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助理教授。候选人的长期目标是发展独立的职业生涯，将临床研究与临床医学相结合。该候选人对通过研究儿童和青少年的危险因素以及影响其发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。她对这一领域的兴趣在研究期间发展起来，当时她对肥胖、左心室质量（LVM）、胰岛素抵抗和血脂之间的关系产生了兴趣。拟议的职业发展计划包括一个多学科方案，旨在提供密集的、密切指导的、以病人为导向的研究经验，并结合全面结构的流行病学教学课程。在Alan Sinaiko博士和David Jacobs博士的指导下，候选人将在参加流行病学部门的硕士学位课程的同时，研究青春期心血管危险因素对成年期心血管风险建立的影响。本研究将检验身体肥胖、胰岛素抵抗、脂质和LVM之间的流行病学关联，并将检验青春期身体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为13岁的200名受试者中进行，这些受试者来自一般人群中血压分布最高的15%的人群，并在17岁时重新评估。先前对13岁年龄组的研究表明，LVM对体型增加的反应在男性和女性之间存在差异；一项对17岁的孩子及其父母进行的分离分析已经推断出一个影响空腹胰岛素水平的主要基因的存在。因此，本研究的第二个目的是确定青年左心室质量与青春期心血管危险因素之间的性别差异；第三个目标是确认当参与者是年轻的成年人，与父母共享较少的童年家庭环境时的基因结果。

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.