Are Overweight Children with T1DM at Increased Risk of Cardiovascular Disease?

简介（由申请人提供）：Ingrid Libman博士是一名儿科内分泌学家，之前接受过流行病学培训，目前是匹兹堡大学儿科助理教授。候选人的长期目标是成为一名学术医师和独立的临床科学家，将她的培训从儿童糖尿病（DM）的人口流行病学领域扩展到以患者为导向和介入性研究，特别关注肥胖对1型糖尿病（T1 DM）的影响，特别是对心血管疾病（CVD）的发展。这种兴趣是在过去几年里发展起来的，当时利布曼博士发现，在这个通常被认为不超重的人群中，肥胖的患病率有所上升。这种增加的后果目前尚不清楚。在博士的指导下。Silva Arslanian, Dorothy Becker， Ronald LaPorte和Bradley Keller， Libman博士提出了一个全面的职业发展计划，包括使用高胰岛素-血糖钳评估胰岛素抵抗的培训，测量早期心血管疾病标志物，如颈动脉超声测量内膜介质厚度和脉搏波速度，以及在临床患者导向研究中精心挑选的课程。研究计划是对三组儿童进行为期三年的横断面研究：超重T1DM儿童、非超重T1DM儿童和超重无DM儿童，以比较CVD的早期风险标志物。本研究还将评估胰岛素抵抗的作用，通过在前两组中使用高胰岛素-正血糖钳技术来测量，并验证胰岛素抵抗综合征评分，包括临床参数，可能用于临床和基于人群的研究。本研究将招募120名年龄在12至18岁之间的儿童，他们将在儿科临床转化研究中心（PCTRC）接受24小时的问卷调查，身体测量，血压，空腹血液检查，全身DEXA，颈动脉超声检查，糖尿病组接受高胰岛素-血糖钳夹。本研究的目的是：1)验证超重的T1型糖尿病儿童与不超重的T1DM儿童和同样超重但没有糖尿病的T1DM儿童相比有更多早期动脉粥样硬化标志物的假设，这是由构成代谢综合征的因素介导的；2)评估胰岛素抵抗的作用。（摘要结束）

DESCRIPTION (provided by applicant): Dr. Ingrid Libman is a pediatric endocrinologist with previous training in epidemiology who is currently an Assistant Professor in Pediatrics at the University of Pittsburgh. The candidate's long term goal is to become an academic physician and independent clinical scientist expanding her training from the area of population based epidemiology of childhood diabetes mellitus (DM) to patient oriented and interventional research, with particular focus on the impact of obesity on type 1 diabetes mellitus (T1 DM), in particular on the development of cardiovascular disease (CVD). This interest developed during the last years when Dr. Libman identified an increase in the prevalence of obesity in this population, usually considered not to be overweight. The consequences of this increase are currently not known. Under the mentorships of Drs. Silva Arslanian, Dorothy Becker, Ronald LaPorte and Bradley Keller, Dr. Libman proposes a comprehensive career development plan composed of training in the use of the hyperinsulinemic-euglycemic clamp to assess insulin resistance, measurement of early CVD markers such as carotid ultrasonography to measure intima media thickness and pulse wave velocity and carefully selected course work in clinical patient-oriented research. The research plan is a three year cross sectional study of three groups of children: overweight children with T1DM, non-overweight children with T1DM and overweight children with no DM in order to compare early risk markers of CVD. This study will also assess the role of insulin resistance, measured by the use of the hyperinsulinemic-euglycemic clamp technique in the first two groups, and validate an insulin resistance syndrome score, consisting of clinical parameters which could potentially be used in clinical and population-based studies. This study will recruit 120 children between the ages of 12 and 18 years who will attend the Pediatric Clinical Translational Research Center (PCTRC) for 24 hours to undergo questionnaire, body anthropometry, blood pressure, fasting blood tests, whole body DEXA, carotid ultrasonography and in the groups with diabetes, an hyper insulinemic-euglycemic clamp. Objectives of the study are to 1) test the hypothesis that overweight children with T1 DM have more markers of early atherosclerosis compared to those with T1DM who are not overweight and to those equally overweight with no diabetes and this is mediated by factors which constitute the metabolic syndrome and 2) assess the role of insulin resistance. (End of Abstract)