Epidemiology of Diabetes Complications (EDC) Phase II: renewal

糖尿病并发症流行病学 (EDC) 第二阶段：更新

• 批准号: 8815670
• 负责人: TREVOR J. ORCHARD
• 金额: $ 63.5万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 1985
• 资助国家: 美国
• 起止时间: 1985-09-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8815670
• 关键词: Address; Advanced Glycosylation End Products; Blood Glucose Self-Monitoring; Childhood; Clinical; Collaborations; Complex; Complication; Complications of Diabetes Mellitus; Data; Development; Diabetes Mellitus; Diabetes prevention; Diagnosis; Employee Strikes; Epidemiology; Glycosylated hemoglobin A; Health Insurance; Healthcare; Immune response; Incidence; Individual; Inflammatory; Instruction; Insulin-Dependent Diabetes Mellitus; Investigation; Knowledge; Life Expectancy; Morbidity - disease rate; Natural History; Non-Insulin-Dependent Diabetes Mellitus; Participant; Pediatric Hospitals; Peer Review; Phase; Population Study; Prevalence; Principal Investigator; Publications; Registries; Risk; Risk Factors; Role; Skin; Stress; Surveys; Testing; Women' s Health; biological adaptation to stress; cohort; cytokine; follow-up; insight; insulin dependent diabetes mellitus onset; programs

Program Director/Principal Investigator (Last, First, Middle): O r c h a r d , T r e v o r J . PROJECT SUMMARY (See instruclions): Unlike type 2 diabetes, where prevention is possible, type 1 diabetes is currently neither preventable nor curable and its Incidence continues to rise approximately 3% peryr. Thus, the continuing investigation of type 1 diabetes complications remains imperative. The Epidemiology of Diabetes Complications (EDC) study has examined the prevalence and incidence of and risk factors contributing to the diabetes complications for 25 yrs. The study population is a well defined cohort of childhood onset type 1 diabetes identified from the Children's Hospital of Pittsburgh Registry (diagnosis: 1950-80). All 658 participants attending a clinical exam at study entry (1986-88) have been subsequently followed for up to 25 yrs, leading to over 150 peer reviewed publications. A number of striking observations were made during the last phase of the study which have given rise to questions and hypotheses this continuation will continue to address. These include the increasingly complex interaction between various pro- and anti-glycoxidative and inflammatory cytokines, as well as the rapidly changing natural history of complications which provides further insight into the interrelationships of, and specific risk factors for, complications, and renders historic data outdated for health care and insurance purposes. The current proposal, therefore, focuses on further assessment of complication development for a total follow up period of 30 yrs, thus allowing reasonably stable estimates of complication development over 40 yrs duration of childhood onset type 1 diabetes. This gives the opportunity to document morbidity risk and to estimate life expectancy in the modern era, i.e. for those diagnosed in 1965-80 and who have had more than half their diabetes duration since the availability of HbA1c testing and self monitoring of blood glucose. The roles of glycemic, oxidative and inflammatory stress, and the host's responses they invoke, on complication development will be another major focus along with women's health issues and continuing a number of collaborations. Finally, we will evaluate skin advanced glycosylation end products as a complication predictor for 232 individuals with at least one such assessment. This will be facilitated by continuing the annual surveys and, at 30 yrs of follow up, a full exam. RELEVANCE (See instructions): Type 1 diabetes is currently neither preventable nor curable and its incidence continues to rise about 3% per yr. Thus, the continuing investigation of type 1 diabetes complications remains imperative. The current proposal will not only provide insight on complication incidence, but also fill gaps in knowledge on T1D women's health issues, and the role of stress and host's response and skin AGE on complications.

项目负责人/主要研究者（最后一名、第一名、中间名）：O r c a r d、T r e v o r J。 项目总结（见附录）： 与2型糖尿病不同的是，预防是可能的，1型糖尿病目前既不可预防， 可治愈，其发病率继续上升，每年约3%。因此，继续调查 1型糖尿病并发症仍然是当务之急。糖尿病并发症的流行病学（EDC） 一项研究调查了糖尿病的患病率、发病率和危险因素 研究人群是一个明确定义的儿童期1型糖尿病队列， 匹兹堡儿童医院登记处（诊断：1950-80）。所有658名参与者 在研究入组时参加临床检查（1986-88）的患者随后随访长达25年， 超过150篇同行评审的出版物。在最后一个阶段， 本报告将继续探讨引起问题和假设的研究结果。 这些包括各种促和抗糖氧化剂之间日益复杂的相互作用， 炎症细胞因子，以及并发症的快速变化的自然史， 进一步深入了解并发症的相互关系和特定风险因素，并使其成为历史 用于医疗保健和保险目的的过时数据。因此，目前的建议侧重于进一步 评估30年总随访期的并发症发展，从而合理地允许 儿童期发病1型糖尿病40年并发症发展的稳定估计。这 提供了记录发病风险和估计现代预期寿命的机会，即 那些在1965-80年被诊断出糖尿病的人，自从有了糖尿病， HbA 1c检测和自我血糖监测。血糖、氧化和炎症的作用 压力和宿主对并发症发展的反应将是另一个主要焦点 沿着妇女健康问题，并继续开展一些合作。最后，我们将评估皮肤 晚期糖基化终末产物作为232例至少有一种这种 考核这将通过继续进行年度调查和在30年的随访中进行全面检查来促进。 相关性（参见说明）： 1型糖尿病目前既不可预防也不可治愈，其发病率每年持续上升约3%。 年人工老化因此，1型糖尿病并发症的持续调查仍然是必要的。当前 该提案不仅将提供对并发症发生率的见解，还将填补T1 D知识的空白 妇女的健康问题，以及压力和主机的反应和皮肤年龄对并发症的作用。