SEARCH For Diabetes in Youth, Phase 3: Cohort Study-Carolina Center

青少年糖尿病研究是一项正在进行的多中心研究， 种族多样的青年糖尿病患者的研究。根据RFA-DP 10 -001， 组成部分B，SEARCH队列研究将利用这一独特资源，继续研究选定的 鼓励参与者解决以下目标：1）评估以下疾病的患病率、发生率和风险因素： 慢性微血管（视网膜病变、肾病和自主神经病变）的选定标志物， 糖尿病大血管并发症（高血压、动脉硬化）; 2）评估发病率和风险 糖尿病急性并发症的因素，包括严重低血糖和糖尿病酮症酸中毒; 3） 对死亡率进行监测; 4）确定护理障碍、护理质量和 过渡到成人护理影响糖尿病相关的健康结果，包括生活质量。覆盖在这些 目的，我们将重点关注种族/民族和其他社会文化因素的影响，以及生物化学方面 糖尿病类型，糖尿病相关的健康结果。该队列研究将进行一项面对面的 对2002年或之后发生的糖尿病事件的研究性访视，糖尿病持续时间> 5年， 完成基线数据（预期n=3699）。在本研究期间，病史、人体测量、 将收集和分析生化、生理和调查数据。由迈尔-戴维斯博士担任PI， 2002年的全国主席，正如我们在整个2004年所做的那样，卡罗莱纳临床 中心将提供实质性的科学领导。对于队列研究，我们在以下领域带来了新的领导力： 糖尿病性视网膜病变和糖尿病性肾病。重要的是，卡罗莱纳人口构成了最低的 目前的黑人社会经济地位，超过一半的非洲裔美国青年， 来自卡罗莱纳中心。此外，有相当一部分2型糖尿病患者 来自这个中心。本研究将利用研究人群的规模和种族多样性， 按传统的临床糖尿病类型、按主要的糖尿病类型、按主要的 美国的种族/族裔群体;以及采用一种新的方法来隔离传统的临床糖尿病 病理生理学维度的类型。因此，这项队列研究很有可能使 对美国所有主要种族的青年糖尿病患者的临床护理产生了重大影响， 国家公共卫生政策。

SEARCH for Diabetes in Youth (SEARCH) is an on-going, multi-center study containing the largest and most ethnically diverse population of youth with diabetes ever studied in the US. In response to RFA-DP10-001, Component B, the SEARCH Cohort Study will utilize this unique resource by continuing the study of selected SEARCH participants to address the following Aims: 1) assess the prevalence, incidence, and risk factors for selected markers of chronic microvascular (retinopathy, nephropathy, and autonomic neuropathy) and macrovascular complications (hypertension, arterial stiffness) of diabetes; 2) assess the incidence and risk factors for acute complications of diabetes including serious hypoglycemia and diabetic ketoacidosis ; 3) conduct surveillance of mortality; and 4) determine the degree to which barriers of care, quality of care, and transition to adult care impact diabetes-related health outcomes including quality of life. Overlaid across these Aims, we will focus on the impact of race/ethnicity and other sociocultural factors, and biochemical dimensions of diabetes type, on diabetes-related health outcomes. The SEARCH Cohort Study will conduct an in-person research study visit on SEARCH participants incident in 2002 or later, with duration of diabetes > 5 years and with baseline data completed (expected n=3699). During this study medical history, anthropometric, biochemical, physiologic, and survey data will be collected and analyzed. With the Dr Mayer-Davis as PI and the national chairperson for SEARCH 2, and as we have done throughout SEARCH, the Carolina Clinical Center will provide substantial scientific leadership. For the Cohort Study we bring new leadership in the areas of diabetic retinopathy and diabetic nephropathy. Importantly, the Carolina population comprises the lowest socioeconomic status among the current SEARCH sites, and over half of the African American youth in SEARCH are from the Carolina Center. Additionally, and a substantial proportion of youth with type 2 diabetes are from this Center. This study will exploit the size and ethnic diversity of the study population to identify differences in both processes of care and health outcomes by traditional, clinical diabetes type; by the major race/ethnic groups in the US; and by employing a novel approach to segregate traditional clinical diabetes types by pathophysiologic dimensions. Thus, the SEARCH cohort study has a high likelihood of making a significant impact on the clinical care of youth with diabetes from all the major ethnic groups in the US and on national public health policy.