Uro-EDICII: Risk and Progression of Urologic Complications in Type 1- Diabetes

Uro-EDICII：1 型糖尿病泌尿系统并发症的风险和进展

• 批准号: 7938939
• 负责人: ARUNA V SARMA
• 金额: $ 51.54万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-25 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7938939
• 关键词: Affect; Age Factors; Age-Years; Aging; American; Ancillary Study; Androgens; Biological; Biological Markers; Biology; Bladder; Cardiac; Cardiovascular Diseases; Collection; Complex; Complication; Complications of Diabetes Mellitus; Data; Databases; Decreased Libido; Diabetes Mellitus; Disease; Disease Marker; Education; Elderly; Epidemiology; Erectile dysfunction; Family; Female; Frequencies; Functional disorder; Genetic Predisposition to Disease; Genitourinary system; Glycosylated hemoglobin A; Goals; Growth; Health; Healthcare Systems; High Risk Woman; Hypogonadism; Incidence; Insulin-Dependent Diabetes Mellitus; Intervention; Investigation; Kidney Diseases; Magnetic Resonance Imaging; Maps; Measures; Mental Depression; National Institute of Diabetes and Digestive and Kidney Diseases; Neuropathy; Parents; Participant; Patient Self-Report; Patients; Perceived quality of life; Peripheral Nervous System Diseases; Persons; Phenotype; Policy Maker; Population; Prevalence; Preventive Intervention; Prostate; Prostate-Specific Antigen; Prostatic Diseases; Quality of life; Questionnaires; Randomized Controlled Trials; Recruitment Activity; Regulation; Reporting; Retinal Diseases; Risk; Risk Factors; Sampling; Serum; Severities; Sexual Dysfunction; Specimen; Surveys; Symptoms; Testosterone; Time; Time Study; Urinary Incontinence; Vascular Diseases; Weight; Woman; age related; burden of illness; catalyst; cohort; cost; diabetes control; diabetes mellitus therapy; diabetic; early onset; experience; follow-up; gene environment interaction; genome wide association study; glycemic control; health related quality of life; insight; instrument; interest; intimal medial thickening; lower urinary tract symptoms; meetings; men; multidisciplinary; novel; prevent; public health relevance; research study; response; urologic

DESCRIPTION (provided by applicant): Urinary incontinence, lower urinary tract symptoms and sexual dysfunction are common health problems that reduce quality of life and markedly increase in prevalence and incidence with advancing age. Earlier onset and increased severity of those conditions among men and women with diabetes result in costly and debilitating symptoms. However, data to define incidence, associated factors and interventions to reduce the risk of developing these complications among men and women with type 1 diabetes (T1D) are limited. We have assembled a multidisciplinary team to implement an ancillary study to the Epidemiology of Diabetes Intervention and Complication (EDIC) study, a major ongoing NIDDK research study. The collection of additional survey information from EDIC participants, combined with existing and new biological specimens, will repurpose this important study to measure the new onset of urological symptoms during an important window of time in which the frequency of urological complications is accelerating. Our hypothesis is that urological complications of diabetes impair quality of life (QOL) and that diabetic and systemic factors can be identified that predict men and women at risk for these complications. Our specific aims are to 1) measure the onset and progression of urinary incontinence (UI), lower urinary tract symptom severity (LUTS), and sexual dysfunction (SDF) in men and women with T1D and determine the influence of glycemic therapy and diabetes severity on these complications; 2) determine the influence of low testosterone levels and prostate growth on the associations between glycemic therapy, diabetes severity and the complications of LUTS and SDF in men and 3) measure the impact of the onset and progression of urologic complication on health related QOL I men and women with T1D. The timing of this study is critical in order to capture the upswing in incidence of urological complications as the EDIC cohort reaches 50 years of age. The completion of these aims will provide comprehensive insight into the association between urologic complication and T1D and the impact of these symptoms on QOL. Predictive and protective factors will be identified that map out strategies for intervention and prevention studies. Findings from this proposal may also reveal important relationships between diabetic factors and ageing, bladder and prostate biology, and provide a data repository for biomarker discovery and genome wide association studies. Public Health Relevance: (adapted from the application) The proposed study is likely to offer an opportunity to complete important investigations on urological complications of type 1diabetes by repurposing the DCCT/EDIC parent study and its established cohorts. The collection of additional survey information from recruited study participants is likely to give a one-time chance to capture incident urological complications and the impact of these conditions on quality of life. The precise data from this study will be important to educate patients and their families, help develop biomarkers of urological complications and provide refined phenotypes for genetic susceptibility studies.

描述（由申请人提供）： 尿失禁、下尿路症状和性功能障碍是降低生活质量的常见健康问题，并且随着年龄的增长，患病率和发病率显著增加。在患有糖尿病的男性和女性中，这些疾病的早期发作和严重程度增加导致代价高昂和使人衰弱的症状。然而，数据来定义发病率，相关因素和干预措施，以减少男性和女性1型糖尿病（T1 D）患者发生这些并发症的风险是有限的。我们已经组建了一个多学科团队，以实施糖尿病干预和并发症流行病学（EDIC）研究的辅助研究，这是一项正在进行的NIDDK研究。从EDIC参与者中收集额外的调查信息，结合现有和新的生物标本，将重新调整这项重要研究的目的，以测量在泌尿系统并发症频率加快的重要时间窗口期间新出现的泌尿系统症状。我们的假设是，糖尿病的泌尿系统并发症损害生活质量（QOL），糖尿病和全身因素可以确定，预测男性和女性在这些并发症的风险。我们的具体目标是：1）测量T1 D男性和女性患者尿失禁（UI）、下尿路症状严重程度（LUTS）和性功能障碍（SDF）的发生和进展，并确定血糖治疗和糖尿病严重程度对这些并发症的影响; 2）确定低睾酮水平和前列腺生长对血糖治疗之间的关联的影响，糖尿病的严重程度和LUTS和SDF的并发症，3）测量泌尿系统并发症的发作和进展对T1 D男性和女性健康相关QOL I的影响。本研究的时间是至关重要的，以捕捉上升的泌尿系统并发症的发病率，因为EDIC队列达到50岁。这些目标的完成将为泌尿系统并发症和T1 D之间的关联以及这些症状对QOL的影响提供全面的见解。将确定预测和保护因素，制定干预和预防研究的战略。该提案的发现还可能揭示糖尿病因素与衰老、膀胱和前列腺生物学之间的重要关系，并为生物标志物发现和全基因组关联研究提供数据库。 公共卫生相关性：（改编自申请）拟议的研究可能提供一个机会，通过重新利用DCCT/EDIC母研究及其已建立的队列，完成对1型糖尿病泌尿系统并发症的重要研究。从招募的研究参与者中收集额外的调查信息可能会提供一次性的机会来捕捉泌尿系统并发症以及这些疾病对生活质量的影响。这项研究的精确数据对于教育患者及其家属，帮助开发泌尿系统并发症的生物标志物以及为遗传易感性研究提供精细的表型非常重要。