Conventional and Metabolomic Predictors of Pediatric Prediabetes & Insulin Resist

儿童糖尿病前期的常规和代谢组学预测因子

• 批准号: 8629297
• 负责人: Joyce Lee
• 金额: $ 64.47万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-01 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8629297
• 关键词: Adolescence; Adolescent; Adult; American; Biological Markers; Biometry; Carbohydrates; Cardiovascular Diseases; Child; Childhood; Clinical; Cross-Sectional Studies; Development; Diabetes Mellitus; Diabetes prevention; Diagnosis; Diet; Dietary Intervention; Early Intervention; Early identification; Epidemic; Epidemiologic Studies; Epidemiology; Etiology; Functional disorder; Future; Glycosylated hemoglobin A; Growth; Human; Impaired fasting glycaemia; Incidence; Individual; Insulin; Insulin Resistance; Intake; Interdisciplinary Study; Intervention; Lead; Link; Longitudinal Studies; Macronutrients Nutrition; Measures; Medical Research; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Overweight; Pathogenesis; Pattern; Performance; Policies; Population; Prediabetes syndrome; Prevalence; Preventive Intervention; Puberty; Research Personnel; Research Project Grants; Risk; Risk Factors; Science; Time; Youth; cohort; diabetes risk; disorder risk; feeding; glucose tolerance; high risk; human disease; impaired glucose tolerance; insight; insulin sensitivity; interest; metabolomics; novel; nutrition; obesity in children; performance tests; polyunsaturated fat; primary care setting; public health relevance; response; screening; trend

PROJECT SUMMARY Rates of prediabetes and diabetes are increasing in the pediatric population, due to the epidemic of childhood obesity. Epidemiologic studies have linked prediabetes in childhood with a higher risk of type 2 diabetes in adulthood. Because children with prediabetes represent a high-risk group of individuals who may benefit from early identification and intervention, there is increasing interest in the use of biomarkers previously validated in adults for pediatric populations. The proposed study will evaluate the longitudinal test performance of an array of conventional biomarkers of glycemia, including Hemoglobin A1c (HbA1c), and novel metabolomic biomarkers for identifying progression of glucose tolerance (normal to prediabetes or prediabetes to diabetes) in an overweight and obese pediatric cohort. In addition, a feeding study will also be conducted to examine variability in metabolomic biomarkers associated with abnormal glucose tolerance in response to macronutrient diet composition. The specific aims of this study are the following: Specific Aim #1: Assess whether conventional biomarkers of glycemia longitudinally predict progression of glucose tolerance (normal to prediabetes or prediabetes to diabetes) in a cohort of overweight/obese children. Specific Aim #2a: Identify novel metabolomic measures that longitudinally predict progression of glucose tolerance (normal to prediabetes or prediabetes to diabetes) and insulin resistance in a cohort of overweight/obese children. Specific Aim #2b: Evaluate the variability in metabolomic biomarkers associated with abnormal glucose tolerance in response to high carbohydrate and high polyunsaturated fat diets in an overweight/obese adolescent population. Application of the science of metabolomics to human disease risk is a major focus of the NIH's Roadmap for Medical Research. Although an increasing number of metabolomic studies have been conducted in adults, few studies have been conducted in children. This will be one of the first longitudinal studies to evaluate the predictive capacity of a comprehensive set of conventional and novel biomarkers for identifying adolescents with insulin sensitivity and progression of glucose tolerance status. The proposed research project represents a unique multidisciplinary collaboration of investigators with expertise in pediatric obesity and diabetes, diabetes epidemiology, metabolomics, human nutrition, and biostatistics, and will provide important information relevant for future pediatric screening policy, insights into the pathogenesis of prediabetes/type 2 diabetes during adolescence, and information on specific dietary interventions and their impact on the metabolomic 'at risk' profile.

项目总结 由于儿童时期的流行，儿科人群中糖尿病前期和糖尿病的发病率正在增加。 肥胖。流行病学研究已经将儿童时期的糖尿病前期与#年2型糖尿病的高风险联系在一起。 成人期。因为患有前驱糖尿病的儿童是一群高危人群，他们可能会受益于 早期识别和干预，人们对使用以前在 成人用于儿科人群。拟议的研究将评估阵列的纵向测试性能 血糖的常规生物标志物，包括血红蛋白A1c(HbA1c)和新的代谢组学 识别糖耐量进展的生物标志物(从正常到糖尿病前期或从糖尿病前期到糖尿病) 在一个超重和肥胖的儿童队列中。此外，还将进行喂养研究，以检查 代谢组生物标志物的变异性与糖耐量异常对大量营养素的反应有关 饮食构成。这项研究的具体目标如下： 具体目标1：评估传统的血糖生物标志物是否可以纵向预测糖尿病的进展 超重/肥胖儿童队列中的糖耐量(正常到糖尿病前期或糖尿病前期)。 具体目标#2a：确定新的代谢指标，纵向预测血糖的进展 一组人群的耐受性(对糖尿病前期或糖尿病前期)和胰岛素抵抗 超重/肥胖儿童。 具体目标#2b：评估与异常血糖相关的代谢生物标记物的变异性 超重/肥胖者对高碳水化合物和高多不饱和脂肪饮食的耐受性 青少年人口。 将代谢组学科学应用于人类疾病风险是美国国立卫生研究院 医学研究。尽管越来越多的代谢组学研究在成人中进行，但很少有 已经在儿童身上进行了研究。这将是第一批纵向研究之一，评估 一套全面的常规和新型生物标志物对青少年识别的预测能力 与胰岛素敏感性和糖耐量状态的进展有关。拟议的研究项目代表了 拥有儿童肥胖和糖尿病专业知识的研究人员进行了独特的多学科合作， 糖尿病流行病学、代谢组学、人类营养和生物统计学，并将提供重要信息 与未来的儿科筛查政策相关，对糖尿病前期/2型糖尿病发病机制的洞察 在青春期，以及关于特定饮食干预及其对代谢的影响的信息 Risk‘简介。