Patient-oriented Research in Maternal Perinatal Overnutrition and Child Adiposity

描述(由申请人提供)：这项K24申请的总体目标是为Emily Oken医学博士、公共卫生硕士提供有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周期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，也是布里格姆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。她领导了几项大型的以患者为导向的研究，包括由NICHD资助的R01项目，该项目涉及14,000多名11岁儿童，之前参加了母乳喂养干预的随机试验；正在进行的NIEHS资助的R01项目，研究孕妇产前鱼类摄入、汞暴露与7岁儿童发育；以及CDC资助的项目，开发基于电子医疗记录的系统，以支持妊娠体重增加咨询和跟踪。奥肯博士已经成功地为十多名临床医生提供了培训和博士生的研究指导。这一K24奖项将在奥肯博士职业生涯的关键时刻到来，因为她巩固了自己的独立研究轨迹，并寻求增加自己指导初级调查人员的机会。该奖项还将支持一项新的研究调查，该调查建立在Oken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。早期关于早期生命营养的生命过程影响的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大量证据表明，产前过度营养，包括暴露于过量的母亲体重、妊娠期血糖和体重增加，与后代超重有关。然而，现有的人体研究是有限的，因为除了体重之外，很少有结果衡量标准。拟议的科学目标将利用Project Viva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调查员，以确定母亲体重、孕期体重增加和妊娠期葡萄糖耐量与肥胖的程度，并确定7岁儿童心脏代谢风险的衡量标准。该项目还将利用全面的代谢图谱(“代谢组学”)确定7岁儿童血浆中的新代谢标记物，这些标记物与母亲产前过度营养以及同一时间点的儿童肥胖和标准的心脏代谢风险因素有关。

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.