Patient-oriented Research in Maternal Perinatal Overnutrition and Child Adiposity

描述（由申请人提供）：本 K24 申请的总体目标是为 Emily Oken MD、MPH 提供受保护的时间，作为初级临床医生研究人员的导师，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对生命全程健康影响的既定工作的基础上。奥肯博士是哈佛医学院人口医学系的副教授，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，包括由 NICHD 资助的 R01，该研究对先前参加的一项母乳喂养干预随机试验的 14,000 多名 11 岁儿童进行了研究；由 NIEHS 资助的一项正在进行的 R01，涉及孕产妇产前鱼类消费、汞暴露和 7 岁时儿童发育；疾病预防控制中心资助的项目开发基于电子病历的系统，以支持妊娠体重增加咨询和跟踪。 Oken 博士已成功担任十几位临床医生培训和博士生的研究导师。这项 K24 奖项将在 Oken 博士职业生涯的关键时刻颁发，因为她巩固了自己的独立研究轨迹，并寻求增加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，该调查以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为基础。关于生命早期营养对生命历程影响的早期研究主要集中在生长不良和营养不足。最近，各种研究结果提供了实质性证据，表明产前过度营养，包括接触过量的母亲体重、妊娠葡萄糖和体重增加，与后代超重有关。然而，现有的人类研究是有限的，因为很少包括体重以外的结果测量。拟议的科学目标将利用 Viva 项目的现有数据，这是一项独特的美国产前队列研究，Oken 博士是该研究的联合首席研究员，以确定母亲体重、妊娠体重增加和妊娠葡萄糖耐量与肥胖的相关程度，并确定 7 岁儿童心脏代谢风险的衡量标准。该项目还将利用综合代谢分析（“代谢组学”）确定 7 岁时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以及儿童肥胖和同一时间点的标准心脏代谢危险因素相关。

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.