Understanding the Transition From Low Birth Weight to Insulin Resistance in Child

项目总结（见说明）： 在美属维尔京群岛（USVI）和美国大陆一样，糖尿病的患病率在儿童中已达到流行病水平。在美国，非裔美国儿童2型糖尿病的患病率较高，这与他们更倾向于胰岛素抵抗有关，而胰岛素抵抗不能用传统的危险因素来解释。据报道，与其他东加勒比地区人口相比，USVI儿童糖尿病的发病率较高，这种差异似乎与遗传易感性的差异无关。 初步研究表明，非洲裔加勒比妇女使用某些应对方式与皮质醇激素失调有关，而皮质醇激素失调又与出生体重不足和随后儿童出现胰岛素抵抗的风险增加有关。然而，非洲裔加勒比人或非洲裔美国人儿童的应对方式、低出生体重和胰岛素抵抗之间的联系尚未得到探讨。 初步研究还表明，低出生体重儿体重的追赶性增加与14至16岁的非洲-加勒比青少年的胰岛素抵抗有关。人们对母亲的应对方式如何影响导致非裔加勒比人或非裔美国儿童体重追赶性增加的生活方式因素知之甚少。 这项拟议中的研究将研究母亲的应对方式与激素皮质醇失调、低出生体重、出生体重增加和USVI儿童胰岛素抵抗的关系。此外，这项研究将评估在非洲裔加勒比青少年中观察到的性别、出生体重低、体重增加、糖尿病家族史和胰岛素抵抗之间的关系是否延伸到2至4岁的儿童。

PROJECT SUMMARY (See instructions): In the U.S. Virgin Islands (USVI) as on the US mainland, the prevalence of diabetes mellitus has reached epidemic levels in children. In the USA the higher prevalence of Type 2 diabetes in African American children is linked to their greater tendency to insulin resistance which cannot be accounted for by conventional risk factors. The incidence of childhood diabetes is reported to be higher in the USVI compared to other eastern Caribbean populations, and this difference does not appear to be related to differences in genetic susceptibility. Preliminary research suggest that use of certain coping styles by Afro-Caribbean women is associated with dysregulation of the hormone Cortisol which is associated with increased risk for low birth weight and subsequent development of insulin resistance in children. However the link between coping styles, low birth weight and insulin resistance in Afro-Caribbean or African American children has not been explored. Preliminary research has also shown that catch-up weight gain among children born low birth weight is associated with insulin resistance in Afro-Caribbean adolescents age 14 to 16. Little is known about how a mother's coping styles might influence lifestyle factors that contribute to catch-up weight gain in Afro-Caribbean or African American Children. The proposed study will examine the relationship of a mother's coping style to dysregulation of the hormone Cortisol, low birth weight, weight gain from birth and insulin resistance in USVI children. Moreover, the study will assess whether relationships between gender, low birth weight, catch-up weight gain, family history of diabetes and insulin resistance that were observed in Afro-Caribbean adolescents extend to children ages 2 to 4.