SEARCH 3 Cohort Study to Assess Incidence of Acute and Chronic Diabetes-related C

项目摘要 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，即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。在与其他人的合作下， 除了临床中心外，俄亥俄州研究中心将从所有合格病例中收集本提案中描述的数据。 我们预计约有646例俄亥俄州受试者有资格参加研究。在2002-2005年的事件中，85% 的俄亥俄州参与者返回至少一次随访，这是研究范围内最高的响应 率俄亥俄州团队的实验室岩心样本完整率也是最高的。事件2006 俄亥俄州的完整性为99%，事件2008例的完整性为100%。在这项提案中， 俄亥俄州研究中心将采用与研究1和研究2相同的方法和技术，以保持高受试者 保留率。因此，俄亥俄州工厂很有可能达到本提案中的招聘目标 这对研究小组的成功做出了重大贡献。这项研究将利用规模和 研究人群的种族多样性，以确定护理过程和健康结果的差异， 传统的临床糖尿病类型;美国的主要种族/民族;以及采用新的 通过病理生理学维度分离传统临床糖尿病类型的方法。因此， 队列研究很有可能对青年糖尿病患者的临床护理产生重大影响， 美国的所有主要种族群体和国家公共卫生政策。

Project Summary 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 socio-cultural 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. In collaboration with the other SEARCH clinical centers, the Ohio site will collect the data described in this proposal from all eligible cases. We expect approximately 646 Ohio subjects will be eligible to participate. For Incident 2002-2005 cases, 85% of the Ohio participants have returned for at least one follow-up visit, which is the highest study-wide response rate. The Ohio team also has the highest rate for completeness of laboratory core samples. For Incident 2006 cases, Ohio had 99% completeness, and 100% completeness for Incident 2008 cases. In this proposal the Ohio site will employ the same approach and techniques used in SEARCH 1 and 2 to maintain high subject retention rates. Thus, the Ohio site has a very high likelihood of meeting the recruitment goals in this proposal contributing significantly to the success of the SEARCH Cohort Study. 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.