Epidemiology of Glycemia Inflammation & Cognition

此应用程序是KOI指导研究科学家发展奖，通过该候选人将了解2型糖尿病，葡萄糖紊乱，炎症如何导致认知能力下降和痴呆症。本提案的总体目标是确定在整个葡萄糖耐量范围内和不同种族人群中，胰岛素水平和胰岛素血症是否可预测认知能力下降。此外，炎症的差异是否解释了炎症和认知表现之间的预测关联将被检查。在研究计划中，将通过进行三项前瞻性研究来实现这一目标。具体目标如下： 1）。确定认知功能与血糖和胰岛素血症指标的相关性。 2）。确定2型糖尿病（糖尿病和胰岛素血症的标志物）与认知功能的相关性是否由炎症水平（包括c反应蛋白、肿瘤坏死因子α-1、白细胞介素-6和纤溶酶原激活物-1）介导。 3）。确定胰岛素水平和胰岛素血症的纵向变化与认知功能障碍的关系。 4）。确定糖化血红蛋白与2型糖尿病患者发生痴呆、阿尔茨海默病和血管性痴呆的风险之间的关系。 已经成立了一个由资深研究人员组成的多学科小组，每个人都有不同的专业知识和培训领域，包括糖尿病，神经病学和流行病学，以指导候选人进行研究和职业发展计划。职业计划的培训部分包括从研究计划中收集的技能以及一系列令人印象深刻的结构化活动，包括糖尿病，炎症和内分泌学的正式课程，参与糖尿病和痴呆症的几个系列研讨会，与生物统计学家和老年病学家的额外合作，定期指导互动;以及出席/在几次科学会议上发表演讲。候选人提出了三项研究，旨在获得关于多种族人群中认知障碍的血糖和炎症危险因素的新知识。预期结果应提供新的和 关于血糖控制和葡萄糖紊乱对神经认知功能影响的临床有用信息。拟议的KOI应用程序包括一个良好的研究环境，包括特定于培训计划目标的资源，一个成熟的导师团队和一个重要的研究问题。来自指导科学家职业奖的支持将使候选人能够过渡到独立的研究者， 包括建立一个由校外资助的研究项目。

This application is for a KOI Mentored Research Scientist Development Award through which the candidate will learn how type 2 diabetes, glucose disorders, arid inflammation contribute to cognitive decline and dementia. The overall goal of this proposal will be to determine whether levels of glycemia and insulinemia are predictive of cognitive decline across the entire range of glucose tolerance and across different ethnic groups. Furthermore, whether differences in inflammation explain predictive associations between glycemia and cognitive performance will be examined. Within the research plan, this goal will be achieved though conducting three prospective studies. The following are the specific aims: 1). To determine the association of measures of glycemia and insulinemia with cognitive functioning. 2). To determine if the association of type 2 diabetes, markers of glycemia and insulinemia, with cognition is mediated by levels of inflammation including c reactive protein, tumor necrosis factor alpha-1, interleukin-6, and plasminogen activator-1. 3). To determine how longitudinal changes in glycemia and insulinemia are associated with cognitive impairment. 4). To determine how glycated hemoglobin is associated with risk of incident dementia, Alzheimer's disease and vascular dementia in patients with Type 2 diabetes. A multidisciplinary team of established senior investigators, each with a different area of expertise and training including diabetes, neurology and epidemiology, has been formed to mentor the candidate on the research and career development plan proposed. The training component of the career plan includes the skills gleaned from the research plan as well as an impressive array of structured activities including formal coursework in diabetes, inflammation and endocrinology, participation in several seminar series on diabetes and dementia, additional collaborations with a biostatistician and geriatrician, regular mentoring interactions; and attendance/presentation at several scientific meetings. The candidate has proposed three studies which seek to gain new knowledge about glycemic and inflammatory risk factors for cognitive impairment in multiethnic cohorts. The expected results should provide new and clinically useful information regarding the influences of glycemic control and glucose disorders on neurocognitive functioning. The proposed KOI application includes an excellent research environment including resources specific to the goals of the training plan, an established team of mentors and, an important research question. The support from the Mentored Scientist Career Award will enable the candidate to make the transition to an independent investigator in the area of glycemia and cognition including establishing an extramurally funded research program.