Sleep and cardio-metabolic risk factors: a prospective study of adolescents

睡眠和心脏代谢危险因素：青少年的前瞻性研究

• 批准号: 7888707
• 负责人: Edward O. Bixler
• 金额: $ 57.22万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7888707
• 关键词: 12 year old; Address; Adolescence; Adolescent; Adult; Affect; Age; Age Distribution; Alcohol consumption; Ancillary Study; Arrhythmia; Atrial Premature Complexes; Blood Pressure; Cardiac; Cardiovascular Diseases; Cause of Death; Central obesity; Child; Childhood; Circadian Rhythms; Clinical; Collaborations; Communication; Complex; Conflict (Psychology); Coronary heart disease; Data; Data Analyses; Data Collection; Data Quality; Development; Disease; Dual-Energy X-Ray Absorptiometry; Electrophysiology (science); Elements; Emotional Stress; Epidemic; Epidemiologic Studies; Epidemiologist; Evaluation; Frequencies; Funding; Gender; Health; Heart Diseases; Height; Home environment; Hydrocortisone; Hypertension; Impairment; Inflammation; Insulin; Insulin Resistance; Intervention; Investigation; Ischemia; Knowledge; Laboratories; Life; Measures; Metabolic; Metabolic Diseases; Metabolic Syndrome Pathway; Metabolic stress; Metabolic syndrome; Minority; Modification; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Obesity; Outcome; Parents; Participant; Patient Self-Report; Pattern; Perception; Performance; Physical activity; Population; Population Study; Positioning Attribute; Prevalence; Problem Solving; Prospective Studies; Public Health; Reporting; Research; Research Personnel; Research Project Grants; Resources; Risk; Risk Factors; Sampling; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleep disturbances; Sleeplessness; Smoking; Socioeconomic Status; Stress; Stroke; System; Telephone; Time; Ventricular Premature Complexes; Work; age related; aged; base; cohort; data sharing; early adolescence; early childhood; experience; fasting glucose; follow-up; high risk; hypothalamic-pituitary-adrenal axis; meetings; member; mortality; multidisciplinary; neurobehavioral; neurobehavioral disorder; novel; obesity in children; obesity risk; population based; prospective; psychosocial; public health relevance; skills; sleep abnormalities; success; young adult

DESCRIPTION (provided by applicant): We propose to conduct an 8-year follow-up examination of a population-based sample of 700 young adolescents. The recruitment and baseline exam of this cohort was conducted when they were 5-12 years old. Our overall objective is to assess a wide range of risk factors for and subclinical and clinical consequences of early childhood obesity and sleep problems. Specifically, we propose to evaluate the following three specific aims: 1) the prospective relationships between childhood sleep related factors and obesity in young adulthood; 2a) the longitudinal association between baseline obesity and cardiometabolic, sleep and neurobehavioral outcomes at follow-up; 2b) cross-sectional association between obesity and relevant clinical and subclinical cardiometabolic and sleep abnormalities at follow-up; and 3) whether SDB in adolescence is age-dependent. We plan to assess the independent associations between independent variables in the obesity and sleep domains and three inter-related health outcomes involving cardiometabolic, sleep and neurobehavioral systems. Obesity both in adults and children has become epidemic and is a major public health problem given its association with CVD, the leading cause of death, and other metabolic diseases. However, there are limited data assessing the risk factors for, and outcomes of, childhood obesity. Recent data from our group and others are supportive of a systematic prospective investigation of our hypotheses, and these evidences include: (1) Sleep duration has been recently identified as a novel risk factor for obesity, and the association is modified by factors such as age, gender, stress, physical activity, and socioeconomic status. In our data, we observed a cross-sectional association between sleep duration and obesity based on subjective but not objective reports; (2) Obese adults that are stressed frequently have mild hypercorticolism and are at risk for stress-induced visceral obesity and metabolic syndrome. Our data, from the child and adult samples, support this hypothesis; (3) Obesity in adults is a strong risk factor for cardiovascular disease. In our child sample, we have reported that obesity and SDB are strong and independent risk factor for higher levels of BP and impairment of cardiac autonomic modulation; (4) In adults it is hypothesized that obesity leads to higher risk of CVD via metabolic syndrome pathway and there is increasing concern that metabolic factors are elevated in obese children as well. We and others have reported that SDB in adults is associated with increased risk of the metabolic syndrome. In our child data, SDB was cross-sectionally associated with an increased risk for several metabolic abnormalities; (5) We and others have reported that impaired autonomic modulation is significantly associated with CVD mortality and morbidity. In our children sample, we have reported significant synergistic interactions between SDB-HRV and obesity-HRV on elevated BP, indicative of complex inter-relationships between sleep, obesity, and cardiometabolic health occurring early in life. Finally, in our child data the age distribution of SDB suggested a possible age-dependent relationship within adolescence. PUBLIC HEALTH RELEVANCE: Obesity in childhood has become an epidemic and a major public health problem. This prospective study will assess a wide range of novel risk factors for and subclinical and clinical consequences of early childhood obesity and sleep problems. The knowledge gained from this study will better position our intervention strategies to reduce the public health burden of childhood obesity.

描述（由申请人提供）：我们建议对700名青少年进行为期8年的随访检查。该队列的招募和基线检查在他们5-12岁时进行。我们的总体目标是评估广泛的风险因素，以及儿童早期肥胖和睡眠问题的亚临床和临床后果。具体而言，我们建议评估以下三个具体目标：1）儿童期睡眠相关因素与青年期肥胖之间的前瞻性关系; 2a）基线肥胖与随访时心脏代谢、睡眠和神经行为结果之间的纵向关联; 2b）随访时肥胖与相关临床和亚临床心脏代谢和睡眠异常之间的横截面关联;（3）青春期SDB是否具有年龄依赖性。我们计划评估肥胖和睡眠领域的独立变量与涉及心脏代谢、睡眠和神经行为系统的三个相互关联的健康结果之间的独立关联。成人和儿童的肥胖症已经成为流行病，并且由于其与CVD（死亡的主要原因）和其他代谢疾病的关联，是一个主要的公共卫生问题。然而，评估儿童肥胖的风险因素和结果的数据有限。来自我们小组和其他人的最新数据支持对我们的假设进行系统的前瞻性研究，这些证据包括：（1）睡眠时间最近被确定为肥胖的新风险因素，并且这种关联受到年龄，性别，压力，体力活动和社会经济地位等因素的影响。在我们的数据中，我们观察到睡眠时间和肥胖之间的横截面关联基于主观而非客观的报告;（2）经常受到压力的肥胖成年人有轻度皮质醇过多症，并且有压力诱导的内脏肥胖和代谢综合征的风险。我们的数据，从儿童和成人样本，支持这一假设;（3）成人肥胖是心血管疾病的一个强有力的危险因素。在我们的儿童样本中，我们已经报道了肥胖和SDB是血压水平升高和心脏自主调节受损的强烈和独立的风险因素;（4）在成人中，假设肥胖通过代谢综合征途径导致CVD的风险升高，并且越来越多的人关注肥胖儿童中代谢因子也升高。我们和其他人已经报道了成人SDB与代谢综合征风险增加有关。在我们的儿童数据中，SDB与几种代谢异常的风险增加有关;（5）我们和其他人已经报道了受损的自主调节与CVD死亡率和发病率显著相关。在我们的儿童样本中，我们报告了SDB-HRV和肥胖-HRV之间对血压升高的显著协同作用，表明睡眠、肥胖和生命早期发生的心脏代谢健康之间存在复杂的相互关系。最后，在我们的儿童数据中，SDB的年龄分布表明青春期内可能存在年龄依赖关系。 公共卫生相关性：儿童肥胖已成为一种流行病和一个主要的公共卫生问题。这项前瞻性研究将评估儿童早期肥胖和睡眠问题的各种新的危险因素以及亚临床和临床后果。从这项研究中获得的知识将更好地定位我们的干预策略，以减少儿童肥胖的公共卫生负担。