Project 1: Obesity and adverse dietary patterns as susceptibility factors to pollutant exposure in urban COPD.

项目 1：肥胖和不良饮食模式作为城市慢性阻塞性肺病污染物暴露的易感因素。

• 批准号: 8994762
• 负责人: Nadia N Hansel
• 金额: $ 14.84万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8994762
• 关键词: Adult; Affect; Air; Air Pollutants; Air Pollution; Antioxidants; Appalachian Region; Area; Baltimore; Body Composition; Body fat; Body mass index; Carotene; Catchment Area; Cause of Death; Chronic Obstructive Airway Disease; Cities; Collaborations; Communities; Complex; Consumption; Data; Diet; Dietary Practices; Dietary intake; Disease; Disease Outcome; Dual-Energy X-Ray Absorptiometry; Eating; Environment; Exposure to; Fatty acid glycerol esters; Food; Frequencies; Gold; Habits; Health; Health Food; Health Services Accessibility; High Prevalence; Home environment; Hospitalization; Household; Income; Individual; Indoor Air Pollution; Indoor environment; Inflammation; Intervention; Lead; Literature; Low Income Population; Low income; Lung Inflammation; Lung diseases; Measures; Methods; Morbidity - disease rate; Nitrogen Dioxide; Nutrient; Obesity; Observational Study; Obstructive Lung Diseases; Outcome; Particulate Matter; Pattern; Phenotype; Pollution; Poverty; Predisposition; Prevalence; Progressive Disease; Public Health; Quality of life; Questionnaires; Research; Research Infrastructure; Research Personnel; Resources; Risk; Role; Rural; Rural Community; Scanning; Serum; Skinfold Thickness; Smoker; Smoking; Socioeconomic Status; Structure; Symptoms; Testing; Therapeutic; Time; Tocopherols; United States; Vitamin D; Vitamins; experience; health care service utilization; health disparity; high risk; improved; indexing; inner city; low socioeconomic status; lung injury; novel; nutrition; pollutant; programs; public health priorities; respiratory

Project Summary Chronic obstructive pulmonary disease (COPD) is a progressive disease affecting approximately fifteen million people in the US. COPD prevalence and morbidity is increased in individuals from low income households. Our research group has shown that indoor air pollutant concentrations (particulate matter (PM) and nitrogen dioxide (NO2)) are higher in lower income homes compared to higher income homes. In addition, increased pollutant concentrations in homes of former smokers with COPD are associated with respiratory morbidity, including increased respiratory symptoms, worse quality of life and increased risk of exacerbations and health care utilization. Though there are several factors that coalesce in poor environments that contribute to COPD morbidity or increase susceptibility to pollution exposure we will focus on obesity and dietary intake because: 1) the literature and our preliminary data strongly support the role of obesity and poor diet in contributing to COPD outcomes and susceptibility to air pollution, 2) both factors are prevalent in low-income urban settings therefore positive results are likely to have great potential for significant public health impact, 3) at the individual level, indoor air, diet and obesity are modifiable, unlike other factors such as outdoor air or access to healthcare, and 4) the hypotheses being tested in this application are highly novel. Obesity is traditionally defined by BMI alone, however, the phenotype of obesity as a disease is complex and heterogeneous and it is increasingly recognized that BMI is an imprecise measure of body composition. Given the importance of understanding these highly prevalent susceptibility factors for adverse COPD outcomes, we will use skin fold thickness and DEXA scanning, considered the “gold standard” for the assessment of adiposity, in order to determine whether we can improve our ability to identify susceptible individuals, compared to the use of BMI alone. In addition, we will assess dietary patterns by food frequency questionnaire (FFQ) and assessment of serum vitamin and anti-oxidant levels in an observational study of 120 former smokers with moderate to severe COPD from a catchment area in Baltimore with a high proportion of low-income households. We aim to determine whether elevated fat mass and body composition (ie. higher trunk to total fat ratio) increases susceptibility to indoor pollution in low-income adults with COPD (Specific Aim #1); and whether adverse dietary patterns (Specific Aim #2a) and vitamin or nutrient antioxidant levels (Specific Aim #2b) lead to heightened susceptibility to indoor air pollution contributing to adverse health outcomes in COPD. Our study aims build upon a well-established infrastructure of investigators with complementary areas of expertise. Our study findings may identify several potential intervention strategies to reduce the harmful effects of PM and NO2 exposure in adults with COPD in low income populations. With COPD being the third leading cause of death in the US, developing strategies to reduce morbidity is an important public health priority.

项目摘要 慢性阻塞性肺疾病（COPD）是一种渐进疾病，影响约1500万 美国的人。来自低收入家庭的个体的COPD患病率和发病率增加。 我们的研究小组表明，室内空气污染物浓度（颗粒物（PM）和氮 与较高的收入家庭相比，低收入家庭的二氧化碳（NO2）更高。另外，增加 COPD前吸烟者家庭中污染物浓度与呼吸道发病率有关， 包括增加呼吸道症状，较差的生活质量以及加重和健康的风险增加 护理利用。尽管有几个因素在糟糕的环境中融合有助于COPD 发病率或增加对污染暴露的敏感性，我们将专注于肥胖和饮食摄入量，因为： 1）文献和我们的初步数据强烈支持肥胖和饮食不良在有助于 COPD的结果和对空气污染的敏感性，2）在低收入城市环境中这两个因素都普遍存在 因此，积极的结果可能会对公共卫生产生重大影响有很大的潜力，3） 个人水平，室内空气，饮食和肥胖是可修改的，与其他因素（例如室外空气或进入）不同 医疗保健和4）在此应用程序中检验的假设非常新颖。肥胖是传统上 然而，仅由BMI定义，肥胖的表型是疾病是复杂且异质的，它是 越来越多地认识到BMI是对身体成分的秘密测量。考虑到重要性 了解这些非常普遍的不良COPD结果的敏感性因素，我们将使用皮肤折叠 厚度和DEXA扫描，被认为是评估肥胖的“黄金标准”，以便 与使用BMI相比，确定我们是否可以提高识别易感人物的能力 独自的。此外，我们将通过食物频率问卷（FFQ）评估饮食模式，并评估 在120名中度至重度的前吸烟者的检查中，血清维生素和抗氧化剂水平 来自巴尔的摩的集水区的COPD，低收入家庭中有很高的COPD。我们的目标 确定脂肪质量和身体成分升高（即较高的躯干与总脂肪比）是否增加 COPD的低收入成年人对室内污染的敏感性（特定AIM＃1）；以及是否广告 饮食模式（特定目标＃2A）和维生素或营养抗氧化剂水平（特定目的＃2B）导致 室内空气污染的易感性提高，导致COPD的不良健康结果。我们的研究 目标是建立在具有完善领域的研究人员的建立良好基础设施的基础上。我们的 研究结果可能会确定几种潜在的干预策略，以减少PM的有害影响 低收入人群的成年人的NO2暴露。 COPD是第三主要原因 在美国的死亡，制定减少发病率的策略是重要的公共卫生优先事项。