A gender and culturally specific approach to reduce NAFLD in Mexican American men

减少墨西哥裔美国男性 NAFLD 的性别和文化特定方法

• 批准号: 10307086
• 负责人: David O. Garcia
• 金额: $ 13.33万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-01-07 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10307086
• 关键词: Adherence; Affect; Alleles; Arizona; Attitude; Behavior; Belief; Body Weight; Body Weight decreased; Body mass index; Categories; Characteristics; Consumption; Counseling; County; Data; Data Set; Development; Diet; Dietary Sugars; Disclosure; Disease; Disease Management; Environment; Evaluation; FDA approved; Fatty acid glycerol esters; Foundations; Frequencies; Gender; Genes; Genetic; Genetic Predisposition to Disease; Genotype; Goals; Guidelines; Health; Health behavior; Hispanic; Incidence; Intervention; Interview; Knowledge; Life Style; Life Style Modification; Literature; Liver; Mentored Research Scientist Development Award; Mentors; Mentorship; Metabolic; Methodology; Mexican Americans; Modeling; Monitor; National Institute on Minority Health and Health Disparities; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Obesity associated cancer; Obesity associated disease; Outcome; Participant; Pathogenicity; Pathway interactions; Pharmacologic Substance; Phenotype; Phospholipase; Physical activity; Play; Population; Positioning Attribute; Precancerous Conditions; Predisposition; Prevention therapy; Primary carcinoma of the liver cells; Proteins; Qualitative Research; Reporting; Research; Research Design; Research Methodology; Resources; Risk; Risk Factors; Role; Severities; Structure; Subgroup; Therapeutic Intervention; Time; Training; Universities; Weight maintenance regimen; Work; behavior change; black men; burden of illness; cancer risk; cardiometabolism; career; carrier status; cohort; design; diabetes prevention program; dietary; disorder risk; elastography; high risk; high risk population; imaging biomarker; improved; intervention delivery; lifestyle intervention; male; men; non-alcoholic fatty liver disease; non-invasive imaging; obese person; patient engagement; physical inactivity; programs; recruit; risk variant; satisfaction; skill acquisition; skills; social culture; statistics; stem; sugar; sweetened beverage; therapeutically effective; therapy design; weight loss intervention

ABSTRACT Effective therapeutic interventions are needed to stem the alarming increases in non-alcoholic fatty liver disease (NAFLD) in Mexican-American men, an understudied population at greater risk for the development of hepatocellular carcinoma (HCC). Primary lifestyle risk factors for NAFLD include physical inactivity and sugar- sweetened beverage consumption, characteristics that are highly evidenced in Mexican-American men. The risk of NAFLD is further increased in Mexican-American men by a greater frequency (up to 55%) of the risk allele at the PNPLA3 (patatin-like phospholipase domain-containing protein) gene. This allele confers a substantially greater susceptibility to NAFLD and HCC. In the absence of FDA-approved pharmaceutical agents, lifestyle modification, including weight loss initiated by improvements in dietary and physical activity behavior, is the recommended therapy for the prevention and treatment of NAFLD. Lifestyle interventions targeting modest weight loss (approximately 5% body weight) have been shown to result in significant reductions in liver fat. However, evidence regarding the effects of a lifestyle intervention designed exclusively for Mexican-American men at greater risk for NAFLD is not currently available. Dr. David Garcia has an excellent foundation in lifestyle interventions that has positioned him well to advance toward his goal of reducing obesity-related disease burden in Mexican-American males. The goal of this NIMHD K01 Mentored Research Scientist Development Award is to provide Dr. Garcia with an in-depth understanding of metabolic and pathogenic pathways and risk factors of obesity-related cancers and related diseases, with a specific focus on NAFLD and HCC in Mexican-American men. He also will gain training in non-invasive imaging biomarkers (e.g., transient elastography) for the evaluation and management of disease state and risk factors. Lastly, he will advance his knowledge and skill development in research methodologies (e.g., quantitative analysis and qualitative inquiry) that informs on the design and tailoring of a culturally-specific study to reduce the burden of NAFLD. With the mentorship of Dr. Cynthia Thomson and Dr. Michael Fallon, co-mentors, and collaborators; for the proposed project Dr. Garcia intends to 1) use an available dataset from the Cameron County Hispanic Cohort (CCHC) to assess risk for NAFLD, including the influence of phenotypic factors (lifestyle behaviors) in Mexican-American men; 2) evaluate the knowledge, attitudes, and beliefs of obesity-related cancer risk, with an emphasis on NAFLD and HCC risk in Mexican-American men; and 3) assess the feasibility, acceptability, and preliminary efficacy of a NAFLD-specific weight loss intervention tailored for Mexican-American men. The training plan and research strategy in this K01 application will afford Dr. Garcia the time, resources, and mentorship necessary to achieve his career goal which is enthusiastically endorsed by University of Arizona leaders and an extremely appropriate and supportive research environment.

摘要 需要有效的治疗干预措施来阻止非酒精性脂肪肝的惊人增加 在墨西哥裔美国男性中，NAFLD是一个研究不足的人群， 肝细胞癌（HCC）。NAFLD的主要生活方式风险因素包括身体活动不足和糖- 加糖饮料消费，墨西哥裔美国男性的特征非常明显。的 在墨西哥裔美国男性中，NAFLD的风险进一步增加，风险频率更高（高达55%）， PNPLA 3（patatin-like phospholipase domain containing protein）基因。这个等位基因赋予一个 对NAFLD和HCC的易感性显著增加。在没有FDA批准的药物的情况下， 药物，生活方式改变，包括通过改善饮食和体力活动引起的体重减轻 行为，是预防和治疗NAFLD的推荐疗法。生活方式干预 以适度的体重减轻（约5%体重）为目标已经显示导致显著的 减少肝脏脂肪。然而，关于专门设计的生活方式干预效果的证据 对于墨西哥裔美国男性，NAFLD的风险更大，目前还没有。大卫加西亚医生 良好的基础，在生活方式的干预，使他能够很好地推进他的目标， 减少墨西哥裔美国男性的肥胖相关疾病负担。此NIMHD K 01的目标指导 研究科学家发展奖是为加西亚博士提供深入了解代谢 肥胖相关癌症和相关疾病的致病途径和危险因素， 在墨西哥裔美国男性中的NAFLD和HCC。他还将获得非侵入性成像生物标志物的培训 (e.g.,瞬时弹性成像）用于疾病状态和风险因素的评估和管理。最后他 将促进他在研究方法方面的知识和技能发展（例如，定量分析和 定性调查），告知文化特定研究的设计和剪裁，以减轻 NAFLD。在辛西娅·汤姆森博士和迈克尔·法伦博士的指导下，共同导师和合作者; 对于提议的项目，加西亚博士打算1）使用来自卡梅隆县西班牙裔的可用数据集 队列（CCHC）评估NAFLD风险，包括表型因素（生活方式行为）对NAFLD的影响。 墨西哥裔美国男性; 2）评估肥胖相关癌症风险的知识，态度和信念， 强调墨西哥裔美国男性的NAFLD和HCC风险;和3）评估可行性，可接受性， 以及为墨西哥裔美国男性量身定制的NAFLD特异性减肥干预的初步疗效。的 培训计划和研究策略在这个K 01应用程序将提供加西亚博士的时间，资源， 导师必要的，以实现他的职业目标，这是由亚利桑那大学热情赞同 领导人和一个非常适当和支持性的研究环境。