Patient-oriented Research in Maternal Perinatal Overnutrition and Child Adiposity

以患者为中心的母亲围产期营养过剩和儿童肥胖研究

• 批准号: 8164496
• 负责人: Emily Oken
• 金额: $ 16.91万
• 依托单位: HARVARD PILGRIM HEALTH CARE, INC.
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-16 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8164496
• 关键词: 11 year old; 3 year old; 7 year old; Animals; Anthropometry; Award; Biological Markers; Birth; Blood Pressure; Body Composition; Body fat; Body mass index; Breast Feeding; Centers for Disease Control and Prevention (U.S.); Child; Child Development; Child Overnutrition; Child health care; Childhood; Cohort Studies; Computerized Medical Record; Consumption; Counseling; Data; Development; Doctor of Philosophy; Enrollment; Exposure to; Fatty Acids; Fatty acid glycerol esters; Fishes; Funding; Gestational Diabetes; Glucose; Glucose Intolerance; Goals; Growth; Health; Health behavior; Hospitals; Human; Hypertension; Influentials; Insulin; Intervention; Investigation; Life; Life Cycle Stages; Lipids; Malnutrition; Maternal Health; Measures; Medicine; Mentors; Mentorship; Mercury; Metabolic; Metabolic Marker; Methods; Mid-Career Clinical Scientist Award (K24); Mothers; National Institute of Child Health and Human Development; National Institute of Environmental Health Sciences; Obesity; Outcome; Outcome Measure; Overnutrition; Overweight; Pathway interactions; Perinatal; Plasma; Population; Pregnancy Outcome; Prevalence; Prevention; Primary Care Physician; Principal Investigator; Relative (related person); Research; Research Personnel; Risk; Risk Factors; Scanning; System; Time; Training; United States National Institutes of Health; Weight; Weight Gain; Woman; Women' s Health; Work; adipokines; base; career; disorder risk; experience; fasting glucose; glucose tolerance; in utero; innovation; medical schools; metabolomics; mother nutrition; novel; nutrition; offspring; patient oriented; patient oriented research; perinatal health; pregnant; prenatal; professor; randomized trial; research study

DESCRIPTION (provided by applicant): The overall goals of this K24 application are to provide Emily Oken MD, MPH with protected time to serve as a mentor to junior clinician investigators, and to support new scientific aims that will build upon Dr. Oken's established work on the lifecourse health effects of maternal perinatal health and nutrition. Dr. Oken is an Associate Professor in the Department of Population Medicine at Harvard Medical School, and a Primary Care Physician at the Gretchen and Edward Fish Center for Women's Health at Brigham and Women's Hospital. She leads several large patient-oriented research studies, including an NICHD-funded R01 of over 14,000 11-year-old children previously enrolled in a randomized trial of breastfeeding intervention; an ongoing NIEHS-funded R01 of maternal prenatal fish consumption, mercury exposure, and child development at age 7 years; and a CDC-funded project to develop an electronic medical record-based system to support gestational weight gain counseling and tracking. Dr. Oken has already successfully served as a research mentor to more than a dozen clinicians in training and PhD candidates. This K24 award would come at a critical time in Dr. Oken's career, as she solidifies her independent research trajectory and seeks to increase her availability to mentor junior investigators. The award will also support a new research investigation that builds on Dr. Oken's ongoing NIH supported work in maternal perinatal nutrition and offspring health. Early studies on the life course effects of early life nutrition focused on poor growth and under nutrition. More recently, a variety of research findings provide substantive evidence that prenatal over nutrition, including exposure to excesses of maternal weight, gestational glucose, and weight gain, is associated with overweight in offspring. However, extant human studies are limited in that few have included outcome measures other than weight. The proposed scientific aims will take advantage of existing data from Project Viva, a unique US pre-birth cohort study of which Dr. Oken is the co-Principal Investigator, to determine the extent to which maternal weight, gestational weight gain, and gestational glucose tolerance are each associated with adiposity and established measures of cardio- metabolic risk among children at age 7 years. This project will also identify novel metabolic markers in children's plasma at age 7 years, using comprehensive metabolic profiling ("metabolomics"), that are associated with maternal prenatal over nutrition and with child adiposity and standard cardio-metabolic risk factors at the same time point. PUBLIC HEALTH RELEVANCE: One out of every three women who become pregnant in the US is obese, and the prevalence of both gestational diabetes mellitus and excess gestational weight gains are each high and rising. These conditions have implications not only for pregnancy outcomes and long-term maternal health, but also for child health. The proposed project will better characterize the child health risks associated with maternal perinatal over nutrition.

描述（由申请人提供）：这个K24申请的总体目标是为Emily Oken医学博士，公共卫生硕士提供受保护的时间，作为初级临床医生调查员的导师，并支持新的科学目标，这些目标将建立在Oken博士关于孕产妇围产期健康和营养的生命过程健康影响的既定工作之上。奥肯博士是哈佛医学院人口医学系副教授，也是布莱根妇女医院格雷琴和爱德华·菲什妇女健康中心的初级保健医生。她领导了几项以患者为导向的大型研究，包括一项由nichd资助的R01研究，研究对象是14000多名11岁儿童，他们之前参加了一项母乳喂养干预的随机试验；正在进行的由niehs资助的母亲产前鱼类消费、汞暴露和7岁儿童发育的R01研究；以及cdc资助的一个项目，该项目旨在开发一种基于电子病历的系统，以支持妊娠期体重增加的咨询和跟踪。奥肯博士已经成功地担任了十几名临床医生和博士候选人的研究导师。K24奖的颁发正值奥肯博士职业生涯的关键时刻，因为她正在巩固自己的独立研究轨迹，并寻求增加自己指导初级研究人员的机会。该奖项还将支持一项新的研究调查，该调查建立在奥肯博士正在进行的NIH支持的孕产妇围产期营养和后代健康工作的基础上。早期关于生命早期营养对生命过程影响的研究主要集中在生长不良和营养不良。最近，各种各样的研究结果提供了实质性的证据，表明产前营养过剩，包括暴露于过量的母亲体重，妊娠期葡萄糖和体重增加，与后代超重有关。然而，现有的人类研究受到限制，因为很少有研究包括体重以外的结果测量。提出的科学目标将利用Viva项目的现有数据，这是一项独特的美国产前队列研究，Oken博士是该研究的共同首席研究员，以确定母亲体重、妊娠体重增加和妊娠糖耐量与肥胖的关联程度，并确定7岁儿童心脏代谢风险的测量方法。该项目还将利用综合代谢谱（“代谢组学”）识别7岁儿童血浆中的新型代谢标志物，这些标志物与母亲产前营养过剩、儿童肥胖和标准心脏代谢风险因素在同一时间点相关。