Cardiometabolic Risk Factors and Obesity in Adolescents with Down Syndrome

唐氏综合症青少年的心脏代谢危险因素和肥胖

• 批准号: 9115646
• 负责人: ANDREA Bridget KELLY
• 金额: $ 51.07万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9115646
• 关键词: Address; Adipose tissue; Adolescence; Adolescent; Adult; Affect; Age; Alzheimer' s Disease; Arterial Fatty Streak; Behavioral; Blood Pressure; Body Composition; Body Image; Body mass index; Cardiac; Cardiology; Cardiovascular Diseases; Cardiovascular system; Caring; Cessation of life; Child; Child Psychology; Child health care; Childhood; Chromosomes, Human, Pair 21; Clinical Management; Communities; Comorbidity; Conflict (Psychology); Congenital Disorders; Development; Developmental Endocrinology; Diabetes Mellitus; Dietary Practices; Disease; Down Syndrome; Dual-Energy X-Ray Absorptiometry; Echocardiography; Ethnic Origin; Evidence based treatment; Fatty acid glycerol esters; Feeding behaviors; Foundations; Functional disorder; Glucose Intolerance; Growth; Guidelines; Health; Healthcare; High Prevalence; Hypothyroidism; Individual; Injury; Insulin Resistance; Intellectual functioning disability; Intervention; Left Ventricular Function; Left Ventricular Mass; Life; Life Expectancy; Life Style; Lipids; Maintenance; Measures; Medical; Metabolic; Modeling; Obesity; Operative Surgical Procedures; Organ; Outcome; Parents; Pathology; Physical activity; Physiologic pulse; Physiological; Population; Population Control; Prevention; Prevention strategy; Psychosocial Influences; Puberty; Quality of life; Race; Reporting; Research; Risk; Risk Factors; Security; Skinfold Thickness; Somatotropin; Thyroid Diseases; Thyroid Gland; Thyroxine; Youth; adipokines; arterial stiffness; base; cardiometabolic risk; cardiovascular disorder risk; congenital heart disorder; design; evidence base; experience; glucose tolerance; healthy lifestyle; healthy weight; high risk; improved; indexing; inflammatory marker; insulin sensitivity; lipoprotein cholesterol; multidisciplinary; nutrition; obesity risk; particle; physical conditioning; psychologic; repaired; screening; sex; treatment strategy; type I and type II diabetes; waist circumference; Address; Adipose tissue; Adolescence; Adolescent; Adult; Affect; Age; Alzheimer' s Disease; Arterial Fatty Streak; Behavioral; Blood Pressure; Body Composition; Body Image; Body mass index; Cardiac; Cardiology; Cardiovascular Diseases; Cardiovascular system; Caring; Cessation of life; Child; Child Psychology; Child health care; Childhood; Chromosomes, Human, Pair 21; Clinical Management; Communities; Comorbidity; Conflict (Psychology); Congenital Disorders; Development; Developmental Endocrinology; Diabetes Mellitus; Dietary Practices; Disease; Down Syndrome; Dual-Energy X-Ray Absorptiometry; Echocardiography; Ethnic Origin; Evidence based treatment; Fatty acid glycerol esters; Feeding behaviors; Foundations; Functional disorder; Glucose Intolerance; Growth; Guidelines; Health; Healthcare; High Prevalence; Hypothyroidism; Individual; Injury; Insulin Resistance; Intellectual functioning disability; Intervention; Left Ventricular Function; Left Ventricular Mass; Life; Life Expectancy; Life Style; Lipids; Maintenance; Measures; Medical; Metabolic; Modeling; Obesity; Operative Surgical Procedures; Organ; Outcome; Parents; Pathology; Physical activity; Physiologic pulse; Physiological; Population; Population Control; Prevention; Prevention strategy; Psychosocial Influences; Puberty; Quality of life; Race; Reporting; Research; Risk; Risk Factors; Security; Skinfold Thickness; Somatotropin; Thyroid Diseases; Thyroid Gland; Thyroxine; Youth; adipokines; arterial stiffness; base; cardiometabolic risk; cardiovascular disorder risk; congenital heart disorder; design; evidence base; experience; glucose tolerance; healthy lifestyle; healthy weight; high risk; improved; indexing; inflammatory marker; insulin sensitivity; lipoprotein cholesterol; multidisciplinary; nutrition; obesity risk; particle; physical conditioning; psychologic; repaired; screening; sex; treatment strategy; type I and type II diabetes; waist circumference

DESCRIPTION (provided by applicant): More than 400,000 people living in the US have Down syndrome, a congenital disorder arising from the presence of three, rather than two, copies of chromosome 21. With a life expectancy of 60 years, individuals with Down syndrome are in need of health care that is preventative, evidence-based, and addresses the needs unique to Down syndrome. Increased risks of obesity and thyroid disease have been ascribed to Down syndrome, but the relevance of these issues to cardiovascular and metabolic (cardiometabolic) risk, body image, and quality of life, and their management have not been fully explored. In fact, individuals with Down syndrome have long been considered protected from cardiovascular disease. Unfortunately, the medical community may have been lulled into a false sense of security as more recent evidence suggests that individuals with Down syndrome are actually at increased risk for cardiovascular disease. Because many adult diseases have origins in childhood, examining risks and potential interventions in childhood and adolescence is the key to prevention. Moreover, adolescents with Down syndrome, like others with intellectual disabilities, may have physical, medical, and developmental issues that challenge traditional treatment paradigms and compromise quality of life and body image. The overall objective of this project is to provide a better understanding of the impact of obesity and thyroid dysfunction and their treatments on long-term cardiometabolic risk in adolescents with Down syndrome. This study also hopes to broaden the understanding of quality of life, body image and lifestyle (physical activity and dietary patterns) in these adolescents. Aims: 1) To compare the relationship between body mass index and adiposity (measured by DXA), and cardiometabolic risk factors (non-HDL cholesterol, lipoprotein subclass particles, blood pressure, insulin resistance, glucose tolerance, inflammatory markers, and adipokines) and arterial stiffness (a marker of cardiovascular end organ injury) in pre-adolescents and adolescents with Down syndrome, and in age-, sex-, race-, ethnicity- and BMI-Z score- matched controls. 2) To determine the effect of thyroxine replacement on body mass index, fat mass, cardiometabolic risk factors, and quality of life (QOL) in pre-adolescents and adolescents with Down syndrome and subclinical hypothyroidism. Secondary Aim) To examine the relationship between obesity, lifestyle (physical activity, nutrition), body image, and quality of life in DS, and to explore bariers to maintaining a healthy weight in children with DS.. These studies strive to improve the health care of children and adults with Down syndrome by providing scientific evidence on which to base cardiovascular and metabolic screening and management guidelines.

描述（由申请人提供）：居住在美国的40万人患有唐氏综合症，这是一种先天性疾病，这是由三个（而不是两份）染色体的副本引起的。随着60年的预期寿命，患有唐氏综合症的人需要医疗保健的人，这是预防性，基于证据的，并且对唐氏综合症的需求独特。肥胖和甲状腺疾病的风险增加已归因于唐氏综合症，但是这些问题与心血管和代谢（心脏代谢）风险，身体形象和生活质量及其管理的相关性尚未得到充分探索。实际上，唐氏综合症的个体长期以来被认为是免受心血管疾病的保护。不幸的是，医学界可能已经将其陷入错误的安全感，因为最近的证据表明，患有唐氏综合症的人实际上处于心血管疾病的风险增加。由于许多成人疾病起源于童年，因此检查童年和青春期的风险和潜在干预措施是预防的关键。此外，患有唐氏综合症的青少年，与其他智障人士一样，可能会出现挑战传统治疗范式的身体，医疗和发育问题，并妥协了生活质量和身体形象。该项目的总体目标是更好地了解肥胖和甲状腺功能障碍的影响及其对唐氏综合症青少年长期心脏代谢风险的治疗方法。这项研究还希望扩大对这些青少年生活质量，身体形象和生活方式（体育锻炼和饮食模式）的理解。目的：1）比较体重指数和肥胖（通过DXA测量）与心脏代谢危险因素（非HDL胆固醇，脂蛋白亚级颗粒，血压，胰岛素抵抗，胰岛素耐受性，葡萄糖耐受性，炎症标志物和脂肪的僵硬）（刺激性）（脂肪因子和脂肪因素）（Acastial and cardiover）cardiovers of cardiovers of Cardiovers of Cardiovers of Cardiovers of Cardiovementc唐氏综合症，以及年龄，性别，种族，种族和BMI-Z得分匹配的对照。 2）确定甲状腺素替代对体重指数，脂肪质量，心脏代谢危险因素以及生活质量（QOL）的影响，对唐氏综合症和亚甲状腺甲状腺功能低下的青少年来说。次要目的）检查肥胖，生活方式（体育锻炼，营养），身体形象和DS中的生活质量之间的关系，并探索Bariers在DS儿童中保持健康体重的巴利士。