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.

项目摘要/摘要 神经行为特征有可能预测初始的体重减轻和减肥 肥胖青少年中各种治疗方法的反应。但是，先前的研究受到 横截面分析的繁重关系，专注于浸入式干预措施（例如，住院 治疗），这不是广泛可用的。识别神经行为对临床反应的预测指标 适用的治疗将刺激精密医学的新兴领域所需的进步。建立在 资助，随机比较有效性试验（R01-DK123273），当前的研究可能会 检查初始减肥响应和减肥维持的神经行为预测指标 肥胖症的青少年参加密集生活方式修饰疗法（LMT）或低强度LMT Plus 使用胰高血糖素样肽-1受体激动剂（GLP1-RA），semaglutide的医疗管理。在 拟议的研究我们将：1）确定青少年体重减轻反应的基线神经行为预测指标 肥胖接受干预； 2）对于参与者，在6个月时实现> 5％BMI的降低（即初始 响应者），确定12点减肥的神经行为预测因素； 3）评估差异 在强化LMT和GLP-1RA治疗之间的反应预测中。这项前瞻性，观察性研究 将包括116名具有肥胖症的青少年，并将重点放在执行职能的三个主要方面 - 抑制，认知灵活性和工作记忆 - 以及使用金标准的奖励响应 措施。对于每个域，将通过因子分析和这些潜在创建一个因素（即得分） 因素将用作统计模型中的预测因子。据我们所知，这将是首次研究 评估青少年对GLP-1RA治疗的体重减轻反应的神经行为预测指标。而且， 我们将成为少数几位对治疗反应的神经行为预测指标和 肥胖的青少年减肥。我们的总体目标是超越当前 “万能的”范式，并了解如何最好地匹配肥胖的青少年 治疗，这将最大程度地提高临床结果，同时最大程度地减少对不必要的风险的影响。