Cardiovascular disease burden in minorities: population impact of adiposity

描述(由申请人提供)：这份博士前奖学金(F31)助学金申请旨在促进北卡罗来纳大学博士前学生Shannon Kapuaolaokalaniakea Gellert的培训。她的目标是成为一名独立研究员，在少数族裔社区进行创新的转化性健康研究。在F31培训期间，申请者将由她的赞助人、凯南流行病学教授Gerardo Heiss博士指导。拟议研究计划的主题领域是通过与肥胖相关的生活方式的改变，以人群为基础预防心血管疾病(CVD)的可改变危险因素。这项研究回应了对可预防的与人口肥胖症相关的慢性病的人口负担的经验信息的需要，以帮助确定优先事项和卫生政策，特别是对少数群体。慢性疾病，主要是心血管疾病，是美国少数族裔人口残疾和死亡的主要原因。大多数疾病起源于生命早期，并受到公认的行为、代谢和环境风险因素的影响，包括肥胖。人口肥胖症的持续时间增加表明，迫切需要在人口层面上解决肥胖症对健康的不利影响，以遏制目前的趋势。尽管肥胖症在年轻人中的分布具有动态性质，但迄今为止，很少有人报告这类工作，以评估肥胖症适度变化对人口的影响，在少数群体中也没有。这项拟议的研究将量化肥胖症人群分布的变化对三个心脏代谢风险因素(收缩血压(SBP)、空腹低密度脂蛋白胆固醇(LDL-C)和空腹血糖)的影响，这些变化的幅度类似于美国年轻人和中年人的时间趋势。这些变化对心血管疾病终点的影响将在15,972名年龄在45-之间的非裔美国人和白人成年人的基于社区动脉粥样硬化风险的双种族队列中进行评估。分析将包括在9-12年的随访过程中对参加过4次检查的参与者进行重复观察。这项研究将提供一种新的方法来理解肥胖的微小变化与心脏代谢危险因素和非裔美国人和白人的心血管疾病负担之间的联系。这项研究的潜在影响是，它能够为迫切需要的以人口为基础的预防战略的优先事项确定和政策考虑提供信息，以应对与肥胖人口变化相关的心血管疾病负担。

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.