ADOLESCENT RISK FACTORS AND YOUNG ADULT CARDIAC RISK

Julia Steinberger博士是明尼苏达大学的儿科心脏病专家和儿科助理教授。 候选人的长期目标是发展一个独立的职业生涯结合临床研究与临床医学。 候选人对通过调查儿童和青少年的危险因素以及影响其进展为成人动脉粥样硬化性心脏病的机制来预防心血管疾病感兴趣。 她在这一领域的兴趣发展期间，她成为肥胖，左心室质量（LVM）胰岛素抵抗和脂质之间的关系感兴趣。 拟议的职业发展计划包括一个多学科的计划，旨在提供一个激烈的，密切指导，以病人为导向的研究经验与全面结构化的教学课程在流行病学。 在Alan Sinaiko博士和大卫雅各布斯博士的指导下，候选人将调查青少年心血管风险因素对成年后心血管风险的影响，同时参加流行病学系的硕士学位课程。 本研究将检查肥胖、胰岛素抵抗、脂质和左心室质量的流行病学关联，并将检验青春期肥胖和胰岛素抵抗预测青年期肥胖、胰岛素抵抗、脂质、左心室质量和收缩压水平的假设。 该研究将在平均年龄13岁的200名受试者中进行，这些受试者来自一般人群血压分布的前15%，并在17岁时重新评估。 先前在13岁这个队列中的研究表明，男性和女性之间的差异，在左心室质量的反应，以增加身体的大小;和隔离分析在队列中的17岁和他们的父母推断存在一个主要的基因影响空腹胰岛素水平。 因此，本研究的第二个目标是确定青年期左心室质量与青春期心血管危险因素之间的性别差异;第三个目标是确认参与者是年轻人时的遗传结果，并与父母分享较少的童年家庭环境。

Dr. Julia Steinberger is a pediatric cardiologist and Assistant Professor in Pediatrics at the University of Minnesota. The candidate's long-term goal is to develop an independent career combining clinical research with clinical medicine. The candidate is interested in the prevention of cardiovascular disease by investigating risk factors in children and adolescents and mechanisms that influence their progress to adult atherosclerotic heart disease. Her interests in this field developed during fellowship when she became interested in the relations among obesity, left ventricular mass (LVM) insulin resistance, and lipids. The proposed career development plan incorporates a multi-disciplinary program designed to provide an intense, closely mentored, patient-oriented research experience in association with a comprehensively structured didactic curriculum in epidemiology. Under the mentorship of Dr. Alan Sinaiko and Dr. David Jacobs, the candidate will investigate the effect of cardiovascular risk factors in adolescence on establishment of cardiovascular risk in young adulthood, while enrolled in a master's degree program in the Division of Epidemiology. This research will examine epidemiologic associations of body fatness, insulin resistance, lipids, and LVM and will test the hypothesis that body fatness and insulin resistance during adolescence predict levels of adiposity, insulin resistance, lipids, left ventricular mass, and systolic blood pressure in young adulthood. The study will be conducted in a cohort of 200 subjects recruited at mean age 13 years from the top 15 percent of the blood pressure distribution in a general population, and reevaluated at age 17 years. Previous studies in this cohort at age 13 have shown a difference between males and females in the response of LVM to increases in body size; and a segregation analysis in the cohort at age 17 and their parents has inferred the presence of a major gene influencing the levels of fasting insulin. Therefore, a second objective of this research will be to define gender differences in the association of left ventricular mass in young adulthood with cardiovascular risk factors in adolescence; and a third objective is to confirm the genetic results when the participants are young adults and share less of the childhood familial environment with their parents.