Effect of protein supplementation during weight loss on older adult bone health

减肥期间补充蛋白质对老年人骨骼健康的影响

• 批准号: 10322131
• 负责人: Ashley Weaver
• 金额: $ 13.38万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-02-15 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10322131
• 关键词: 3-Dimensional; Adipocytes; Adipose tissue; Affect; Aging; American; Ancillary Study; Animal Model; Applications Grants; Assessment tool; Attenuated; Award; Biomedical Engineering; Body Composition; Body Weight decreased; Body mass index; Bone Density; Bone Marrow; Bone structure; Carbohydrates; Clinical; Clinical Research; Clinical Trials; Complement; Conduct Clinical Trials; Consumption; Data; Development; Diagnostic; Diet; Dietary Proteins; Dual-Energy X-Ray Absorptiometry; Elderly; Elements; Engineering; Exercise; Femur; Fracture; Geriatrics; Gerontology; Hip region structure; Image; Infrastructure; Intervention; Knowledge; Lead; Measurement; Measures; Medical Imaging; Mentored Research Scientist Development Award; Mentors; Modeling; Musculoskeletal; Nutritional; Nutritional Science; Obesity; Osteoporosis; Osteoporosis prevention; Outcome; Overweight; Participant; Persons; Pharmacotherapy; Phase; Phenotype; Physical Function; Population; Protein-Restricted Diet; Proteins; Radiology Specialty; Randomized; Recommendation; Recommended Dietary Allowance; Recording of previous events; Regulation; Research; Research Personnel; Resources; Risk; Scanning; Supplementation; Techniques; Testing; Thick; Thinness; Training; Trauma; United States National Institutes of Health; Vertebral column; Weight; Woman; X-Ray Computed Tomography; adult obesity; aging nutrition; base; bone; bone health; bone loss; bone mass; bone metabolism; bone preservation; bone quality; bone strength; career; design; experience; follow-up; forest; fracture risk; high risk; improved; innovation; medical schools; men; multidisciplinary; nutrition; osteoporosis with pathological fracture; prevent; prognostic tool; protein intake; research and development; spine bone structure; tool; translational study; weight maintenance

Project Summary. Dr. Weaver seeks this K25 mentored training award to expand her bioengineering research background in medical imaging and finite element modeling of trauma towards pursuit of an independent research career focused on reducing osteoporosis and fracture in older adults. Weight loss poses an increased risk of bone loss and fracture in older adults. The proposed research will test the overall hypothesis that higher dietary protein intake during and following weight loss will attenuate bone loss in older adults with obesity. Guided by an accomplished multidisciplinary mentoring team with expertise in aging, clinical trials, bone metabolism, nutrition, and radiology, the PI will: (1) Develop knowledge of gerontology and geriatric medicine, (2) Acquire training in the design and execution of clinical trials, 3) Obtain in-depth knowledge on bone metabolism and structure, including the influence of nutrition and weight loss, and 4) Develop expertise in dual-energy computed tomography (CT) acquisition and post-processing to measure volumetric bone mineral density, cortical thickness, and bone marrow adipose tissue. Dr. Weaver's training and research will take place at Wake Forest School of Medicine which has a strong history of clinical research in aging and an exceptional radiology infrastructure. The partnership with her co-mentor at Rutgers within the Department of Nutritional Sciences will provide additional resources and expertise related to the nutritional regulation of bone metabolism. The proposed ancillary study to the ongoing clinical trial, UPLIFT: Utilizing Protein During Weight Loss to Impact Physical Function, will examine bone health over 6 months of active weight loss, followed by 12 months of weight maintenance. Musculoskeletal phenotypes will be compared in older adults with obesity randomized to either: (1) a lower protein diet for weight loss and follow-up, (2) a higher protein diet for weight loss only, or (3) a higher protein diet for weight loss and follow-up. The ancillary study expands the UPLIFT trial by adding dual-energy CT scans of the lumbar spine and proximal femur at baseline, 6 months, and 18 months to compare the influence of a higher versus lower protein intake on: vertebral and femoral trabecular volumetric bone mineral density and cortical thickness (Primary Aim), bone marrow adiposity which may alter the trabecular matrix and affect bone strength (Secondary Aim 1), and bone strength and fracture risk predicted with subject-specific finite element modeling (Secondary Aim 2). The study will test if a higher protein diet improves bone outcomes during active weight loss (evaluated at 6 months), and if maintaining higher protein intake during weight maintenance further preserves bone (evaluated at 18 months). The proposed training and research plan will launch Dr. Weaver's career as an independent investigator focused on applying bioengineering techniques to: 1) develop translational tools for fracture prediction, and 2) assess osteoprotective interventions in clinical trials—ultimately leading to improved diagnostics, prognostic tools, clinical recommendations, and therapies for preventing osteoporosis and fracture in older adults.

Weaver 博士寻求获得 K25 指导培训奖以扩展她的生物工程研究。 具有医学成像和创伤有限元建模背景以追求独立 研究生涯的重点是减少老年人的骨质疏松和骨折。 拟议的研究将检验老年人骨质流失和骨折的风险较高的总体假设。 减肥期间和减肥后的膳食蛋白质摄入量将减少肥胖老年人的骨质流失。 由一支经验丰富的多学科指导团队提供，他们在衰老、临床试验、骨代谢、 营养学和放射学方面，PI 将：(1) 发展老年学和老年医学知识，(2) 获得 临床试验设计和执行方面的培训，3）深入了解骨代谢和 结构，包括营养和减肥的影响，以及 4) 发展双能计算方面的专业知识 断层扫描 (CT) 采集和后处理，以测量体积骨矿物质密度、皮质厚度、 韦弗博士的培训和研究将在维克森林大学进行。 医学在衰老临床研究方面拥有悠久的历史和卓越的放射学基础设施。 与她在罗格斯大学营养科学系的共同导师的合作将提供额外的帮助 与骨代谢营养调节相关的资源和专业知识拟议的辅助研究。 正在进行的临床试验 UPLIFT：在减肥期间利用蛋白质影响身体功能，将 检查 6 个月主动减肥后的骨骼健康状况，以及随后 12 个月的体重维持情况。 将比较肥胖老年人的肌肉骨骼表型，随机分为：(1) 较低 用于减肥和后续治疗的蛋白质饮食，(2) 仅用于减肥的高蛋白饮食，或 (3) 高蛋白饮食 辅助研究通过增加双能 CT 扫描来扩展 UPLIFT 试验。 基线、6 个月和 18 个月时的腰椎和股骨近端，以比较较高水平的影响 与较低的蛋白质摄入量相比： 椎骨和股骨小梁体积骨矿物质密度和皮质 厚度（主要目标），骨髓脂肪过多，可能会改变小梁基质并影响骨强度 （次要目标 1），以及通过特定主题的有限元建模预测骨强度和骨折风险 （次要目标 2）该研究将测试高蛋白饮食是否可以改善主动减肥过程中的骨骼状况。 （6个月时评估），如果在维持体重期间保持较高的蛋白质摄入量可以进一步保持体重 拟议的培训和研究计划将开启 Weaver 博士的职业生涯。 独立研究者专注于应用生物工程技术：1）开发转化工具 骨折预测，2) 评估临床试验中的骨保护干预措施——最终导致改善 预防骨质疏松症和骨折的诊断、预后工具、临床建议和疗法 在老年人中。