Cardiovascular disease burden in minorities: population impact of adiposity

描述（由申请人提供）：此博士前奖学金（F31）资助申请旨在促进北卡罗来纳州大学博士前学生Shannon Kapuaolaokalaniakea Gellert的培训。她的目标是成为一名独立的研究人员，在少数民族社区进行创新的转化健康研究。在F31培训期间，申请人将由她的赞助商Gerardo Heiss博士，凯南流行病学教授指导。拟议研究计划的主题领域是通过肥胖的生活方式相关转变，以人群为基础预防心血管疾病（CVD）的可改变风险因素。该研究回应了对与肥胖相关的慢性疾病的可预防人口负担的经验信息的需求，以帮助制定优先事项和卫生政策，特别是针对少数群体。慢性疾病（主要是心血管疾病）是美国少数族裔残疾和死亡的主要原因。大多数慢性疾病起源于生命早期，并由公认的行为、代谢和环境风险因素（包括肥胖）介导。人群中肥胖症的持续时间增加表明迫切需要在人群水平上解决肥胖症对健康的不利影响，以遏制目前的趋势。尽管年轻人的肥胖分布具有动态性，但迄今为止，很少有此类工作报告用于评估肥胖适度变化对人口的影响，在少数群体中也没有。这项拟议中的研究将量化肥胖人口分布变化的影响，其幅度与美国年轻人和中年人记录的时间趋势相似，三种心脏代谢危险因素（收缩压（SBP）、空腹低密度脂蛋白胆固醇（LDL-C）和空腹血糖）。将在15，972名年龄在45-64岁之间的非裔美国人和白色成人的基于两种族人群的社区动脉粥样硬化风险（ARIC）队列中估计这些变化对CVD终点的影响。分析将包括对在9-12年随访期间参加4次检查的受试者的重复观察。这项研究将提供一种新的方法来了解肥胖的微小变化与非裔美国人和白人的心脏代谢危险因素和CVD负担之间的关系。该研究的潜在影响是其能够为迫切需要的基于人群的预防策略提供优先级设置和政策考虑，以应对与肥胖人群变化相关的CVD负担。

DESCRIPTION (provided by applicant): This pre-doctoral fellowship (F31) grant application is designed to promote the training of Shannon Kapuaolaokalaniakea Gellert, a pre-doctoral student at the University of North Carolina (UNC). Her goal is to become an independent researcher who conducts innovative, translational health studies in minority communities. During the F31 training the applicant will be mentored by her sponsor Dr. Gerardo Heiss, Kenan Professor of Epidemiology. The topical area for the proposed research plan is population-based prevention of modifiable risk factors for cardiovascular disease (CVD) through life-style related shifts in adiposity. The research responds to a need for empirical information on the preventable population burden of chronic diseases associated with adiposity in populations, to aid in priority setting and health policy, particularly for minority populations. Chronic diseases, predominantly CVD, are prominent causes of disability and death in minority populations in the U.S. Most have origins early in life and are mediated by well-established behavioral, metabolic and environmental risk factors, including adiposity. The sustained temporal increase in adiposity in populations suggests an urgent need to address the adverse health effects of adiposity at the population level, to arrest current trends. Despite the dynamic nature of adiposity distributions i the young, little work of this kind has been reported to date to assess the population impact of modest changes in adiposity, and none in minority populations. The proposed study will quantify the impact of changes in the population distribution of adiposity, similar in magnitude to the temporal trends documented for young and middle-aged adults in the U.S., on three cardio-metabolic risk factors (systolic blood pressure (SBP), fasting low density lipoprotein cholesterol (LDL-C), and fasting glucose). The effect on CVD endpoints of these changes will be estimated in the bi-racial population-based Atherosclerosis Risk in Communities (ARIC) cohort of 15,972 African American and White adults between the ages of 45-64 years. Analyses will include repeat observations on participants who attended 4 examinations over the course of 9-12 years of follow-up. This study will provide a novel approach to understanding the association between small changes in adiposity and both cardio-metabolic risk factors and the burden of CVD in African Americans and whites. The potential impact of the study is its ability to inform priority setting and policy considerations for urgently needed population-based prevention strategies to counter the burden of CVD associated with population changes in adiposity.