Preventing Obesity in Preterm Infants

项目总结 这项研究项目的目的是确定脂肪组织发育和 代谢是识别早产儿儿童肥胖风险的候选生物标志物 心脏代谢异常。胎龄在32周到36周之间的中度早产婴儿， 与足月出生的人相比，成年后患肥胖症和心脏代谢性疾病的几率高20%。 中度早产占所有出生人口的8%，约占美国出生儿童总数的30万 每年都有。可能导致早产儿肥胖风险的因素包括发育迟缓 由于围产期暴露于母亲肥胖和糖尿病，方案的制定。初步数据显示， 糖尿病母亲的中度早产儿在平均9天内有较大的住院发育 与非糖尿病母亲的婴儿相比，经胎龄、性别和种族调整后。加速 这些婴儿的生长可能是由于脂肪的发育、新陈代谢和定位的改变。 组织。在一组预期的中度早产儿队列中，该项目的目的是：确定 母亲肥胖和妊娠期糖尿病对足月校正年龄和妊娠期肥胖发生的影响 它与出生时脂肪组织代谢生物标记物的相关性(目标1)和确定早期身体的作用 出生时磁共振成像和脂肪组织代谢生物标记物的成分评估 在2岁时预测儿童早期肥胖症和心脏代谢异常的生长发育 年(目标2)。识别这些围产期生物标记物对于对婴儿进行风险分层的能力至关重要。 肥胖症和心脏代谢异常的风险增加，以及未来干预措施的发展 优化早产儿健康成长，减少肥胖。 巴克博士是一名新生儿科医生，他的长期目标是领导一项独立研究，研究围产期风险。 会影响早产儿的生长发育。这份提案的职业发展计划 以巴克博士之前在流行病学和临床研究方法方面的培训为基础，通过研究生阶段 在纵向研究设计、高级生物统计学方法、生物标志物和 身体成分评估，并进行临床试验研究。巴克博士已经组建了一支强大的、坚定的 具有婴儿营养、儿科内分泌学、围产期流行病学专业知识的导师和顾问团队 和生物统计学，以帮助指导她成功地过渡到成为一名独立调查人员，优化 早产儿健康生长发育与最大限度地减少肥胖和 这一脆弱人群的心脏代谢异常。

PROJECT SUMMARY The objective of this research project is to determine if indicators of adipose tissue development and metabolism are candidate biomarkers to identify preterm infants at risk of childhood obesity and cardiometabolic abnormalities. Infants born moderately preterm, between 32- and 36-weeks of gestational age, have 20% higher odds of obesity and cardiometabolic disease in adulthood compared with those born at term. Moderate preterm birth accounts for 8% of all births, or approximately 300,000 children born in the United States each year. Factors that may contribute to obesity risk among preterm infants include developmental re- programming due to perinatal exposure to maternal obesity and diabetes. Preliminary data shows that moderate preterm infants of mothers with diabetes have greater in-hospital growth over an average of 9 days compared with infants of non-diabetic mothers, after adjustment for gestational age, sex, and race. Accelerated growth in these infants may be due to alterations in the development, metabolism, and localization of adipose tissue. In a prospective cohort of moderately preterm infants, the aims of this project are: To determine the effect of maternal obesity and gestational diabetes on the development of adiposity at term corrected age and its association with adipose tissue metabolism biomarkers at birth (Aim 1) and to identify the role of early body composition assessments by magnetic resonance imaging and adipose tissue metabolism biomarkers at birth in predicting early childhood growth and development of adiposity and cardiometabolic abnormalities at age 2 years (Aim 2). Identification of these perinatal biomarkers is critical in the ability to risk-stratify infants at heightened risk of obesity and cardiometabolic abnormalities, and for the future development of interventions to optimize healthy growth and reduce obesity among preterm infants. Dr. Buck is a neonatologist whose long-term goal is to lead independent research examining perinatal risks that influence growth and development among preterm infants. The career development plan for this proposal builds upon Dr. Buck's prior training in epidemiology and clinical research methods through graduate-level coursework and mentored training in longitudinal study design, advanced biostatistical methods, biomarker and body composition assessment, and clinical trial study conduction. Dr. Buck has assembled a strong, committed team of mentors and advisors with expertise in infant nutrition, pediatric endocrinology, perinatal epidemiology, and biostatistics to help guide her successful transition to becoming an independent investigator, optimizing healthy growth and development of preterm infants and minimizing the development of obesity and cardiometabolic abnormalities in this vulnerable population.