Predictors of Weight Loss and Weight Loss Maintenance to Lifestyle Modification Therapy and Pharmacotherapy for Adolescents with Obesity

肥胖青少年生活方式改变疗法和药物治疗的减肥和减肥维持的预测因素

• 批准号: 10667622
• 负责人: Amy C. Gross
• 金额: $ 37.19万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10667622
• 关键词: Address; Adolescence; Adolescent; Adolescent obesity; Adult; Affect; Agonist; Area; Behavior; Body Weight decreased; Body mass index; Brain; Brain region; COVID-19 pandemic; Characteristics; Childhood; Chronic; Chronic Disease; Clinical; Cognitive; Cross-Sectional Studies; Cues; Data; Desire for food; Development; Disease; Educational workshop; Exposure to; Factor Analysis; Food; Foundations; Funding; GLP-I receptor; Goals; Health; Heterogeneity; Hyperphagia; Immersion; Impairment; Individual; Informal Social Control; Inpatients; Intervention; Life Expectancy; Life Style Modification; Longevity; Maintenance; Medical; National Institute of Diabetes and Digestive and Kidney Diseases; Obesity; Observational Study; Outcome; Parents; Participant; Pharmaceutical Preparations; Pharmacotherapy; Population; Prediction of Response to Therapy; Predictive Factor; Process; Public Health; Randomized; Research; Resistance; Rewards; Risk; Short-Term Memory; Statistical Models; Time; United States National Institutes of Health; Weight Gain; Weight maintenance regimen; Youth; adult obesity; clinical application; clinical care; clinically relevant; comorbidity; comparative effectiveness trial; critical developmental period; effective intervention; effective therapy; executive function; experience; flexibility; high reward; improved; neurobehavioral; neurodevelopment; novel strategies; obesity treatment; precision medicine; predicting response; preference; prospective; public health relevance; response; standard measure; success; treatment response; treatment strategy; virtual

Project Summary/Abstract Neurobehavioral characteristics have the potential to predict initial weight loss and weight loss maintenance in response to various treatment approaches in adolescents with obesity. However, prior research is limited by heavy reliance on cross-sectional analyses and a focus on immersion-type interventions (e.g., inpatient treatment), which are not widely available. Identifying neurobehavioral predictors of response to clinically applicable treatments will stimulate needed progress in the emerging field of precision medicine. Building on a funded, randomized comparative effectiveness trial (R01-DK123273), the current study will prospectively examine neurobehavioral predictors of initial weight loss response and weight loss maintenance for adolescents with obesity participating in intensive lifestyle modification therapy (LMT) or low intensity LMT plus medical management using the glucagon-like peptide-1 receptor agonist (GLP1-RA), semaglutide. In the proposed study we will: 1) identify baseline neurobehavioral predictors of weight loss response in adolescents with obesity undergoing intervention; 2) for participants achieving >5% BMI reduction at 6 months (i.e. initial responders), identify neurobehavioral predictors of weight loss maintenance at 12; and 3) evaluate differences in predictors of response between intensive LMT and GLP-1RA therapy. This prospective, observational study will include 116 adolescents with obesity and will focus on the three main aspects of executive functions - inhibition, cognitive flexibility, and working memory – as well as reward responsivity using gold-standard measures. For each domain, a single factor (i.e., score) will be created from factor analysis and these latent factors will be used as predictors in the statistical models. To our knowledge, this will be the first study to evaluate neurobehavioral predictors of weight loss response to GLP-1RA therapy in adolescents. Moreover, we will be one of few who have prospectively evaluated neurobehavioral predictors of treatment response and weight loss maintenance for adolescents with obesity. Our overarching goal is to move beyond the current “one-size-fits-all” paradigm and understand how to best match adolescents with obesity to personally effective treatment, which will maximize clinical outcomes while minimizing exposure to unnecessary risks.

项目概要/摘要 神经行为特征有可能预测初始体重减轻和体重减轻维持 肥胖青少年对各种治疗方法的反应然而，先前的研究受到限制。 严重依赖横断面分析并注重沉浸式干预措施（例如住院患者 治疗），但尚未广泛识别临床反应的神经行为预测因子。 适用的治疗方法将刺激新兴精准医学领域取得必要的进展。 资助的随机比较有效性试验（R01-DK123273），当前的研究将前瞻性地 检查初始减肥反应和减肥维持的神经行为预测因素 参加强化生活方式改变疗法 (LMT) 或低强度 LMT 加的肥胖青少年 使用胰高血糖素样肽-1 受体激动剂 (GLP1-RA) 索马鲁肽进行医疗治疗。 拟议的研究我们将：1）确定青少年减肥反应的基线神经行为预测因子 肥胖正在接受干预；2) 参与者在 6 个月时体重指数降低超过 5%（即最初） 响应者），确定 12 岁时体重减轻维持的神经行为预测因子，并 3）评估差异； 这项前瞻性、观察性研究是强化 LMT 和 GLP-1RA 治疗之间反应的预测因素。 将包括 116 名患有肥胖症的青少年，并将重点关注执行功能的三个主要方面 - 抑制、认知灵活性和工作记忆——以及使用黄金标准的奖励反应能力 对于每个域，将从因素分析和这些潜在因素中创建一个因素（即分数）。 据我们所知，这将是第一个将因素用作统计模型中的预测因子的研究。 评估青少年对 GLP-1RA 治疗的减肥反应的神经行为预测因子。 我们将成为少数几个前瞻性评估治疗反应的神经行为预测因子的人之一 我们的首要目标是超越目前的肥胖青少年维持体重。 “一刀切”范式，了解如何最好地将肥胖青少年与个人有效相匹配 治疗，这将最大限度地提高临床结果，同时最大限度地减少不必要的风险。