Epidemiology of Diabetes Complications (EDC) Phase II: renewal

糖尿病并发症流行病学 (EDC) 第二阶段：更新

• 批准号: 8004724
• 负责人: TREVOR J. ORCHARD
• 金额: $ 1.58万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-12-23 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8004724
• 关键词: Achievement; Address; Advanced Glycosylation End Products; Affect; Age; Antioxidants; Binding; Blood Glucose; Blood Glucose Self-Monitoring; Blood Vessels; Brain; Cardiology; Cardiovascular system; Centers for Disease Control and Prevention (U.S.); Childhood; Clinic; Clinical; Collaborations; Complex; Complication; Complications of Diabetes Mellitus; Coronary Arteriosclerosis; Coronary heart disease; Country; Creatinine clearance measurement; Data; Defense Mechanisms; Development; Devices; Diabetes Mellitus; Diabetes prevention; Diagnosis; Disease; Documentation; Employee Strikes; Epidemiology; Event; Exposure to; Fluorescence; Fluorescence Spectrometry; Follow-Up Studies; Funding; General Population; Genotype; Glomerular Filtration Rate; Glycosylated hemoglobin A; Grant; Haptoglobins; Health; Healthcare; Hemoglobin; Hemoglobin concentration result; Immune response; Impaired Renal Function; Incidence; Individual; Inflammatory; Insulin; Insulin Resistance; Insulin-Dependent Diabetes Mellitus; Insurance; Insurance Carriers; Investigation; Kidney Diseases; Knowledge; Life Expectancy; Life Insurance; Magnetic Resonance Imaging; Measurement; Measures; Mediator of activation protein; Menopausal Status; Menopause; Modeling; Morbidity - disease rate; Natural History; Nested Case-Control Study; Neuropathy; Non-Insulin-Dependent Diabetes Mellitus; Participant; Pathogenesis; Patients; Pattern; Pediatric Hospitals; Peer Review; Phase; Population Study; Postmenopause; Pregnancy; Pregnancy loss; Prevalence; Prevention approach; Progress Reports; Proteomics; Public Health; Publications; Recording of previous events; Registries; Reporting; Research; Research Infrastructure; Research Personnel; Risk; Risk Estimate; Risk Factors; Risk Marker; Role; Self Care; Series; Sister; Skin; Specimen; Stress; Surveys; Testing; Time; Variant; Women' s Health; adipokines; adiponectin; age effect; base; calcification; cohort; coronary artery calcification; cytokine; disability; follow-up; genetic analysis; high risk; improved; insight; instrument; insulin dependent diabetes mellitus onset; mortality; novel strategies; phase 2 study; prospective; public health relevance; response; stressor; success; urinary

DESCRIPTION (provided by applicant): Unlike type 2 diabetes, where prevention is possible, type 1 diabetes is currently neither preventable nor curable and its incidence continues to rise approximately 3% per year. Thus, the continuing investigation of type 1 diabetes complications remains imperative. The Epidemiology of Diabetes Complications (EDC) study has examined the prevalence and incidence of and risk factors contributing to the diabetes complications for 20 years. The study population is a well defined cohort of childhood onset type 1 diabetes identified from the Children's Hospital of Pittsburgh Registry (diagnosis: 1950-80). All 658 participants attending a clinical exam at study entry (1986-88) have been subsequently followed for up to 20 years, leading to over 114 peer reviewed publications. A number of striking preliminary observations made during the last phase of the study have given rise to questions and hypotheses this renewal aims to address. These include the increasingly complex interaction between various pro- and anti-glycoxidative and inflammatory cytokines, as well as the rapidly changing natural history of complications which provides further insight into the interrelationships of, and specific risk factors for, complications, and renders historic data outdated for health care and insurance purposes. The current application, therefore, focuses on further assessment of complication development for a total follow up period of 25 years, thus allowing reasonably stable estimates of complication development over 40 years duration of childhood onset type 1 diabetes. This gives the opportunity to document morbidity risk and to estimate life expectancy in the modern era, i.e. for those diagnosed in 1965-80 and who have had more than half their diabetes duration since the availability of HbA1c testing and self monitoring of blood glucose. The roles of glycemic, oxidative and inflammatory stress, and the host's responses they invoke, on complication development will be another major focus along with women's health issues and continuing a number of collaborations. Finally, we will evaluate skin advanced glycosylation end products using a new instrument and how they relate to complication risk. This will be facilitated by continuing the annual surveys and, at 25 years of follow up, a full examination. PUBLIC HEALTH RELEVANCE: The significance of this application lies in the ability to provide, in a large type 1 diabetes cohort, documentation of morbidity risk and estimates of life expectancy in the modern era of HbA1c testing and self monitoring of blood glucose, whereas the availability of stored specimen offers the opportunity to address the role of stress (glycemic, oxidative and/or inflammatory) and the host's response it provokes, in the pathogenesis of vascular complications. This application also addresses women's health issues and evaluates new instruments in their ability to predict complication risk. As currently type 1 diabetes is neither preventable nor curable, the continuing investigation of its complications remains imperative and the present study may both further our knowledge of the natural history of complications and also point to novel approaches to prevention and management.

描述（由申请人提供）：与可以预防的 2 型糖尿病不同，1 型糖尿病目前既无法预防也无法治愈，并且其发病率每年持续上升约 3%。因此，对 1 型糖尿病并发症的持续研究仍然势在必行。糖尿病并发症流行病学 (EDC) 研究调查了 20 年来糖尿病并发症的患病率、发生率以及导致糖尿病并发症的危险因素。研究人群是匹兹堡儿童医院登记处确定的明确的儿童期 1 型糖尿病队列（诊断：1950-80 年）。所有 658 名参加研究时（1986-88 年）参加临床考试的参与者随后都被跟踪长达 20 年，发表了超过 114 篇同行评审出版物。在研究的最后阶段做出的一些引人注目的初步观察结果引发了本次更新旨在解决的问题和假设。其中包括各种促糖氧化和抗糖氧化以及炎症细胞因子之间日益复杂的相互作用，以及并发症的快速变化的自然史，这可以进一步深入了解并发症的相互关系和特定的风险因素，并使历史数据对于医疗保健和保险目的来说已经过时。因此，当前的应用重点是在 25 年的总随访期内进一步评估并发症的发展，从而可以对儿童期发病 1 型糖尿病 40 年期间的并发症发展进行相当稳定的估计。这为记录发病风险并估计现代的预期寿命提供了机会，即对于那些在 1965-80 年间诊断出来的人，以及自 HbA1c 测试和血糖自我监测出现以来一半以上患有糖尿病的人。血糖、氧化和炎症应激的作用以及它们引起的宿主反应对并发症发展的作用将与妇女健康问题和继续进行的许多合作一样成为另一个主要焦点。最后，我们将使用新仪器评估皮肤高级糖基化最终产品以及它们与并发症风险的关系。这将通过继续进行年度调查以及在 25 年的后续行动中进行全面检查来促进。公共健康相关性：该应用的重要性在于能够在大型 1 型糖尿病队列中提供发病风险记录以及现代 HbA1c 测试和血糖自我监测时代的预期寿命估计，而存储样本的可用性提供了解决压力（血糖、氧化和/或炎症）及其引起的宿主反应的作用的机会。 血管并发症的发病机制。该应用程序还解决了女性的健康问题，并评估了新仪器预测并发症风险的能力。由于目前 1 型糖尿病既无法预防也无法治愈，因此对其并发症的持续研究仍然势在必行，本研究既可以进一步加深我们对并发症自然史的了解，也可以指出新的预防和管理方法。