Iron Deficiency and Adversity in Early Life and Cardiometabolic Risk in Adulthood

 说明(申请人提供)：缺铁(ID)与心血管事件有关，如儿童中风和成年后的心血管疾病(CVD)和各种原因的死亡。然而，尚不清楚婴儿期的ID是否会导致心血管疾病和代谢综合征(心脏代谢风险)的发展。对早期智障的发育影响的研究表明，智障对认知功能、行为和社会情绪发展有长期的负面影响。这些变化可能会影响增加心脏代谢风险的健康行为。早期的逆境(如贫穷、虐待)与较高的心脏代谢风险有关，也可能通过类似的认知、行为和社会情感途径起作用。由于ID在低SES和其他不利情况下更常见，一个尚未检验的假设是，既有ID又有早期不良经历的双重负担，这些不良经历对功能产生负面影响，并随后增加心脏代谢风险。该项目的目标是了解早期失调症与逆境和成人心脏代谢风险之间的途径，以便确定预防和干预的目标，并发现功能和心脏代谢健康中断风险最高的亚群。这一目标将使用从婴儿期到成年早期(PI：Betsy Lozoff和Sheila Gahagan)的关于ID影响的大型纵向研究(n&gt；1000)的数据来实现。课程将利用有关早期智障和逆境(社会经济状况、生活压力、母亲抑郁、父亲不在)、青少年认知功能、健康行为和心理健康以及成人心脏代谢风险(BMI、脂肪质量、血压、血脂、新陈代谢激素调节)的信息。第一个目标将测试早期失调症是否通过与青少年认知功能、健康行为和心理健康相关的途径间接影响成年人的心脏代谢风险。第二个目标将研究早期的逆境是否通过相似或不同的途径影响心脏代谢风险。第三个目标将研究ID和逆境的双重负担是否会通过这些青少年途径进一步增加成年后的心脏代谢风险。这些目标将通过一个培训计划来实现，该培训计划强调早期ID(赞助者Lozoff)的神经生物学和行为影响、童年对心脏代谢风险的影响(共同赞助者Gahagan)、早期逆境(Lozoff和Gahagan)以及先进的统计方法。完成这项研究和培训将是PI职业计划的第一步，以开展与政策相关的研究，研究营养和逆境对一生中心理和身体健康的影响。

 DESCRIPTION (provided by applicant): Iron deficiency (ID) is associated with cardiovascular events such as stroke in children and cardiovascular disease (CVD) and all-cause mortality in adulthood. However, it is unknown whether ID in infancy contributes to the development of CVD and metabolic syndrome (cardio-metabolic risk). Studies of developmental effects of early ID demonstrate long-term negative effects on cognitive functioning, behavior, and socio-emotional development. Such changes may affect health behaviors that increase cardio-metabolic risk. Early adversity (e.g., poverty, maltreatment) is linked to higher cardio-metabolic risk and might also operate through similar cognitive, behavioral, and socio-emotional pathways. As ID is more common in low SES and other disadvantaged circumstances, a yet untested hypothesis is that there is a dual burden of having both ID and early adverse experiences that negatively affects functioning and subsequently increases cardio-metabolic risk. The goal of this project is to understand pathways between early ID and adversity and adult cardio-metabolic risk in order to identify targets for prevention and intervention and to detect subgroups at highest risk for disruptions in functioning and cardio-metabolic health. This goal will be accomplished using data from a large longitudinal study (n > 1000) of the effects of ID from infancy to early adulthood (PIs: Betsy Lozoff and Sheila Gahagan). Information on early ID and adversity (SES, life stress, maternal depression, father absence), adolescent cognitive functioning, health behaviors, and mental health, and adult cardio-metabolic risk (BMI, fat mass, blood pressure, blood lipids, hormonal regulators of metabolism) will be utilized. The first aim will test whether there are indirect effects of early ID on adult cardio-metabolic risk through pathways related to adolescent cognitive functioning, health behaviors, and mental health. The second aim will examine whether early adversity affects cardio-metabolic risk through similar or different pathways. The third aim will examine whether the dual burden of ID and adversity further increases cardio-metabolic risk in adulthood through these adolescent pathways. These aims will be accomplished with a training plan emphasizing the neurobiological and behavioral effects of early ID (sponsor Lozoff), childhood influences on cardio-metabolic risk (co-sponsor Gahagan), early adversity (Lozoff and Gahagan), and advanced statistical methods. Completing this research and training will be the first step in the PI's career plan to conduct policy-relevant research on the impact of nutrition and adversity on mental and physical health throughout the lifespan.