CV Disease in Adolescents with Type 2 Diabetes

患有 2 型糖尿病的青少年的心血管疾病

• 批准号: 6870307
• 负责人: Stephen R Daniels
• 金额: $ 69.24万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-06-01 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6870307
• 关键词: adolescence (12-20); cardiovascular disorder diagnosis; cardiovascular disorder risk; cardiovascular function; cardiovascular imaging /visualization; clinical research; heart function; heart imaging /visualization /scanning; human subject; noninsulin dependent diabetes mellitus; obesity

DESCRIPTION (provided by applicant): The prevalence of type 2 diabetes mellitus has increased dramatically in adolescents. This appears to be a direct result of the increase in prevalence and severity of obesity in the pediatric population. In adults with type 2 diabetes, it is well known that the risk for cardiovascular disease (CVD) is quite high. This has led to current clinical recommendation that adults with diabetes be considered equivalent in risk to those adults who already have existing coronary artery disease. It is not known if adolescents with type 2 diabetes have an equivalent high level of risk of CVD as the adult population. If they do then it would be expected that they would develop clinical CVD in their late 20's or 30's. This would have important clinical implications and would suggest the need for very aggressive management of CVD risk factors and diabetes. The proposed study is a cross-sectional evaluation of cardiac and vascular structure and function in a population of adolescents with type 2 diabetes compared to a group with similar age, sex, race and BMI with obesity alone and a non obese group with similar age, sex and race. 300 subjects with type 2 diabetes, 300 subjects with obesity and 300 non obese subjects will be studied. Assessment of CVD development will be accomplished using novel non invasive imaging methods for subclinical atherosclerosis including echocardiographic measurement of cardiac structure and function, ultrasound evaluation of carotid intimalmedial thickness, and evaluation of endothelial function by brachial artery reactivity. The primary hypothesis is that adolescents with type 2 diabetes will have greater abnormality in cardiac and vascular structure and function compared to controls with obesity. Subjects with obesity alone will have greater abnormality in cardiac and vascular structure and function compared to controls who are not obese. Correlates of cardiac and vascular abnormalities including markers of inflammation, adiponectin, diet and physical activity will also be evaluated. The results of the proposed study will fill an important gap in knowledge, will serve as the baseline for future longitudinal studies and may provide the basis for clinical strategies to prevent the development of CVD in young patients with type 2 diabetes and those with obesity.

描述（由申请人提供）：青少年中2型糖尿病的患病率急剧增加。这似乎是儿科人群肥胖患病率和严重程度增加的直接结果。众所周知，2型糖尿病成人患心血管疾病（CVD）的风险相当高。这导致了目前的临床建议，认为糖尿病成人患者的风险与那些已经患有冠状动脉疾病的成年人相当。目前尚不清楚2型糖尿病青少年是否与成人人群具有同等高的CVD风险水平。如果他们这样做，那么预计他们将在20多岁或30多岁时发展为临床CVD。这将具有重要的临床意义，并建议需要非常积极的管理心血管疾病的危险因素和糖尿病。这项研究是对2型糖尿病青少年人群的心脏和血管结构和功能进行横断面评价，并与年龄、性别、种族和BMI相似的单纯肥胖组和年龄、性别和种族相似的非肥胖组进行比较。将研究300例2型糖尿病受试者、300例肥胖受试者和300例非肥胖受试者。CVD发展的评估将使用新的非侵入性成像方法进行亚临床动脉粥样硬化，包括心脏结构和功能的超声心动图测量，颈动脉内膜中层厚度的超声评价，以及肱动脉反应性内皮功能的评价。主要假设是，与肥胖对照组相比，2型糖尿病青少年患者的心脏和血管结构和功能异常更严重。与不肥胖的对照组相比，单独肥胖的受试者在心脏和血管结构和功能方面具有更大的异常。还将评估心脏和血管异常的相关性，包括炎症标志物、脂联素、饮食和体力活动。拟议研究的结果将填补一个重要的知识空白，将作为未来纵向研究的基线，并可能为预防2型糖尿病和肥胖的年轻患者发生CVD的临床策略提供基础。