Iodine Nutrition and Thyroid Disease During Pregnancy and Lactation

妊娠期和哺乳期的碘营养与甲状腺疾病

• 批准号: 8638052
• 负责人: Angela Mei-Tin Leung
• 金额: $ 12.87万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8638052
• 关键词: Academic Medical Centers; Address; Advisory Committees; Affect; Appointment; Area; Award; Biological Markers; Biostatistical Methods; Boston; Breast; Breast Feeding; Caucasoid Race; Childhood; Clinical; Clinical Investigator; Clinical Research; Clinical Research Curriculum Award; Country; Cross-Sectional Studies; Data; Databases; Development Plans; Diabetic Diet; Dietary Iodine; Discipline of obstetrics; Educational process of instructing; Endocrine; Endocrinology; Environment; Environmental Exposure; Epidemiologic Methods; Epidemiology; Exposure to; Faculty; Fellowship; Female of child bearing age; First Pregnancy Trimester; Fostering; Funding; Future; Grant; Guidelines; Health; Hour; Human Milk; Hypothyroidism; Infant; Infant Health; Ingestion; Institutes; Intake; Interdisciplinary Study; Iodine; Knowledge; Laboratories; Lactation; Los Angeles; Master of Science; Measures; Medicine; Mental Retardation; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Mothers; NCI Scholars Program; National Health and Nutrition Examination Survey; National Research Service Awards; Outcome; Perchlorates; Perinatal; Physiology; Population; Population Database; Postpartum Women; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Prenatal Nutrition; Public Health; Public Health Schools; Publications; Regression Analysis; Research; Research Personnel; Research Project Grants; Research Training; Residencies; SECTM1 gene; Serum; Site; Standardization; Testing; Thiocyanates; Thyroid Diseases; Thyroid Function Tests; Thyroid Gland; Thyroid Hormones; Time; Training; Training Programs; Trust; United States National Institutes of Health; Universities; Urine; Variant; Woman; Women' s Health; Work; World Health Organization; career; career development; cigarette smoking; college; design; experience; fetal; hatching; infant nutrition; instructor; interest; iodine deficiency syndrome; meetings; member; neurodevelopment; nutrition; pregnant; premature; prenatal; professor; programs; reproductive; screening; secondary outcome; skills; sodium-iodide symporter; symposium; uptake; urinary

DESCRIPTION (provided by applicant): My research experience began with laboratory projects at Occidental College in Los Angeles. During my residency and fellowship training at Boston University Medical Center (BUMC), I undertook several clinical research projects with Drs. Lewis Braverman and Elizabeth Pearce. In June 2009, I completed a clinical and research fellowship in the Section of Endocrinology, Diabetes, and Nutrition at Boston University Medical Center (BUMC), the last 2 years of which were supported by an NIH T32 National Research Service Award. I completed the BUMC Clinical Research Training (CREST) program (an NIH K30 Clinical Research Curriculum Award) from 2007-2009. In July 2009, I became a junior faculty member at Boston University, a Clinical and Translational Institute (CTSI) site, (BU-BRIDGE). I received a Master of Science in Epidemiology degree at the Boston University School of Public Health in January 2010. I have had 5 original research publications related to the topics of the current proposal, including 3 as first author. I am supported by a Charles A. King Trust Postdoctoral Fellowship Award and an NIH K12 Building Interdisciplinary Research Careers in Women's Health (BIRCWH) grant at Boston University. The BIRCWH scholars program promotes career development of young investigators through mentored research, monthly research meetings, academic guidance, and national research presentations. During the K23 award period, my career development plans include participation in research-oriented seminars, presenting at national endocrine meetings, attending BUMC didactic conferences, teaching activities, and formal coursework at BUMC. I have assembled a research advisory committee who will assess my progress and provide ongoing guidance as I pursue my research plan. The skills and mentorship I will obtain through the BIRCWH and K23 awards will allow me to develop future research hypotheses aimed at specific strategies of achieving adequate iodine nutrition and normal thyroid function during pregnancy and lactation. This work will then prepare me to embark on the design and implementation of an R01 award aimed at specific strategies to achieve universal adequate iodine nutrition and normal thyroid function during pregnancy and lactation. Environment I am currently an Instructor of Medicine in the Section of Endocrinology, Diabetes, and Nutrition (Shalender Bhasin, MD; Chief) at BUMC, where the majority of my current appointment is devoted to research. The Section is comprised of 45 full-time faculty members (including one of the largest thyroid groups in the country with 7 fulltime MD faculty) and boasts over 12 million dollars in research funding, an NIH training grant, and several program and center projects. My mentor on this proposal is Dr. Lewis Braverman, Professor of Medicine at BUMC and an accomplished mentor to over 60 fellows in various aspects of thyroid physiology over his nearly 50-year career. My co-mentor is Dr. Elizabeth Hatch, Associate Professor of Epidemiology at Boston University School of Public Health, who has extensive experience and research interests in prenatal and childhood exposures relating to adverse reproductive outcomes. Research Iodine deficiency is debilitating, prevalent, and the leading cause of mental retardation worldwide. Dietary iodine is necessary for thyroid hormone synthesis. Normal thyroid function is particularly important during pregnancy and lactation, as maternal thyroid hormone levels are crucial for proper fetal and infant neurodevelopment. The impact of breast milk iodine levels on infant thyroid function is unknown. In addition, environmental exposures to perchlorate and cigarette smoke (which is metabolized to thiocyanate) decrease iodine uptake into the lactating breast, thereby further impairing iodine availability to the infant and potentially directly affecting infant thyroid function. The broad objective of this proposal is to test the hypotheses that: 1) hypothyroidism during pregnancy is associated with premature birth and other adverse obstetric/perinatal outcomes, and 2) breast milk perchlorate and thiocyanate levels, by their inhibition of NIS, decrease breast milk iodine levels (which fluctuate in relationship to dietary iodine ingestion), and are associated with infant hypothyroidism. The results of this research will have important public health implications for thyroid function screening among pregnant women and adequate maternal iodine nutrition during pregnancy and lactation. Specific Aim 1 will be a database review studying the relationships between maternal hypothyroidism during pregnancy and obstetric/perinatal outcomes. Specific Aim 2 will be an interventional assessment of an iodine load on the effects and timing of peak breast milk iodine levels in postpartum women. Specific Aim 3 will be a cross-sectional study of maternal and infant iodine intake, maternal and infant perchlorate and cigarette smoke (thiocyanate) exposures, and infant thyroid function. The pursuit of these projects, in conjunction with formal coursework in biostatistical and epidemiological methods, is intended to foster my career as an independent academic clinical investigator in thyroid disease as it relates to women's and infant health.

描述（由申请人提供）：我的研究经历始于洛杉矶西方学院的实验室项目。在波士顿大学医学中心（Boston University Medical Center， BUMC）实习期间，我与dr。刘易斯·布雷弗曼和伊丽莎白·皮尔斯。2009年6月，我在波士顿大学医学中心（BUMC）完成了内分泌学、糖尿病和营养学的临床和研究奖学金，最后两年得到了NIH T32国家研究服务奖的支持。2007-2009年，我完成了BUMC临床研究培训（CREST）项目（NIH K30临床研究课程奖）。2009年7月，我成为波士顿大学临床与转化研究所（CTSI） （BU-BRIDGE）的初级教员。我于2010年1月在波士顿大学公共卫生学院获得流行病学硕士学位。我已经发表了5篇与本次提案主题相关的原创研究论文，其中3篇为第一作者。我得到了查尔斯·a·金信托博士后奖学金奖和波士顿大学NIH K12妇女健康跨学科研究事业（BIRCWH）资助。BIRCWH学者计划通过指导研究、月度研究会议、学术指导和国家研究报告来促进年轻研究者的职业发展。在K23奖励期间，我的职业发展规划包括参加研究型研讨会，在全国内分泌会议上发言，参加北卡罗来纳大学的教学会议，教学活动，以及北卡罗来纳大学的正式课程。我已经组建了一个研究咨询委员会，他们将评估我的进展，并在我进行研究计划时提供持续的指导。我将通过BIRCWH和K23奖项获得的技能和指导将使我能够制定未来的研究假设，旨在实现妊娠和哺乳期充足的碘营养和正常甲状腺功能的具体策略。然后，这项工作将使我准备着手设计和实施R01奖，旨在实现怀孕和哺乳期间普遍充足的碘营养和正常甲状腺功能的具体战略。我目前是北卡罗来纳大学内分泌学、糖尿病和营养学（Shalender Bhasin，医学博士；主任）的医学讲师，我目前的大部分工作都是研究。该科由45名全职教师组成（包括全国最大的甲状腺小组之一，拥有7名全职医学博士教师），拥有超过1200万美元的研究资金，NIH培训补助金，以及几个计划和中心项目。我的导师是刘易斯·布雷弗曼博士，他是北卡罗来纳医学院的医学教授，在他近50年的职业生涯中，他在甲状腺生理学的各个方面指导了60多名研究员。我的共同导师是伊丽莎白·哈奇博士，她是波士顿大学公共卫生学院流行病学副教授，在产前和儿童时期暴露与不良生殖结果相关方面有着丰富的经验和研究兴趣。碘缺乏症是一种使人虚弱、普遍的疾病，也是全世界智力迟钝的主要原因。膳食碘是合成甲状腺激素所必需的。正常的甲状腺功能在孕期和哺乳期尤为重要，因为母体甲状腺激素水平对胎儿和婴儿的正常神经发育至关重要。母乳碘含量对婴儿甲状腺功能的影响尚不清楚。此外，环境暴露于高氯酸盐和香烟烟雾（其被代谢为硫氰酸盐）减少碘吸收到哺乳期乳房，从而进一步损害碘对婴儿的可利用性，并可能直接影响婴儿甲状腺功能。本提案的主要目的是验证以下假设：1)怀孕期间甲状腺功能减退与早产和其他不利的产科/围产期结局有关；2)母乳高氯酸盐和硫氰酸盐水平通过抑制NIS降低母乳碘水平（其随饮食碘摄入而波动），并与婴儿甲状腺功能减退有关。这项研究的结果将对孕妇甲状腺功能筛查和孕期和哺乳期孕妇碘营养充足具有重要的公共卫生意义。具体目标1将是一个数据库综述，研究孕期孕产妇甲状腺功能减退与产科/围产期结局之间的关系。具体目标2将是碘负荷对产后妇女母乳碘水平峰值的影响和时间的干预性评估。具体目标3将是一项关于母婴碘摄入量、母婴高氯酸盐和香烟烟雾（硫氰酸盐）暴露以及婴儿甲状腺功能的横断面研究。对这些项目的追求，加上生物统计学和流行病学方法的正式课程，旨在培养我作为甲状腺疾病独立学术临床研究者的职业生涯，因为它与妇女和婴儿健康有关。