by applicant): The Pathobiology and Reversibility of Prediabetes in a Biracial Cohort (PROP-ABC) study proposes to study an extant cohort, comprising ~400 normoglycemic African American and Caucasian offspring of parents with type 2 diabetes for an additional 5-year. The subjects were enrolled between 2006 and 2009 and have been followed up to 2012, during which 11 have developed diabetes and 100 developed prediabetes, without evidence of racial disparities. The objective of the present proposal is to gain a fuller understanding of the natural history and metabolic predictors of early glucose abnormalities, by assessing the role of race during the second wave of glycemic progression, and the time dependency of reversibility of prediabetes. The study tests 4 hypotheses: 1) Among offspring of parents with type 2 diabetes, early progression from normal to impaired glucose regulation (within 5 yr.) occurs in the highest-risk subjects independently of race, whereas late progression (5-10 yr.) displays racial disparities, and is predicted by physiological, biochemical and behavioral markers; 2) Early microvascular complications, peripheral vascular disease (PVD), and endothelial dysfunction manifest during transition from normal to impaired glucose regulation, display racial disparities, and are predicted by glycemic and nonglycemic factors; 3) The "metabolically healthy" insulin-sensitive obese (ISO) phenotype displays racial disparities in its association with cardiometabolic risk factors and incident dysglycemia among African-Americans and Caucasians offspring of parents with type 2 diabetes; and 4) Duration of the prediabetic state is a major determinant of, and is inversely related to, the efficacy of lifestyle intervention to induce regression of the prediabetic phenotype and restoration of normal glucose regulation. The 100 participants with prediabetes will receive Intensive Lifestyle intervention (ILI), to reverse prediabetes and restore normoglycemia. The ~260 participants who have maintained normal glucose status will continue follow-up for 5 years; persons who develop prediabetes will immediately receive ILI. Understanding the predictors of the escape from normoglycemia, the role of race, and the reversibility of new-onset prediabetes is of utmost importance, because the discovery of interventions for reversal of prediabetes will also help eliminate ethnic disparities in downstream diabetes events. The additional 5 years of follow-up will provide data on 10-yr rates and predictors of incident prediabetes, racial patterns during the second wave of progression, and, time-dependent reversibility of prediabetes. Focusing on prediabetes is of immense public health significance, as its successful reversal prevents diabetes and associated complications.

描述（由申请人提供）：混血儿队列（PROP-ABC）研究中糖尿病的病理生物学和可逆性提议研究现存的队列，其中包括约400个正常血糖的非洲裔美国人和与2型2型糖尿病的父母的正常同类群体，同时使用5年。这些受试者在2006年至2009年之间进行了招募，并一直在2012年进行随访，在此期间，有11例患有糖尿病和100个发展中的糖尿病前期，没有种族差异的证据。本提议的目的是通过评估种族在第二波血糖进展中的作用以及预糖性可逆性的时间依赖性，以更深入地了解早期葡萄糖异常的自然史和代谢预测因子。研究测试4个假设：1）在2型糖尿病的父母的后代中，早期从正常到受损的葡萄糖调节（在5年内）发生在最高风险的受试者中，而与种族无关，而晚期进展（5-10年）（5-10年）表现出种族差异，并且是由生理学，生理学，生理学标记预测的； 2）早期微血管并发症，周围血管疾病（PVD）和内皮功能障碍在从正常到葡萄糖调节受损的过渡期间表现出来，表现出种族歧视性，并由血糖和非血糖因素预测； 3）“代谢健康”的胰岛素敏感肥胖（ISO）表型表现出种族差异与非裔美国人和高加索人在2型2型糖尿病的父母的后代中与心脏代谢危险因素和事件性血糖的相关性； 4）前糖尿病状态的持续时间是生活方式的效力的主要决定因素，并且是成反比的干预以诱导糖尿病前表型的回归和正常葡萄糖调节的恢复。具有糖尿病前期的100名参与者将接受密集的生活方式干预（ILI），以逆转糖尿病和恢复正常血糖。维持正常葡萄糖状况的约260名参与者将继续进行5年的随访；发展糖尿病前期的人将立即接受ILI。了解逃避正常血糖的预测因素，种族的作用以及新发行前观之前的可逆性至关重要，因为发现逆转糖尿病前期的干预措施也将有助于消除下游糖尿病事件中种族差异。额外的5年随访将提供有关10年率的数据和事件前的预测因子，种族模式第二波进展，以及糖尿病前期的时间依赖性可逆性。关注糖尿病前期具有巨大的公共卫生意义，因为其成功的逆转可防止糖尿病和相关的并发症。

项目成果

期刊论文数量（27）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Recruitment strategies and yields for the Pathobiology of Prediabetes in a Biracial Cohort: a prospective natural history study of incident dysglycemia.

DOI：
10.1186/1471-2288-13-64
发表时间：
2013-05-10
期刊：
BMC medical research methodology
影响因子：
4
作者：
Ebenibo S;Edeoga C;Ammons A;Egbuonu N;Dagogo-Jack S;Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) Research Group
通讯作者：
Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) Research Group

Glycemic Response to Oral Dexamethasone Predicts Incident Prediabetes in Normoglycemic Subjects With Parental Diabetes.