Metabolic, behavioral and social determinants of youth-onset T2D

青年发病 T2D 的代谢、行为和社会决定因素

• 批准号: 10583215
• 负责人: Carmen R. Isasi
• 金额: $ 6.87万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-24 至 2029-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10583215
• 关键词: Accelerometer; Adult; Ancillary Study; Behavioral; Beta Cell; Biological Factors; Biological Specimen Banks; Cell physiology; Child; Child Health Services; Childhood; Clinical; Communities; Complications of Diabetes Mellitus; Continuous Glucose Monitor; Country; County; Data; Development; Diabetes Mellitus; Dietary Assessment; Disease; Disease Progression; Disparity; Economics; Eligibility Determination; Enrollment; Ethnic Origin; Family; Foundations; Functional disorder; Future; Glucose; Individual; Inequity; Infrastructure; Joints; Knowledge; Machine Learning; Medical; Medical center; Metabolic; Metabolic Diseases; Non-Insulin-Dependent Diabetes Mellitus; OGTT; Obesity; Obesity Epidemic; Overweight; Pediatric Hospitals; Physical activity; Physiological; Population; Positioning Attribute; Prediabetes syndrome; Prevention; Prevention strategy; Process; Protocols documentation; Provider; Public Health; Publications; Questionnaires; Race; Research Design; Risk; Risk Factors; Shapes; Site; Sleep; Socioeconomic Status; Techniques; Testing; Translations; Youth; biobank; cohort; community-level factor; diabetes risk; ethnic disparity; ethnic diversity; ethnic minority; follow up assessment; food insecurity; glucose tolerance; glycemic control; health disparity; high risk; lifestyle factors; low socioeconomic status; novel; primary care practice; primary outcome; protocol development; racial disparity; racial diversity; racial minority; recruit; response; risk prediction model; secondary endpoint; social; social determinants; social health determinants; sociocultural determinant; socioeconomic disparity; treatment strategy; working group

ABSTRACT Youth-onset type 2 diabetes (YT2D) has emerged as one of the most important clinical and public health consequences of the current obesity epidemic. Not only have the rates of YT2D been increasing over the years, achieving and maintaining optimal glycemic control in this population poses unique challenges. Furthermore, disease progression in youth is faster than in adults, with a higher risk of developing diabetes complications earlier in the disease process than adults. Importantly, there are profound disparities in the burden of YT2D, with racial/ethnic minorities the most at risk. Despite these facts, the pathophysiology that leads to the development of YT2D is not well understood and even less is known about the social determinants of health (SDOH) associated with YT2D risk. Given that SDOH are major drivers of disease among racial/ethnic minorities, there is a critical need to assess the intersection of SDOH and biological factors in shaping the risk of developing YT2D. In response to RFA-DK-21-002, we propose to establish a cohort of children at risk of YT2D by recruiting from the Children’s Hospital at Montefiore Medical Center (CHAM) pediatric primary care practices (the largest provider of children’s health services in the Bronx). The Bronx is one of the most racially and ethnically diverse counties in the country; children in the Bronx have a high burden of obesity-related metabolic disorders and of social and economic adversities (e.g. food insecurity). Thus, our site is very well positioned to contribute to a better understanding of the factors that lead to inequities in YT2D risk and to inform development of more effective prevention and glycemic control strategies. Our overall objectives are to: (1) Develop more precise and clinically feasible prediction of which individuals are truly at risk for developing YT2D, by assessing the combined impact of metabolic and lifestyle factors, socio-economic status (SES), sociocultural factors, and other SDoH; (2) Increase understanding of the physiologic drivers of YT2D; (3) Provide a platform and supportive infrastructure for in-depth ancillary studies on critical aspects related to YT2D using cohort data and banked specimens

抽象的 青少年发病的 2 型糖尿病 (YT2D) 已成为最重要的临床和公共卫生问题之一 当前肥胖流行的后果不仅是 YT2D 的发病率在过去几年中不断增加。 多年来，在这一人群中实现和维持最佳血糖控制提出了独特的挑战。 此外，青少年的疾病进展速度比成人快，患糖尿病的风险更高 重要的是，在疾病过程中出现并发症的时间比成人更早。 尽管有这些事实，但病理生理学表明，少数族裔面临的风险最大。 导致Y​​T2D发展的原因尚不为人所知，对于其中的社会决定因素更是知之甚少 鉴于 SDOH 是疾病的主要驱动因素，因此与 YT2D 风险相关。 种族/族裔少数群体中，迫切需要评估 SDOH 与生物因素的交叉点 塑造 YT2D 的风险 为了回应 RFA-DK-21-002，我们建议建立一个队列 从 Montefiore 医疗中心 (CHAM) 儿童医院招募有 YT2D 风险的儿童 儿科初级保健实践（布朗克斯区最大的儿童健康服务提供者）。 布朗克斯是全国种族和民族最多元化的县之一； 与肥胖相关的代谢紊乱以及社会和经济逆境（例如粮食不安全）。 该网站非常适合帮助更好地了解导致 YT2D 不平等的因素 风险并为制定更有效的预防和血糖控制策略提供信息。 目标是： (1) 对哪些个体真正面临风险进行更精确且临床可行的预测 为了发展 YT2D，通过评估代谢和生活方式因素、社会经济因素的综合影响 地位 (SES)、社会文化因素和其他 SDoH；(2) 加深对 SDoH 生理驱动因素的了解； YT2D；（3）为关键方面的深入辅助研究提供平台和支持基础设施 使用队列数据和储存样本与 YT2D 相关