Early Life Determinants of Accelerated Pubertal Development in Adolescent Girls

青春期女孩青春期加速发育的早期决定因素

• 批准号: 9121381
• 负责人: Ai Kubo
• 金额: $ 19.7万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9121381
• 关键词: Affect; Age; Anthropometry; Biometry; Birth; Body Composition; Body fat; Breast; California; Cancer Etiology; Central obesity; Child; Childhood; Classification Scheme; Cohort Studies; Colon; Complement; Computerized Medical Record; Data; Databases; Daughter; Development; Doctor of Philosophy; Documentation; Early Intervention; Electronics; Endocrinology; Endometrium; Environment; Estrogens; Event; Exposure to; Fat Body; Female Adolescents; Future; Gestational Diabetes; Goals; Health; Health Planning; Hormones; Human; Hyperglycemia; Infant; Insulin; Insulin Resistance; Intervention; Leptin; Life; Link; Malignant Neoplasms; Mammary Gland Parenchyma; Measures; Mediating; Medical Records; Menarche; Mentors; Mentorship; Metabolic; Metabolic syndrome; Metabolism; Mothers; Obesity; Outcome; Ovary; Participant; Pattern; Perinatal Exposure; Physical activity; Play; Polycystic Ovary Syndrome; Population; Positioning Attribute; Postmenopause; Pregnancy; Premenopause; Prevalence; Prevention strategy; Prospective Studies; Proxy; Puberty; Registries; Reporting; Research; Risk; Risk Factors; Role; Sexual Maturation; Staging; Time; Time Factors; Training; United States; Variant; Visit; Vulnerable Populations; Weight Gain; Woman; base; cancer epidemiology; cancer prevention; cancer risk; career; cohort; design; early onset; ethnic difference; experience; gestational weight gain; girls; glucose metabolism; glucose tolerance; health data; health disparity; high risk; indexing; innovation; intergenerational; malignant breast neoplasm; mammary gland development; member; modifiable risk; multidisciplinary; nutrition; obesity in children; offspring; postnatal; prenatal; prevent; programs; pubertal timing; racial and ethnic; reproductive; responsible research conduct; skills; transmission process; trend

DESCRIPTION (provided by applicant): Dr. Kubo's long-term career goal is to understand early-life determinants of cancer risk factors that relate to obesity and metabolic dysregulation, and to identify high-risk sub-populations that can benefit from early intervention strategies. Her primary research aim is to examine whether factors such as intrauterine exposure to maternal gestational diabetes (GDM), excessive gestational weight gain, obesity, and rapid infant weight gain increase the risk of accelerated pubertal onset in adolescent girls, an important breast and reproductive cancer risk factor. Her secondary aim is to explore the causes of the observed racial/ethnic differences in timing of puberty. No previous studies have examined these associations. These research goals will take advantage of electronic health data that are available in Kaiser Permanente Northern California (KPNC), a large integrated health plan that covers about 450,000 girls. Two specific approaches are proposed: 1. Linkage of mothers' and daughters' electronic health data in an on-going prospective study of predictors of sexual maturation in adolescent girls (U01 ES/CA019435) (Study 1); and, 2. Establishment of a new cohort of 20,000 multiethnic mother-daughter pairs using the electronic databases within KPNC (Study 2). Study 1 will utilize data from the CYGNET study (PI: Lawrence H. Kushi, ScD), which has been following 444 girls annually since 2005 with extensive information on pubertal development and anthropometric measures. The KPNC GDM and Pregnancy Glucose Tolerance Registry (Director: Assiamira Ferrara, MD, PhD) will be linked to the CYGNET data to accomplish study 1. In addition, the Registry will be used to establish a new cohort of mother-daughter pairs. This will allow Dr. Kubo gain experience and skills in establishing and follow a cohort based on KPNC electronic medical record data, and to explore racial/ethnic differences in pubertal onset. Electronic documentation of Tanner stage (an established five-stage classification scheme to assess pubertal development) from routine pediatric visits has recently been implemented at KPNC, and this availability on a large and diverse pediatric population makes this study unique and innovative. The candidate's research goals will be complemented with formal, mentored training through coursework and tailored tutorials in pediatric endocrinology, intergenerational transmission of metabolic dysregulation, advanced biostatistics, cancer prevention and health disparities, and responsible conduct of research. KPNC's Division of Research is an ideal environment for the proposed training because it provides unique and extensive electronic databases, access to data from a large, multiethnic membership, and internationally-recognized multidisciplinary experts. The planned scientific training and mentorship will build on the candidate's previous training in nutrition and cancer epidemiology, and uniquely position her to attain her goals. The proposed studies will provide crucial skills in establishing a new cohort, providing a platform for Dr. Kubo to develop successful R01 research to further elucidate early life determinants of pubertal onset and other cancer risk factors.

Kubo博士的长期职业目标是了解与肥胖和代谢失调有关的癌症风险因素的早期决定因素，并确定可以从早期干预策略中受益的高危亚群。她的主要研究目的是检查宫内暴露于母体妊娠糖尿病（GDM），过度妊娠体重增加，肥胖和婴儿体重快速增加等因素是否会增加青春期女孩青春期加速发病的风险，这是一个重要的乳腺癌和生殖癌风险因素。她的第二个目的是探索观察到的青春期时间的种族/民族差异的原因。以前的研究没有检查过这些关联。这些研究目标将利用凯泽永久北方加州（KPNC）提供的电子健康数据，这是一个覆盖约45万女孩的大型综合健康计划。提出了两个具体的方法：1。母亲和女儿的电子健康数据的联系，在一个正在进行的前瞻性研究的预测性成熟的青春期女孩（U 01 ES/CA 019435）（研究1）;和，2。利用KPNC内部的电子数据库建立一个新的20 000对多族裔母女队列（研究2）。研究1将利用来自CYGNET研究的数据（PI：Lawrence H. Kushi，ScD），自2005年以来，每年跟踪444名女孩，提供有关青春期发育和人体测量的广泛信息。KPNC GDM和妊娠葡萄糖耐量登记研究（负责人：Assiamira费拉拉，MD，PhD）将与CYGNET数据相关联，以完成研究1。此外，登记处将用于建立一个新的母女配对队列。这将使Kubo博士获得建立和跟踪基于KPNC电子病历数据的队列的经验和技能，并探索青春期开始的种族/民族差异。最近在KPNC实施了常规儿科访视的坦纳分期（一种既定的评估青春期发育的五期分类方案）的电子文件，这种对大量不同儿科人群的可用性使本研究具有独特性和创新性。候选人的研究目标将通过课程和儿科内分泌学，代谢失调的代际传递，先进的生物统计学，癌症预防和健康差异以及负责任的研究行为的量身定制的教程进行正式的指导培训。KPNC的研究部门是拟议培训的理想环境，因为它提供了独特而广泛的电子数据库，可以访问来自大型多种族成员和国际公认的多学科专家的数据。计划中的科学培训和指导将建立在候选人之前在营养和癌症流行病学方面的培训基础上，并使她能够实现自己的目标。拟议的研究将为建立一个新的队列提供关键技能，为Kubo博士开发成功的R 01研究提供平台，以进一步阐明青春期发病和其他癌症风险因素的早期决定因素。