Bone Metabolism in Adolescents UndergoingBariatric Surgery

接受减肥手术的青少年的骨代谢

基本信息

批准号：
10115703
负责人：
Miriam Antoinette Bredella
金额：
$ 18.99万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
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：
2017-04-01 至 2023-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10115703
关键词：
Accounting Address Adipose tissue Adolescent Adolescent obesity Adrenal Glands Adult Androgens Anorexia Nervosa Award Biomechanics Body Composition Bone Density Bone Resorption Charge Childhood Clinical Clinical Investigator Clinical Research Clinical and Translational Science Awards Complex Development Distal Dual-Energy X-Ray Absorptiometry Endocrine Endocrinology Environment Estrogens Faculty Fatty acid glycerol esters Female Adolescents Finite Element Analysis Foundations Functional Imaging Funding Future Gastrectomy Gastric Bypass General Hospitals Goals Grant Growth Disorders Hip Fractures Hip region structure Impairment Institution Insulin Insulin-Like Growth Factor I Intervention Investigation Investigative Techniques Joints Lead Leadership Magnetic Resonance Imaging Male Adolescents Marrow Massachusetts Mediating Mentors Metabolic Metabolism Mid-Career Clinical Scientist Award (K24)Mission Modeling Morbid Obesity Musculoskeletal National Institute of Diabetes and Digestive and Kidney Diseases Non obese Obesity Osteogenesis Outcomes Research Patients Peer Review Peer Review Grants Peripheral Physiological Positioning Attribute Procedures Publications Radial Radiology Specialty Research Research Peer Review Research Personnel Research Project Grants Research Support Resources Risk Risk Estimate Site Somatotropin Spinal Fractures Structure Techniques Thinness Time Training Translational Research United States National Institutes of Health Vertebral column Weight-Bearing state Work bariatric surgery base bone loss bone metabolism bone strength bone turnover cardiometabolic risk career catalyst experience falls fracture risk ghrelin innovation interest medical schools medical specialties metabolic imaging mid-career faculty muscle form musculoskeletal imaging novel novel imaging technique nutrition patient oriented research programs prospective radiologist skeletal soft tissue subcutaneous synergism tibia training opportunity

项目摘要

Project Summary/Abstract The applicant, Miriam Bredella MD, is a clinically active staff radiologist in the Division of Musculoskeletal Imaging and Interventions at the Massachusetts General Hospital and an Associate Professor of Radiology at Harvard Medical School. Over the last 11 years Dr. Bredella’s research has focused on advanced functional imaging techniques investigating mechanisms of bone loss in obesity. Her prior mentoring experience, publication and funding record together with her current and planned research support demonstrate her commitment and passion for patient-oriented research and provide an excellent foundation to accomplish the goals and objectives of the K24 Award. The specific aims addressing the purpose of the K24 Award are: 1) To enable Dr. Bredella to dedicate 50% of her time to mentor junior clinical investigators based on her already NIH funded R01 grant on bone metabolism in adolescents undergoing bariatric surgery; 2) To mentor junior clinical investigators from the Endocrine and Radiology Departments and other specialties interested in metabolic research, investigators from the T32 program in Nutrition and Metabolism, and the pool of residents and fellows in Endocrinology and Radiology with the goal to develop them into clinical researchers who can successfully compete for peer-reviewed grants related to the mission of the NIDDK; and 3) To enable Dr. Bredella to further establish a patient-oriented research program that combines innovative translational, clinical, and outcomes research in metabolic imaging and that provides an ideal environment to develop future leaders in clinical research. The training environment at the PI's institution is outstanding in terms of didactic resources and availability of techniques to assess complex metabolic endpoints. Importantly, Dr. Bredella enjoys strong commitment from the leadership of both Endocrinology and Radiology who have enthusiastically endorsed her successful mentoring efforts to date and the plans in the current proposal. The specific research aims of the application are based on the candidate’s successfully funded R01, investigating in morbidly obese adolescent boys and girls undergoing Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG) 1) whether areal and volumetric BMD and strength estimates by finite element analysis (FEA) will decrease, and cortical and trabecular microarchitecture will be impaired whereas marrow adipose tissue (MAT) will increase and bone resorption markers will exceed those of bone formation markers and 2) investigating novel physiologic mechanisms mediating skeletal changes after RYGB and VSG. New directions proposed in the current application will estimate risk of fracture after RYGB and VSG by using a novel, biomechanically-based approach that encompasses both bone strength (by FEA) and skeletal loading (by musculoskeletal modeling), thereby accounting for extreme changes in body composition that influence fracture risk.

项目概要/摘要申请人是医学博士 Miriam Bredella，是肌肉骨骼部门的一名临床活跃的放射科医生马萨诸塞州总医院的影像和介入治疗以及放射学副教授哈佛医学院过去 11 年里，Bredella 博士的研究重点是高级功能。成像技术研究肥胖症骨质流失的机制她之前的指导经验，出版物和资助记录以及她当前和计划的研究支持表明她对以患者为中心的研究的承诺和热情，并为实现这一目标提供了良好的基础 K24 奖的目标和目标解决 K24 奖目的的具体目标是： 1) 使 Bredella 博士能够根据她已获得 NIH 的经验，投入 50% 的时间来指导初级临床研究人员资助接受减肥手术的青少年骨代谢的 R01 补助金 2) 授予初级临床导师；来自内分泌科和放射科以及其他对代谢感兴趣的专业的研究人员研究人员、T32 营养和代谢项目的研究人员以及居民和内分泌学和放射学研究员，目标是将他们培养成能够成功竞争与 NIDDK 使命相关的同行评审资助；以及 3) 使 Dr. Bredella 进一步建立以患者为中心的研究计划，结合创新的转化、代谢成像的临床和结果研究，为未来的发展提供了理想的环境 PI 机构的培训环境在教学方面非常出色。重要的是，Bredella 博士表示评估复杂代谢终点的资源和技术的可用性。享有内分泌科和放射科领导层的坚定承诺，他们热情地认可她迄今为止成功的指导工作以及当前提案中的具体研究计划。该申请的目的是基于候选人成功资助的 R01，调查病态肥胖接受 Roux-en-Y 胃绕道手术 (RYGB) 或垂直袖状胃切除术 (VSG) 的青春期男孩和女孩 1) 通过有限元分析 (FEA) 估算的面积和体积 BMD 以及强度是否会减少，皮质和小梁微结构将受损，而骨髓脂肪组织（MAT）将受损增加和骨吸收标志物将超过骨形成标志物，并且 2) 研究新的 RYGB 和 VSG 后介导骨骼变化的生理机制提出了新的方向。当前的应用程序将通过使用一种新颖的、基于生物力学的方法来估计 RYGB 和 VSG 后骨折的风险涵盖骨强度（通过 FEA）和骨骼负荷（通过肌肉骨骼建模）的方法，从而解释影响骨折风险的身体成分的极端变化。