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

基本信息

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
项目类别：
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&apos 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

项目摘要

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）：超过 400,000 名生活在美国的人患有唐氏综合症，这是一种因 21 号染色体的三个（而不是两个）拷贝而引起的先天性疾病。唐氏综合症患者的预期寿命为 60 岁需要预防性、循证的医疗保健，并满足唐氏综合症的独特需求。肥胖和甲状腺疾病风险增加被归因于唐氏综合症，但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的相关性及其管理尚未得到充分探讨。事实上，唐氏综合症患者长期以来一直被认为可以预防心血管疾病。不幸的是，医学界可能陷入了一种错误的安全感，因为最近的证据表明患有唐氏综合症的人实际上患心血管疾病的风险更高。由于许多成人疾病起源于儿童期，因此检查儿童期和青少年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力障碍患者一样，可能存在身体、医疗和发育问题，这些问题挑战传统的治疗模式并损害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治疗对唐氏综合症青少年长期心脏代谢风险的影响。这项研究还希望扩大对这些青少年的生活质量、身体形象和生活方式（身体活动和饮食模式）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、脂蛋白亚类颗粒、血压、胰岛素抵抗、葡萄糖耐量、炎症标志物和脂肪因子）之间的关系患有唐氏综合症的青春期前和青少年以及年龄、性别、种族、民族和 BMI-Z 的动脉僵硬度（心血管终末器官损伤的标志）分数匹配对照。 2) 确定甲状腺素替代对患有唐氏综合症和亚临床甲状腺功能减退症的青春期前和青少年的体重指数、脂肪量、心脏代谢危险因素和生活质量 (QOL) 的影响。次要目标）检查 DS 患者肥胖、生活方式（体力活动、营养）、身体形象和生活质量之间的关系，并探讨 DS 儿童保持健康体重的障碍。这些研究致力于改善 DS 儿童的健康状况。通过提供心血管和代谢筛查和管理指南的科学证据来护理患有唐氏综合症的儿童和成人。

项目成果

期刊论文数量（1）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Caregiver-Reported Quality of Life in Youth with Down Syndrome.

护理人员报告的患有唐氏综合症的青少年的生活质量。

DOI：
发表时间：
2017
期刊：
影响因子：
0
作者：
Xanthopoulos, Melissa S;Walega, Rachel;Xiao, Rui;Prasad, Divya;Pipan, Mary M;Zemel, Babette S;Berkowitz, Robert I;Magge, Sheela N;Kelly, Andrea
通讯作者：
Kelly, Andrea