Lifecourse Approach to Developmental Repercussions of Environmental Agents on Metabolic and Respiratory Health (LA DREAMERs)

环境因素对代谢和呼吸系统健康的发育影响的生命全程方法（LA DREAMERs）

• 批准号: 10412804
• 负责人: Theresa M Bastain
• 金额: $ 12.02万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-21 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10412804
• 关键词: Accounting; Adverse effects; Biological Markers; Birth; Birth Weight; Child; Childhood; Chronic Disease; Cohort Studies; Complex; Data; Development; Diet; Dietary Intervention; Dietary Practices; Dietary intake; Disease; Energy Intake; Ethnic Origin; Ethnic group; Factor Analysis; Family; Food; Gestational Age; Gestational Diabetes; Grain; Health; Healthy Eating; Hispanics; Impairment; Individual; Infant; Insulin Resistance; Intake; Intermediate Variables; Latina; Linear Regressions; Link; Logistic Regressions; Mediating; Meta-Analysis; Metabolic; Methods; Modeling; Morbidity - disease rate; Not Hispanic or Latino; Nutrient; Obesity; Outcome; Participant; Pathway interactions; Physiology; Population; Pregnancy; Prenatal Nutrition; Race; Recommendation; Risk; Risk Factors; Sampling; Self Administration; Variant; Vegetables; Woman; adverse birth outcomes; base; cohort; dietary; disorder risk; environmental agent; epidemiologic data; ethnic difference; ethnic disparity; ethnic diversity; fasting plasma glucose; fetal; fetal programming; gestational weight gain; improved; indexing; interest; maternal obesity; model design; nutritional epidemiology; obesity in children; outcome prediction; prenatal; racial and ethnic; racial difference; respiratory health; response; study population; theories

ABSTRACT Background: Prenatal diet may contribute to metabolic alterations (e.g., insulin resistance) that could influence fetal programming and, subsequently, birth weight, a known determinant of impaired development, morbidity, and chronic disease risk such as obesity later in life1. Prenatal overall diet, as in a dietary pattern (DP), derived particularly in relevance to fasting plasma glucose, an intermediate variable between diet and birth weight, was found to be associated with birth weight2. These findings, however, are specific to predominantly non-Hispanic white women, limiting generalizability of findings to other populations such as Hispanic/Latina women who are at disproportionately greater risk of having adverse birth outcomes and children with childhood obesity3. Specific aims: 1) Derive prenatal DPs in a racially/ethnically diverse pooled sample from the two cohorts using RRR alternately with gestational weight gain (GWG) and fasting plasma glucose (FG) as intermediate response variables and characterize resulting DPs based on higher-loading foods; 2) Identify racial/ethnic differences in DPs by using the RRR approach in Aim 1 in groups stratified by race/ethnicity and compare racial/ethnic-specific DPs with DPs derived in the combined sample; 3) Determine whether racial/ethnic-specific prenatal DPs (Aim 2), versus those derived in a racially/ethnically diverse pooled sample (Aim 1), better predict birth weight and large-for-gestational age (LGA) by comparing how well they predict the outcomes within these racial/ethnic groups. Methods: Using existing data from two ECHO pregnancy cohorts, MyPyramid Equivalent food group daily intakes will be averaged across two or more Automated Self-Administered 24-hr dietary recalls and used as input variables in a reduced-rank regression model designed to derive linear combinations of foods that maximally explain the variability in two intermediate response variables (GWG and FG) hypothesized to be on the causal pathway between prenatal diet and the outcomes of interest (Aim 1). Additionally, DPs will be characterized based on higher-loading foods. The same approach from Aim 1 will be used in Aim 2 stratified by race/ethnicity (non-Hispanic white, Hispanic/Latina). DP differences by race/ethnicity will be based on higher food group factor loadings (>0.20) for similar food groups. In each racial/ethnic group, two sets of multivariable linear regression (birth weight) and logistic regression (LGA) adjusted for relevant covariates will be performed. The first set of models will include DPs derived from Aim 1 in each racial/ethnic group, while the second set will include DPs derived from Aim 2 in each racial/ethnic group. Qualitative comparisons between magnitude and strength of associations between sets of DPs in each racial/ethnic group will be performed to determine whether there are meaningful differences in prediction of birth weight between racial/ethnic-specific DPs and those derived from a mixed population. Significance and impact: Understanding dietary differences by race/ethnicity may help explain disparities in birth outcomes and early markers of childhood obesity and inform prenatal dietary recommendations.

抽象的 背景：产前饮食可能有助于代谢改变（例如胰岛素抵抗） 影响胎儿编程，随后是出生体重，是发展受损的已知决定因素， 发病率和慢性疾病风险，例如生命后期的肥胖症。产前饮食，如饮食方式 （DP），特别是与禁食等离子体葡萄糖相关的，这是饮食和 发现出生体重与出生体重有关2。但是，这些发现是特定于 主要是非西班牙裔白人妇女，将调查结果的普遍性限制在其他人群中，例如 西班牙裔/拉丁裔妇女的出生结果不成比例的风险不成比例 儿童肥胖的孩子3。具体目的：1）在种族/种族多样的合并中得出产前DP 使用RRR与妊娠体重增加（GWG）和禁食等离子体的两个队列中的样本 葡萄糖（FG）作为中间响应变量，并根据较高负载来表征所得的DPS 食物； 2）通过使用AIM 1中的RRR方法在分层的组中使用AIM 1中的RRR方法来确定DPS的种族/种族差异 种族/种族和种族/民族特异性DP与在组合样本中得出的DP进行比较； 3）确定 种族/民族特异性的产前DPS（AIM 2），与种族/种族多样的汇集 样本（AIM 1），通过比较它们的表现如何，更好地预测出生体重和大胎龄（LGA） 预测这些种族/族裔群体中的结果。方法：使用来自两个回声的现有数据 怀孕队列，乳素类药物组的每日摄入量将在两个或更多范围内平均 自动化自动辅助24小时饮食召回并用作减少级别回归中的输入变量 旨在得出食物的线性组合设计的模型，这些食物最大程度地解释了两个中间体的可变性 响应变量（GWG和FG）假设是在产前饮食和 感兴趣的结果（目标1）。此外，将根据较高的食物来表征DPS。相同 AIM 1的方法将用于AIM 2通过种族/种族（非西班牙裔白人，西班牙裔/拉丁裔）分层。 DP 种族/民族的差异将基于类似食品组的较高食物组因子负荷（> 0.20）。 在每个种族/种族中，两组多变量线性回归（出生重）和逻辑回归 （LGA）将对相关的协变量进行调整。第一组模型将包括从 在每个种族/族裔中的目标1，而第二组将包括从AIM 2派生的DP 种族/族裔。一组之间的关联的大小与强度之间的定性比较 每个种族/种族中的DPS都将进行，以确定是否存在有意义的差异 种族/种族特异性DP与从混合人群中的出生体重的预测。 意义和影响：了​​解种族/种族的饮食差异可能有助于解释差异 儿童肥胖症的出生结果和早期标记，并为产前饮食建议提供信息。