ChartGlucose4Moms: Characterizing, by Trimester, Continuous Glucose Monitoring Measurements for determining effects on Maternal & Offspring Metabolic Sequelae

ChartGlucose4Moms：按三个月表征连续血糖监测测量，以确定对母亲的影响

• 批准号: 10021656
• 负责人: TERESA A HILLIER
• 金额: $ 66.26万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-20 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10021656
• 关键词: Adipose tissue; Affect; Age; Biological Assay; Biological Markers; Birth; Brachial plexus structure; C-Peptide; C-reactive protein; Cesarean section; Child; Clinical; Data; Deposition; Detection; Development; Diabetes Mellitus; Diagnosis; Dystocia; Ensure; Environment; Fasting; First Pregnancy Trimester; Fracture; Functional disorder; Future; Gestational Age; Gestational Diabetes; Glucose; Glycosylated hemoglobin A; Hawaii; Health; Hyperglycemia; Hypertriglyceridemia; Infant; Inflammation; Injury; Insulin Resistance; Laboratories; Lead; Life Style; Machine Learning; Measurement; Measures; Metabolic; Metabolic dysfunction; Modeling; Morbidity - disease rate; Mothers; Non-Insulin-Dependent Diabetes Mellitus; Nonesterified Fatty Acids; OGTT; Oral Diagnosis; Organogenesis; Outcome; Outpatients; Participant; Perinatal; Phenotype; Placenta; Plasma; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnant Women; Regimen; Risk; Sampling; Screening procedure; Shoulder; Symptoms; Technology; Testing; Third Pregnancy Trimester; Time; Triglycerides; Uterus; Woman; Work; biomarker identification; delivery complications; early pregnancy; ethnic minority population; experience; fetal; glucose monitor; high risk; improved; metabolic phenotype; metabolic profile; mortality; neonatal death; obesogenic; offspring; perinatal complications; perinatal outcomes; postpartum outcome; pregnancy hypertension; primary outcome; racial minority; rapid detection; recruit; reproductive; screening; stillbirth; tool

PROJECT SUMMARY/ABSTRACT: Gestational diabetes (GDM) rates are on the rise in the US, particularly among racial and ethnic minorities. GDM is associated with higher rates of large for gestational age (LGA) infants, C-section, and serious perinatal complications, and increased long-term risks of Type 2 diabetes and morbidity in both mothers and infants. Women who get treatment for GDM are less likely to experience perinatal complications and give birth to LGA infants than those who do not; therefore, rapid detection of GDM may be critical to reducing perinatal complications and disparities in birth outcomes. GDM is normally diagnosed by oral glucose tolerance testing (OGTT) at 24-28 weeks gestation, but clinically important insulin resistance and metabolic dysfunction may be missed by not testing earlier. A metabolically unhealthy uterine environment in early pregnancy may lead to long-term negative impacts on mother and child, but how and when to test for insulin resistance and associated metabolic dysfunction in pregnancy is poorly defined. More data are needed on how glucose levels and other metabolic measures change across pregnancy to better evaluate women's metabolic risks and how those risks relate to perinatal and long-term outcomes. Using continuous glucose monitoring (CGM) and metabolic biomarker assays, we will describe detailed metabolic phenotype profiles over the course of pregnancy and examine how they are associated with perinatal and postpartum outcomes. We propose to recruit a diverse sample of 400 women in their first trimester from Kaiser Permanente Northwest and Kaiser Permanente Hawaii and to perform CGM, OGTT, and obtain biomarkers at 12 weeks, 20 weeks, and 28 weeks of gestation to examine how these measures relate to each other and to perinatal outcomes. Aim 1 and Aim 3 will assess the effects of CGM variables (Aim 1) and OGTT and other biomarkers (Aim 3) at each time point on the risk of LGA, other perinatal outcomes, and postpartum diabetes. Aim 2 will assess the relationship between CGM variables and diagnosis of GDM by OGTT, as well as the relationship between CGM variables and other metabolic biomarkers. We hypothesize that dysglycemia is just one marker of a much larger metabolic dysregulation that can be characterized through the work of this consortium. Characterizing a broader spectrum of metabolic dysregulation and its association with adverse perinatal outcomes will lead to improved screening regimens and treatments for pregnant women and better outcomes for both mothers and babies.

项目摘要/摘要：妊娠糖尿病（GDM）率在美国上升， 特别是在种族和少数民族中。 GDM与妊娠较高的较高率有关 年龄（LGA）婴儿，剖腹产和严重的围产期并发症，并增加了2型的长期风险 母亲和婴儿的糖尿病和发病率。获得GDM治疗的女性不太可能 经历围产期并发症并生育LGA婴儿，而不是那些没有的婴儿；因此，快速 GDM的检测对于减少围产期并发症和出生结果差异可能至关重要。 GDM通常通过口服葡萄糖耐量测试（OGTT）在24-28周进行诊断，但在临床上诊断 重要的胰岛素抵抗和代谢功能障碍可能会通过不早些时候测试而错过。代谢 怀孕初期不健康的子宫环境可能会导致对母亲的长期负面影响，并 孩子，但是如何以及何时测试怀孕的胰岛素抵抗和相关代谢功能障碍是 定义不佳。需要更多有关葡萄糖水平和其他代谢措施如何变化的数据 怀孕以更好地评估妇女的代谢风险以及这些风险与围产期和长期的关系 结果。 使用连续的葡萄糖监测（CGM）和代谢生物标志物测定法，我们将描述详细的 在怀孕过程中，代谢表型谱并检查它们与它们的相关性 围产期和产后结果。我们建议在第一次招募400名女性的不同样本 来自Kaiser Permanente Northwest和Kaiser Permanente Hawaii的孕期，并执行CGM，OGTT， 并在12周，20周和妊娠28周时获得生物标志物，以检查这些措施如何 彼此相关并与围产期结局有关。 AIM 1和AIM 3将评估CGM变量的影响 （AIM 1）和OGTT和其他生物标志物（AIM 3）在每个时间点有关LGA的风险，其他围产期 结果和产后糖尿病。 AIM 2将评估CGM变量与 OGTT诊断GDM，以及CGM变量与其他代谢之间的关系 生物标志物。我们假设血糖只是大得多的代谢失调的一个标记 这可以通过该财团的工作来表征。表征更广泛的范围 代谢失调及其与不良围产期结果的关联将导致筛查的改善 孕妇的方案和治疗方法以及母亲和婴儿的更好结果。