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

项目摘要 寻找青年糖尿病(SEARCH)是一项正在进行的、多中心的研究，包含了最大和最多的 曾在美国学习过的不同种族的糖尿病青年群体。响应RFA-DP10-001， B部分，搜索队列研究将利用这一独特资源，继续研究选定的 寻找参与者以解决以下目标：1)评估以下疾病的患病率、发病率和危险因素 选定的慢性微血管标记物(视网膜病变、肾病和自主神经病变)和 糖尿病大血管并发症(高血压、动脉僵硬)；2)评估发病率和风险 糖尿病急性并发症的相关因素，包括严重低血糖和糖尿病酮症酸中毒； 进行死亡率监测；以及4)确定护理障碍、护理质量和 过渡到成人护理会影响糖尿病相关的健康结果，包括生活质量。覆盖在这些 目标，我们将侧重于种族/族裔和其他社会文化因素以及生物化学方面的影响 糖尿病类型对糖尿病相关健康结果的影响。搜索队列研究将进行面对面的 对2002年或以后发生的糖尿病病程为5年及以上的搜索参与者进行的研究访问 已完成基线数据(预期n=3699)。在这项研究中，医学史，人体测量学， 将收集和分析生化、生理和测量数据。与其他人合作 搜索临床中心，俄亥俄州的网站将从所有符合条件的病例中收集本提案中描述的数据。 我们预计大约有646名俄亥俄州的受试者有资格参加。就2002-2005年的突发事件而言，85% 俄亥俄州的参与者中，至少有一次返回进行后续访问，这是整个研究范围内反应最高的一次 费率。俄亥俄州的团队也拥有最高的实验室岩心样本完成率。针对2006年事件 俄亥俄州的案例完成率为99%，2008年事件案例的完成率为100%。在这份提案中， 俄亥俄州网站将使用与搜索1和搜索2相同的方法和技术来保持高主题 留存率。因此，俄亥俄州的网站很有可能达到该提案中的招聘目标 对搜索队列研究的成功做出了重大贡献。这项研究将利用大小和 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；由美国的主要种族/民族；并通过使用一种新的 以病理生理维度区分传统临床糖尿病类型的方法。因此，搜索 队列研究很有可能对青少年糖尿病患者的临床护理产生重大影响 美国所有主要种族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.