Early Environmental Stressors and Emerging Cardiometabolic Risk

早期环境压力源和新出现的心脏代谢风险

基本信息

批准号：
9330007
负责人：
Alicia S Kunin-Batson
金额：
$ 63.53万
依托单位：
HEALTHPARTNERS INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-21 至 2018-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9330007
关键词：
4 year old 9 year old AIDS prevention Address Age Behavior Behavioral Biological Body Composition Buffers Cardiovascular Diseases Cardiovascular system Cessation of life Child Child Rearing Child health care Childhood Development Dietary intake Disease Environment Fostering Goals Gold Hair Health and Behavior in Children Health behavior Healthy Eating Heart Diseases Home environment Hydrocortisone Hypothalamic structure Inflammation Intervention Knowledge Link Longitudinal trends Low income Measurement Measures Mediating Mediator of activation protein Metabolic Metabolic Diseases National Heart, Lung, and Blood Institute Neighborhoods Obesity Outcome Oxidative Stress Parents Pathway interactions Pattern Physical activity Physiological Pituitary Gland Prevention Prevention trial Preventive Intervention Process Prospective Studies Randomized Regulation Reporting Research Risk Sampling Science Stress Structure Time Translating United States National Institutes of Health Work Youth arm cardiometabolic risk cohort early childhood environmental stressor ethnic diversity executive function high risk improved innovation longitudinal dataset middle childhood obesity prevention obesity treatment prevent psychosocial racial and ethnic resilience skills socioeconomic disadvantage standard measure stressor

项目摘要

Project Summary/Abstract There is a fundamental gap in understanding the pathways, timing, and risk and protective factors that translate early environmental stressors into emerging cardiometabolic risk during childhood. Improved knowledge of the pathways through which early environmental stressors give rise to emerging dysregulation in cardiometabolic processes, the timing during childhood when impacts are observed, and the protective factors that foster resilience, is necessary to optimize interventions to prevent the development of cardiovascular and metabolic diseases. The proposed study will address this knowledge gap using a unique cohort of 534 racially/ethnically diverse, low income children who participated in a two-arm randomized controlled obesity prevention trial and have been followed since 2-4 years of age [The NET-Works Trial (U01HD068890; Sherwood/French PIs), part of the COPTR consortium (Child Obesity Prevention and Treatment Research, NIH/NHLBI/DCVS/PPSP)]. The goal of this prospective study is to characterize the emergence of dysregulation in cardiometabolic processes in this high-risk cohort of children at 7-9 years of age, and identify malleable factors that mitigate the deleterious impact of early environmental stressors on later cardiometabolic risk. State-of-the-art measures of environmental stressors (objective and perceived neighborhood and home environment), child and parent behavior patterns (gold standard measures of children's health behaviors, executive functioning skills, and parenting factors) and physiological mediators (cortisol levels from hair samples), have already been obtained at four time points during early childhood. New measurements at ages 7-9 will allow the most cutting-edge assessment of cardiometabolic risk, including cardiovascular and metabolic parameters, body composition, pubertal stage, and oxidative stress/inflammation. Specifically, this study will (1) examine whether longitudinal patterns of children's health behavior, executive functioning, and parenting practices during early childhood buffer the relationship between early environmental stressors and emerging cardiometabolic risk, (2) examine whether HPA-axis regulation is on the pathway to emerging cardiometabolic risk, and determine the extent to which child and parenting factors exert a buffering effect through modulating children's cortisol levels, and (3) explore whether participation in a multi-level behavioral obesity prevention intervention can enhance the buffering effects of children's health behaviors, executive functioning, and parenting factors on cardiometabolic risk by altering the trajectories of these modifiable factors. This approach is innovative, because it represents a substantial departure from the status quo by focusing on the pathways through which early environmental stressors give rise to cardiometabolic risk during middle childhood and the protective factors which buffer against this risk, and significant because it is expected to have direct implications for optimizing interventions for young children living in stressful early environments to prevent cardiovascular and metabolic diseases.

项目概要/摘要在理解发生这种情况的途径、时机、风险和保护因素方面存在着根本性的差距。将早期环境压力源转化为儿童时期新出现的心脏代谢风险。改进了解早期环境压力源引起新出现的失调的途径心脏代谢过程、儿童时期观察到影响的时间以及保护因素增强复原力，对于优化干预措施以预防心血管疾病和心血管疾病的发展是必要的代谢性疾病。第 534 章参加双臂随机对照肥胖研究的种族/民族多样化、低收入儿童预防试验，并从 2-4 岁开始进行跟踪[NET-Works 试验 (U01HD068890； Sherwood/French PIs），COPTR 联盟（儿童肥胖预防和治疗研究， NIH/NHLBI/DCVS/PPSP)]。这项前瞻性研究的目的是描述出现的特征 7-9 岁高危儿童群体中心脏代谢过程的失调，并确定减轻早期环境压力源对后期心脏代谢的有害影响的可塑性因素风险。最先进的环境压力测量（客观和感知的邻里和家庭环境），儿童和父母的行为模式（儿童健康行为的黄金标准衡量标准，执行功能技能和养育因素）和生理介质（头发中的皮质醇水平）样本），已经在幼儿期的四个时间点获得。新的年龄测量 7-9 将允许对心脏代谢风险进行最前沿的评估，包括心血管和代谢参数、身体成分、青春期和氧化应激/炎症。具体来说，这研究将（1）检查儿童健康行为、执行功能和行为的纵向模式是否幼儿时期的养育方式缓冲了早期环境压力源和新出现的心脏代谢风险，(2) 检查 HPA 轴调节是否正在导致新出现的心脏代谢风险心脏代谢风险，并确定儿童和养育因素发挥缓冲作用的程度通过调节儿童的皮质醇水平，以及（3）探索是否参与多层次的行为肥胖预防干预可增强儿童健康行为的缓冲效应通过改变这些可改变的轨迹来影响功能和养育因素对心脏代谢风险的影响因素。这种方法是创新的，因为它与现状有很大的不同重点关注早期环境压力因素导致心脏代谢风险的途径童年中期和缓冲这种风险的保护因素，并且意义重大，因为它是预期的对优化对生活在有压力的早期环境中的幼儿的干预措施有直接影响预防心血管和代谢疾病。