Arterial stiffness in mother/infant dyads: Life course approach to prevent cardiovascular disease

母婴二人的动脉僵硬度：预防心血管疾病的生命全程方法

• 批准号: 10581158
• 负责人: Kim A Boggess
• 金额: $ 17.76万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10581158
• 关键词: Abdomen; Address; Adipose tissue; Aging; Alabama; Biological; Blood Vessels; Body Composition; Body fat; Body mass index; Cardiovascular Diseases; Cohort Studies; Complement; Data; Data Collection; Development; Disease Management; Dual-Energy X-Ray Absorptiometry; Enrollment; Fatty acid glycerol esters; Female; General Population; Goals; Health; Hour; Infant; Knowledge; Learning; Life Cycle Stages; Maternal Health; Measures; Medical; Medicine; Mentors; Mentorship; Minority Women; Mothers; North Carolina; Not Hispanic or Latino; Obesity; Overweight; Pattern; Perinatal; Perinatal Care; Physiologic pulse; Positioning Attribute; Postpartum Period; Postpartum Women; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy Rate; Pregnant Women; Prevalence; Proxy; Race; Reporting; Research; Research Personnel; Research Project Grants; Risk; Risk Factors; Scanning; Site; Technology; Time; Ultrasonography; United States; Universities; Visceral; Visceral fat; Visit; Woman; abdominal fat; arterial stiffness; black women; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; career; clinical practice; cohort; design; diet and exercise; disorder risk; ethnic diversity; ethnic minority; experience; gestational weight gain; health care availability; high body mass index; high risk population; improved; innovation; lifestyle intervention; modifiable risk; multidisciplinary; parent grant; pregnancy hypertension; pregnant; prenatal; prevent; racial disparity; racial diversity; racial minority; response; risk stratification; social; vascular inflammation

ABSTRACT Greater than 45% of women in the United States experience excessive gestational weight gain (GWG) leading to increased cardiovascular disease (CVD) risk during pregnancy, postpartum and beyond (≥10 years). Excess fat accumulation and specific fat distribution patterns, such as abdominal visceral fat, accelerate vascular aging in the general population. However, the composition of GWG is scarcely reported. Therefore, a knowledge gap exists in understanding whether the vascular aging response is associated with changes in body composition and fat distribution during pregnancy and postpartum. This proposal supplements the Mother and Infant Determinants of vascular Aging Study (MIDAS; R01HL157075). The MIDAS study will enroll 840 racially and ethnically diverse healthy and medically complicated mother/infant dyads between 34-40 weeks gestation. At 34-40 weeks gestation, within 48 hours of delivery, and at 6 and 12 months postpartum, the MIDAS study will assess vascular aging and CVD risk by measuring pulse wave velocity (PWV), and examine relationships among biologic, personal, social, and ecological disease risk factors with PWV. The objective of this proposal is to elucidate how body composition (Aim 1) and fat distribution (Aim 2) changes during and following pregnancy impact postpartum CVD risk. Although obesity, defined by body mass index, is a proposed modifiable risk factor, body composition (i.e., %fat) and fat distribution (i.e., visceral adipose tissue) were not a focus of the parent grant. Therefore, this proposal will complement the existing MIDAS study by leading the data collection and in-depth analysis of gestational and postpartum body composition. The study specific aims are: 1) determine the association between the trajectory of %fat from 34-40 weeks gestation to 12 months postpartum and PWV at 12 months postpartum in 840 racially and ethnically diverse pregnant women, and 2) determine the association between the change in fat distribution from 6 to 12 months postpartum with PWV at 12 months postpartum in a subset of women (n=280). We will also explore whether race moderates the proposed associations in Aims 1 and 2; racial and ethnic minority women have a greater prevalence of obesity and are at a greater risk for pregnancy complications and CVD compared with non-Hispanic white women. This time sensitive supplement leverages access to a large, diverse cohort of pregnant and postpartum women and a multi-disciplinary team of mentors with expertise in CVD risk and maternal health. As a result, we are well positioned to complete the proposed aims. Additionally, this supplement will enable an early career investigator to: 1) gain experience conducting a well-defined research project evaluating CVD risk in pregnant women, 2) develop her grantsmanship and, 3) expand her research network and learn from a successful mentorship team. This supplement will be an integral component to the MIDAS study by focusing on adiposity- related risk to maternal cardiovascular health and it will provide an early career investigator with support to advance her career trajectory and establish an independent, fundable research line.

抽象的 美国超过45％的妇女经历超级妊娠体重增加（GWG）领先 在怀孕，产后及以后（≥10岁）期间，心血管疾病（CVD）的风险增加。过量的 脂肪积累和特定的脂肪分布模式，例如腹部内脏脂肪，加速血管衰老 在一般人群中。但是，几乎没有报道GWG的组成。因此，知识差距 存在于了解血管衰老反应是否与身体成分变化有关 怀孕期间和产后的脂肪分布。该建议补充了母亲和婴儿 血管衰老研究的决定因素（MIDAS; R01HL157075）。 MIDAS研究将在种族上注册840个， 在34-40周妊娠之间，种族多样的健康和医学复杂的母亲/婴儿二元组。在 34-40周的妊娠，分娩后的48小时，产后6和12个月，MIDAS研究将 通过测量脉搏波速度（PWV）评估血管衰老和CVD风险，并检查关系 PWV中的生物，个人，社会和生态疾病危险因素中。该提议的目的 是为了阐明身体成分（目标1）和脂肪分布（目标2）如何变化 怀孕影响产后CVD风险。尽管肥胖是由体重指数定义的，但是一个建议 可修改的危险因素，身体成分（即脂肪％）和脂肪分布（即内脏脂肪组织）不是 父母赠款的重点。因此，该提案将通过领导 妊娠和产后身体组成的数据收集和深入分析。研究具体目的 是：1）确定％脂肪的轨迹从34-40周妊娠到12个月之间的关联 产后和PWV在840个种族和种族多样的孕妇中的产后12个月，2） 确定脂肪分布的变化从产后6个月到12个月与PWV的变化 女性子集的产后12个月（n = 280）。我们还将探索种族是否适中 目标1和2中的拟议协会；种族和少数民族妇女的肥胖症患病率更高 与非西班牙裔白人妇女相比，妊娠并发症和CVD的风险更大。 这次，敏感的补充剂利用了大量的，多样化的孕妇和产后妇女的访问权限 以及具有CVD风险和孕产妇健康方面专业知识的导师团队的多学科团队。结果，我们是 良好的位置可以完成拟议的目标。此外，这种补充剂将使早期职业 研究人员：1）获得进行定义明确的研究项目的经验，评估怀孕的CVD风险 妇女，2）发展她的赠款技巧，3）扩大她的研究网络并从成功中学习 属团队。这种补充将是MIDAS研究的组成部分，通过关注肥胖 - 孕产妇心血管健康的相关风险，它将为早期职业调查员提供支持 促进她的职业发展轨迹，并建立独立的，基本的研究线。