Social and Dietary Determinants of Kidney Stone Risk

肾结石风险的社会和饮食决定因素

基本信息

批准号：
10643740
负责人：
Joseph James Crivelli
金额：
$ 18.42万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-05-25 至 2028-02-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10643740
关键词：
Adopted Adult Affect Behavior Biology Biometry Black Populations Black race Body mass index Calcium Oxalate Chronic Chronic Disease Clinical Investigator Clinical Sciences Clinical Trials Cohort Analysis Cohort Studies Consumption Coronary Artery Risk Development in Young Adults Study DASH diet Data Development Diabetes Mellitus Diet Diet Modification Dietary Assessment Dietary Factors Dietary Practices Dietetics Disadvantaged Disease Disparity population Economics Education Enrollment Environment Environmental Risk Factor Epidemiology Ethnic Origin Event Family Study Foundations Funding Future Goals Grant Health Health Care Costs Heart Hispanic Community Health Study/Study of Latinos Hispanic Populations Hour Human Hypertension Incidence Income Individual Institution Jackson Heart Study Kidney Calculi Life Style Link Low Prevalence Measures Medical Mentored Patient-Oriented Research Career Development Award Mentors Modification Multi-Ethnic Study of Atherosclerosis National Institute of Diabetes and Digestive and Kidney Diseases Not Hispanic or Latino Nutritional Study Observational Study Outcome Participant Patients Pattern Population Population Heterogeneity Prevalence Prevention Preventive care Productivity Public Health Quality of life Race Randomized Recording of previous events Reporting Research Research Personnel Resources Risk Risk Factors Science Secondary Prevention Standardization Testing Time Training Training Programs Translational Research Urinary Calculi Urine Work career development clinical center cohort data harmonization dietary disease heterogeneity disorder prevention disorder risk efficacy testing ethnic diversity ethnic minority ethnic minority population experience follow-up good diet health disparity health inequalities healthy lifestyle improved insight modifiable risk nutrition patient oriented prevent primary outcome prospective racial diversity racial minority racial minority population sex social social factors social health determinants social influence structural determinants systemic barrier western diet

项目摘要

Kidney stone disease (KSD) results in billions of dollars in healthcare costs per year, creates large economic losses due to decreased work productivity, and negatively impacts quality of life. Black and Hispanic individuals historically have a lower prevalence of KSD compared to White individuals; however, the rate of increase in the prevalence of KSD among Black and Hispanic individuals is greater than that among White individuals. There is evidence that KSD risk is influenced by social determinants of health (SDOH), potentially contributing to the disproportionate rise in KSD risk in racial and ethnic minority populations who bear the greatest burden of adverse SDOH; however, the extent to which SDOH associate with kidney stone risk in diverse populations has been understudied. Diet and lifestyle clearly influence KSD risk. It is important to describe how all of these factors, as well as their temporal changes, contribute to KSD risk in racial and ethnic minority groups. The overall objective of this project is to assess associations of SDOH with KSD risk in racially and ethnically diverse populations, the contribution of dietary quality to these associations, and the effect of adopting a healthy dietary pattern on KSD risk. To achieve this objective, we aim to: 1) Identify risk factors for KSD prevalence in a racially and ethnically diverse pooled cohort from five observational studies; 2) Measure the associations of temporal changes in risk factors (e.g., dietary pattern, anthropometrics, SDOH, and associated chronic medical conditions) with KSD incidence among participants of Coronary Artery Risk Development in Young Adults (CARDIA; a cohort of Black and White adults with over 30 years of follow-up); and 3) Determine the extent to which adopting a healthy dietary pattern, namely a Dietary Approaches to Stop Hypertension (DASH)-style diet, improves 24-hour urinary stone risk parameters among individuals with KSD through a controlled diet study enrolling CARDIA participants. The proposed research leverages key resources at our institution, including the Birmingham Field Center for CARDIA and the Bionutrition Unit of the Center for Clinical and Translational Science (CCTS). We expect to elucidate the magnitude of the social and dietary determinants of KSD risk in racially and ethnically diverse cohorts, and determine the effect of a DASH-style diet on urinary stone risk factors. We also expect that this will provide the foundation for future independent grant efforts to develop more effective preventive care strategies for disadvantaged patients with KSD. This K23 award will provide the PI with training in biostatistics/epidemiology, SDOH, nutrition/dietetics, and patient-oriented kidney stone research, which will be critical for his career development and long-term goal of becoming an independent investigator. Career development activities will include a Masters of Science in Public Health in Applied Epidemiology, which will incorporate coursework in health inequities and nutrition research; the Clinical Investigator Training Program which offers training on clinical trial oversight; and regular interactions with a team of mentors and collaborators with complementary expertise in SDOH, nutrition, analysis of cohort studies and clinical trials, and KSD epidemiology/prevention.

肾脏石材疾病（KSD）每年导致数十亿美元的医疗保健费用，由于工作生产率降低而造成了巨大的经济损失，并对生活质量产生负面影响。与白人相比，黑人和西班牙裔人的KSD患病率较低。但是，黑人和西班牙裔个体中KSD患病率的增长速度大于白人个体。有证据表明，KSD风险受卫生的社会决定因素（SDOH）的影响，有可能导致种族和少数民族少数民族的KSD风险不成比例的上升，而这些人口承担了不利SDOH的最大负担。但是，SDOH在不同人群中与肾结石风险相关的程度已被研究。饮食和生活方式显然会影响KSD风险。重要的是要描述所有这些因素以及它们的时间变化如何促进种族和少数民族群体的KSD风险。该项目的总体目的是评估SDOH与种族和种族多样性种群中KSD风险的关联，饮食质量对这些关联的贡献以及采用健康饮食模式对KSD风险的影响。为了实现这一目标，我们的目标是：1）从五项观察性研究中确定种族和种族多样化的合并队列中KSD患病率的危险因素； 2）衡量危险因素的时间变化（例如，饮食模式，人类学，人类学，SDOH和相关的慢性医疗状况）与年轻人冠状动脉风险发展参与者之间的KSD发病率（Cardia； Cardia；一组黑人和白人成年人，具有超过30年的随访）； 3）确定采用健康饮食模式的程度，即阻止高血压（DASH）式饮食的饮食方法，通过参加Cardia参与者的受控饮食研究来改善KSD患者的24小时尿石风险参数。拟议的研究利用了我们机构的关键资源，包括伯明翰Cardia和临床和转化科学中心（CCTS）的Bionutrition部门。我们期望阐明种族和种族多样的人群中KSD风险的社会和饮食决定因素的大小，并确定仪表型饮食对尿石危险因素的影响。我们还期望这将为未来的独立赠款工作提供基础，以为处于不利的KSD患者制定更有效的预防性护理策略。该K23奖将为PI提供生物统计学/流行病学，SDOH，营养/饮食学和以患者为导向的肾结石研究的培训，这对于他的职业发展和成为独立研究者的长期目标至关重要。职业发展活动将包括应用流行病学公共卫生科学硕士学位，该学院将纳入健康不平等和营养研究的课程；临床研究者培训计划，提供有关临床试验监督的培训；以及与导师和合作者团队的定期互动，具有SDOH，营养，队列研究和临床试验分析以及KSD流行病学/预防方面的补充专业知识。