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艾米丽奥肯医学博士、公共卫生硕士提供受保护的时间，以作为初级临床研究人员的导师，并支持新的科学目标，该目标将建立在奥肯博士对孕产妇围产期健康和营养的生命周期健康影响的既定工作基础上。Oken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NICHD资助的R 01，研究对象是14，000多名11岁的儿童，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NIEHS资助的R 01，研究对象是母亲产前鱼类消费、汞暴露和7岁儿童发育; CDC资助的一个项目是开发一个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。Oken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。这个K24奖项将在Oken博士职业生涯的关键时刻到来，因为她巩固了她的独立研究轨迹，并寻求增加她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足上。最近，各种研究结果提供了大量证据表明，产前营养过剩，包括暴露于母亲体重，妊娠期葡萄糖和体重增加过多，与后代超重有关。然而，现存的人类研究是有限的，因为很少有包括体重以外的结果测量。拟定的科学目标将利用来自Viva项目的现有数据，该项目是一项独特的美国出生前队列研究，Oken博士是该研究的共同主要研究者，以确定母体体重、妊娠期体重增加和妊娠期葡萄糖耐量与肥胖的相关程度，以及7岁儿童的心血管代谢风险的既定指标。该项目还将使用综合代谢分析（“代谢组学”）确定7岁儿童血浆中的新代谢标志物，这些标志物与同一时间点的母亲产前营养过剩和儿童肥胖症以及标准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.