Lifestyle Intervention in Preparation for Pregnancy (LIPP)

备孕生活方式干预 (LIPP)

• 批准号: 9849601
• 负责人: Patrick Catalano
• 金额: $ 69.68万
• 依托单位: TUFTS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-13 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9849601
• 关键词: Advocate; Affect; Air; Beta Cell; Birth; Birth Weight; Blood; Body Composition; Body Weight decreased; Body fat; Body measure procedure; Breast Feeding; Center for Translational Science Activities; Child; Clinical; Clinical Research; Communities; Conceptions; Data; Densitometry; Energy Metabolism; Environment; Enzyme-Linked Immunosorbent Assay; Esterification; Evaluation; Fatty acid glycerol esters; Fetal Growth; Functional disorder; Glucose; Growth; Health; High birth weight infant; Human; In Vitro; Inflammation; Inflammatory; Insulin; Insulin Resistance; Interleukin-6; Intervention; Isotope Labeling; Leptin; Link; Lipids; Longitudinal Studies; Longterm Follow-up; Low Birth Weight Infant; Maternal Physiology; Measures; Metabolic; Metabolic Pathway; Metabolic dysfunction; Metabolism; Methods; Mitochondria; Molecular; Mothers; Neonatal; Obesity; Outcome; Outcome Study; Overweight; Physiological; Physiology; Pisum sativum; Planned Pregnancy; Plethysmography; Pregnancy; Preparation; Quantitative Reverse Transcriptase PCR; Randomized; Randomized Controlled Trials; Recommendation; Recreation; Reporting; Research; Research Personnel; Retrospective cohort study; Small for Gestational Age Infant; Spectrophotometry; Time; Umbilical Cord Blood; Umbilical cord structure; Weight; Woman; adiponectin; adverse maternal outcomes; base; clinically relevant; conditioning; control trial; epidemiologic data; fatty acid oxidation; fetal adiposity; gestational weight gain; improved; in utero; inflammatory marker; insight; insulin secretion; insulin sensitivity; intervention effect; lean body mass; lifestyle intervention; lipid metabolism; neonatal outcome; neonate; newborn adiposity; obesity management; obesogenic; offspring; oxidation; postpartum weight; prepregnancy; prospective; recruit; response; success; treatment as usual

Project Summary The objective of this proposal is to break the vicious cycle of obesity/metabolic dysfunction during pregnancy. Lifestyle interventions in obese women during pregnancy have had limited success in improving maternal or offspring short and long-term metabolic health. We propose that lifestyle interventions need to be initiated prior to conception in overweight and obese women (henceforth referred to as obese) in order to first improve maternal metabolism. Lifestyle interventions will take place in the Cleveland Community Recreation Centers. Metabolic evaluations will be conducted in the Clinical Research Units of the Case Western Reserve Clinical Translational Science Center (CTSC). This strategy will result in decreased fetal adiposity and improved metabolic function in the offspring. We plan to recruit 200 obese women to pursue the following specific aims: Specific Aim 1: To investigate the physiological significance of lifestyle intervention in preparation for pregnancy (LIPP) on maternal and neonatal metabolism and adiposity in humans. Specific Aim 1a. We hypothesize that preconception lifestyle intervention will facilitate lower maternal insulin resistance, inflammation, weight, adiposity, incretin response and energy expenditure compared to usual care. We will link these changes in maternal metabolism with fetal growth (SA1b). Specific Aim 1b. We hypothesize that in women initiating pre-pregnancy lifestyle intervention will deliver a baby with lower birth weight and fat accretion, insulin resistance, and inflammatory profile at birth. Body composition will be measured using anthropometrics and air displacement densitometry (Pea Pod). Specific Aim 2: To determine the molecular effects whereby lifestyle intervention initiated before pregnancy improves placental mitochondrial lipid oxidation and lipid accumulation. We hypothesize that lifestyle intervention before pregnancy will improve placental mitochondrial oxidation and decrease lipid esterification/storage. Isotope-labeled fatty acid oxidation and esterification will be quantified in vitro in placental explants from a subset of women. Mitochondrial lipid metabolism and content will be measured using qRT-PCR and Elisa. Placental lipids will be quantified by mass spectrophotometry and correlated with neonatal adiposity and maternal metabolism providing a mechanistic link to SA 1.

项目摘要 该提议的目的是打破肥胖/代谢功能障碍的恶性循环 怀孕期间。怀孕期间对肥胖妇女的生活方式干预有限 成功改善孕产妇或后代的短期和长期代谢健康。我们建议 这种生活方式干预需要在超重和肥胖的概念之前开始 妇女（此后称为肥胖），以便首先改善母体代谢。生活方式 干预将在克利夫兰社区娱乐中心进行。代谢 评估将在案例西部储备的临床研究单元中进行 临床转化科学中心（CTSC）。这种策略将导致胎儿减少 后代的肥胖和改善的代谢功能。我们计划招募200名肥胖女性 追求以下特定目标： 特定目的1：研究生活方式干预的生理意义 预怀孕（LIPP）在母亲和新生儿代谢和肥胖方面的准备（LIPP） 人类。 特定目标1a。我们假设先入为主的生活方式干预将有助于较低 母体胰岛素抵抗，炎症，体重，肥胖，肠降血糖素反应和能量 与通常的护理相比，支出。我们将将母体代谢的这些变化与 胎儿生长（SA1B）。 特定目标1B。我们假设在女性开始怀孕前生活方式干预中 将提供较低的出生体重和脂肪积聚，胰岛素抵抗和的婴儿 出生时的炎症特征。人体成分将使用拟人化和空气测量 位移密度法（PEA POD）。 特定目的2：确定分子效应，以便在这种情况下进行生活方式干预 妊娠前启动可改善胎盘线粒体脂质氧化和脂质 积累。 我们假设怀孕前的生活方式干预将改善胎盘线粒体 氧化并减少脂质酯化/储存。同位素标记的脂肪酸氧化和 酯化将在一部分女性的胎盘外植体中在体外进行量化。 线粒体脂质代谢和含量将使用QRT-PCR和ELISA进行测量。 胎盘脂质将通过质量分光光度法进行定量，并与新生儿相关 肥胖和母体代谢提供了与SA 1的机械联系。