CENTRAL OBESITY AND ALBUMIN EXCRETION IN TYPE I DIABETES

I 型糖尿病中的中心性肥胖和白蛋白排泄

基本信息

批准号：
7605967
负责人：
SHALAMAR D SIBLEY
金额：
$ 15.6万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-12-01 至 2007-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7605967
关键词：
Albumins Arteries Cardiovascular Diseases Cardiovascular system Cause of Death Central obesity Clinic Complication Computer Retrieval of Information on Scientific Projects Database Cross-Sectional Studies Data Development Diabetes Mellitus Diabetic Nephropathy Dietitian Disease Dyslipidemias End stage renal failure Excretory function Exhibits Family Funding Grant Hip region structure Hispanics Institution Insulin Resistance Insulin-Dependent Diabetes Mellitus International Kidney Kidney Diseases Lead Metabolic Microalbuminuria Minnesota Native Americans Numbers Nursing Staff Outcome Patients Phenotype Population Control Rate Recruitment Activity Research Research Personnel Resources Risk Role Schedule Site Source Staging Study Subject United States National Institutes of Health Universities Visit Washington Weight Gain Work base clinically significant cohort comparative improved insight preference weight loss intervention

项目摘要

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. In subjects with diabetes microalbuminuria predicts both end-stage renal disease and clinically significant cardiovascular disease. Despite decreases in renal and cardiovascular complication rates over the past few decades, a significant number of patients still progress to endstage renal disease and diabetic nephropathy is the leading cause of endstage renal disease. Cardiovascular disease is the leading cause of death in these patients and the risk begins to accelerate with microalbuminuria. Some studies have shown that nephropahty, insulin resistance, increase weight-hip ratio, and corornary artery disease track through the families of subjects with type I diabetes and nephropathy. In studies of subjects without type I diabetes, central obesity confers increased risk of cardiovascualr disease and elevates AER. This proposal will evaluate the role of IAF mass in the development of elevated albumin excretion and dyslipidemia in subjects with type I diabetes. A better understanding of mechanisms which underlie the relationship between central obesity and the earliest stages of DN may lead to improved outcomes in renal and cardiovascular disease. The insights gained from this work may lead to improved, individualized therapy in type I diabetes. These studies are being done in a group of very well-characterized subjects with type I diabetes, some of whom exhibit a specific phenotype shared by many type 2 patients (tendency to weight gain with intensive therapy and increased IAF). The answers obtained will be applicable to some subjects with type 2 disease, particularly Native American and Hispanic populations which have a high prevelence of central obesity. GCRC support request: This project will be centered at the University of Minnesota, but will also involve the University of Washington, the Mayo Clinic, and the International Diabetes Center in Minneapolis, Minnesota. Subjects recruited for participation in the cross-sectional study of the 3 Minnesota EDIC cohorts will be seen at the University of Minnesota GCRC or at their usual site (Univ. of MN, International Diabetes Center, or Mayo Clinic), based on subject preference and available facilities, for their regularly scheduled EDIC study visit. All subjects recruited for the weight loss intervention will be seen at the U of MN GCRC. The GCRC metabolic kitchen, research dietitians, and nursing staff will all be utilized for this study. A control population without diabetes will provide comparative data.

该子项目是利用该技术的众多研究子项目之一资源由 NIH/NCRR 资助的中心拨款提供。子项目及研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金，因此可以在其他 CRISP 条目中表示。列出的机构是中心，不一定是研究者的机构。在患有糖尿病的受试者中，微量白蛋白尿可预测终末期肾病和具有临床意义的心血管疾病。尽管过去几十年肾脏和心血管并发症发生率有所下降，但仍有大量患者进展为终末期肾病，而糖尿病肾病是终末期肾病的主要原因。心血管疾病是这些患者死亡的主要原因，并且随着微量白蛋白尿的发生，风险开始增加。一些研究表明，肾病、胰岛素抵抗、体重臀比增加和冠状动脉疾病在 I 型糖尿病和肾病患者的家庭中存在。在对非 I 型糖尿病受试者的研究中，中心性肥胖会增加患心血管疾病的风险并提高 AER。该提案将评估 IAF 质量在 I 型糖尿病受试者白蛋白排泄升高和血脂异常的发展中的作用。更好地了解中心性肥胖与 DN 早期阶段之间关系的机制可能会改善肾脏和心血管疾病的预后。从这项工作中获得的见解可能会导致 I 型糖尿病的个体化治疗得到改善。这些研究是在一组特征非常明确的 I 型糖尿病受试者中进行的，其中一些受试者表现出许多 2 型糖尿病患者共有的特定表型（强化治疗和 IAF 增加导致体重增加的倾向）。获得的答案将适用于一些患有 2 型疾病的受试者，特别是中心性肥胖患病率较高的美洲原住民和西班牙裔人群。 GCRC 支持请求：该项目将以明尼苏达大学为中心，但也将涉及华盛顿大学、梅奥诊所和明尼苏达州明尼阿波利斯国际糖尿病中心。根据受试者偏好和情况，招募参加 3 个明尼苏达 EDIC 队列横断面研究的受试者将在明尼苏达大学 GCRC 或其常用地点（明尼苏达大学、国际糖尿病中心或梅奥诊所）就诊。为他们定期安排的 EDIC 研究访问提供便利的设施。所有招募参加减肥干预的受试者都将在明尼苏达大学 GCRC 就诊。 GCRC 代谢厨房、研究营养师和护理人员都将参与这项研究。没有糖尿病的对照人群将提供比较数据。