CARDIA ECHO RC CAN 9-8470189

Cardia ECHO RC CAN 9-8470189

• 批准号: 7961912
• 负责人: Joao A C Lima
• 金额: $ 49.71万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7961912
• 关键词: CARDIA; ECHO; RC; 8470189

Johns Hopkins University serves as the Echocardiography Reading Center for the Coronary Artery Risk Development in Young Adults (CARDIA) Study for the period 2009-13. CARDIA is a population-based observational study of African-American and white men and women of diverse socioeconomic status that began by examining 5115 young adults aged 18-30 in 1985-6. Follow up examinations at years 2, 5, 7, 10, and 15 achieved high retention rates, collected a rich set of high quality data and stored specimens bearing on the causes of cardiovascular disease (CVD), and led to 168 peer-reviewed publications. During the next 5 years we will continue semi-annual telephone contacts, disease event surveillance, and analysis and publication activities. We will carry out a year 20 exam on our cohort, who will be 38-50 years old. We propose to re-examine a't least 73% of those surviving (3650 participants study-wide) with 4 main objectives: 1) To identify predictors of development and progression of subclinical atherosclerosis, we will measure risk factor levels (established, novel, lifestyle, and psychosocial) and subclinical atherosclerosis (coronary artery calcification [CAC] and carotid intima-media thickness [IMT]). We will examine the antecedents of the risk factors with special attention to the growing epidemic of obesity, explore the effects of recent and remote risk factor exposure on CAC, on CAC progression, and on IMT, and assess the role of conditions such as obesity, diabetes and renal impairment, and of differences in socioeconomic status and health care access and utilization. 2) To elucidate possible racial differences in CVD pathogenesis, we will compare the factors associated with CAC incidence and prevalence, and with IMT prevalence, across risk-gender groups. We will explore factors that may explain observed differences. 3) To test whether inflammation precedes subclinical disease, we will examine the time course of the association between inflammatory markers (such as C-reactive protein) and CAC and IMT evidence for atherosclerosis. We will also identify predictors of inflammation (such as infection), and the impact of obesity and of visceral adiposity. 4) To assess the roles of genetic variation and gene by environment interactions in CVD pathogenesis, we will explore their role in the etiology of risk factors, and test if allelic variation in genes such as those regulating obesity, hyperlipidemia, blood pressure, and bone mineralization are associated with CAC and IMT. Additionally, the next examination will study the Brain Magnetic Resonance Imaging (MRI) in a subset of the participants. These data, as well as findings in separately funded ancillary studies, will allow us to examine the antecedents and prevalence of subclinical atherosclerosis in diverse populations. We will analyze the role of predisposing genetic traits in the presence of behavioral and physiologic risk factors in order to detect genotype-by-environment interactions, and to study how these differ in men and women, and in African-Americans and whites. These activities will take full advantage of CARDIA's outstanding database and specimen bank, and team of investigators, organizational structure, and quality control procedures. The study expands the pool of investigators contributing to design, analysis and publication activities by involving new scientists in CARDIA, and enhances dissemination of CARDIA data and analytic support to non-affiliated investigators. These plans will accelerate the growth of our understanding of the 20-year antecedents of middle-aged risk factors and subclinical disease. This knowledge is needed for designing preventive medicine policies that address the growing epidemic of obesity and reduce the public health burden of CVD, and that are tailored to specific population subgroups and settings where they will be most effective.

约翰·霍普金斯大学担任 2009-13 年青年冠状动脉风险发展 (CARDIA) 研究的超声心动图阅读中心。 CARDIA 是一项针对不同社会经济地位的非裔美国人和白人男性和女性的基于人群的观察性研究，最初于 1985 年 6 月对 5115 名 18-30 岁的年轻人进行了调查。第 2、5、7、10 和 15 年的随访检查取得了较高的保留率，收集了丰富的高质量数据并存储了与心血管疾病 (CVD) 原因相关的样本，并发表了 168 篇同行评审出版物。未来5年，我们将继续进行半年一次的电话联系、疾病事件监测以及分析和出版活动。我们将对我们的 38-50 岁群体进行 20 年级考试。我们建议重新检查至少 73% 的幸存者（整个研究范围内有 3650 名参与者），主要目标有 4 个： 1) 为了确定亚临床动脉粥样硬化发生和进展的预测因素，我们将测量危险因素水平（既定的、新的、生活方式和社会心理）和亚临床动脉粥样硬化（冠状动脉钙化 [CAC] 和颈动脉内膜中层厚度 [IMT]）。我们将研究危险因素的前因，特别关注日益流行的肥胖症，探讨近期和远期危险因素暴露对 CAC、CAC 进展和 IMT 的影响，并评估肥胖等疾病的作用，糖尿病和肾功能损害，以及社会经济地位和医疗保健获取和利用方面的差异。 2) 为了阐明 CVD 发病机制中可能存在的种族差异，我们将比较不同危险性别组中与 CAC 发病率和患病率以及 IMT 患病率相关的因素。我们将探讨可以解释观察到的差异的因素。 3) 为了测试炎症是否先于亚临床疾病，我们将检查炎症标志物（例如 C 反应蛋白）与动脉粥样硬化的 CAC 和 IMT 证据之间关联的时间过程。我们还将确定炎症（例如感染）的预测因子以及肥胖和内脏肥胖的影响。 4) 为了评估遗传变异和环境相互作用基因在CVD发病机制中的作用，我们将探讨它们在危险因素病因学中的作用，并测试调节肥胖、高脂血症、血压和骨骼等基因的等位基因变异是否存在矿化与 CAC 和 IMT 相关。 此外，下一次检查将研究一部分参与者的脑磁共振成像 (MRI)。 这些数据以及单独资助的辅助研究的结果将使我们能够检查不同人群中亚临床动脉粥样硬化的前因和患病率。我们将分析在存在行为和生理危险因素的情况下易感遗传特征的作用，以检测基因型与环境的相互作用，并研究这些特征在男性和女性、非裔美国人和白人中的差异。 这些活动将充分利用 CARDIA 出色的数据库和标本库、研究者团队、组织结构和质量控制程序。该研究通过让 CARDIA 的新科学家参与进来，扩大了参与设计、分析和出版活动的研究人员队伍，并加强了 CARDIA 数据的传播和对非附属研究人员的分析支持。这些计划将加速我们对中年危险因素和亚临床疾病 20 年前的了解。需要这些知识来设计预防医学政策，以解决日益流行的肥胖问题并减轻心血管疾病的公共卫生负担，并且针对特定的人群亚组和最有效的环境量身定制。