Early Environmental Stressors and Emerging Cardiometabolic Risk

项目摘要/摘要 在理解途径、时机以及风险和保护因素方面存在根本差距 在儿童时期，将早期环境压力转化为新出现的心脏代谢风险。改进 早期环境应激源引起新出现的调节失调的途径的知识 心脏代谢过程，儿童时期观察影响的时间，以及保护因素 这对于优化干预措施以预防心血管疾病的发展是必要的 代谢性疾病。拟议的研究将使用534个独特的队列来解决这一知识差距 参加双臂随机对照肥胖的种族/民族多样化的低收入儿童 预防试验，从2-4岁开始跟踪[网络试验(U01HD068890； Sherwood/法国PI)，COPTR联盟(儿童肥胖预防和治疗研究， NIH/NHLBI/DCVS/PPSP)]。这项前瞻性研究的目标是描述 在这个7-9岁的高危儿童队列中，心脏代谢过程的失调，并确定 延展性因素缓解早期环境应激源对晚期心脏代谢的有害影响 风险。最先进的环境应激源测量方法(客观和感知的邻居和家庭 环境)、儿童和父母行为模式(儿童健康行为的黄金标准， 执行功能技能和育儿因素)和生理调节因素(头发中的皮质醇水平 样本)，已经在儿童早期的四个时间点获得。年龄的新测量 7-9将允许对心脏代谢风险进行最尖端的评估，包括心血管和 代谢参数、身体成分、青春期和氧化应激/炎症。具体地说，这 研究将(1)检查儿童健康行为、执行功能和 早期环境应激源与儿童早期教育方式之间的关系 新出现的心脏代谢风险，(2)检查HPA轴调节是否在新出现的途径上 心脏代谢风险，并确定孩子和父母因素发挥缓冲作用的程度 通过调节儿童的皮质醇水平，以及(3)探讨是否参与多层次的行为 肥胖预防干预可增强儿童健康行为的缓冲作用 功能和育儿因素通过改变这些可改变的轨迹来影响心脏代谢风险 各种因素。这种方法是创新的，因为它代表着与现状的实质性背离， 关注早期环境应激源引起心脏代谢风险的途径 儿童期中期和缓冲这种风险的保护因素，因为它是预期的，所以意义重大 对优化对生活在压力较大的早期环境中的幼儿的干预具有直接影响 预防心血管和代谢性疾病。

Project Summary/Abstract There is a fundamental gap in understanding the pathways, timing, and risk and protective factors that translate early environmental stressors into emerging cardiometabolic risk during childhood. Improved knowledge of the pathways through which early environmental stressors give rise to emerging dysregulation in cardiometabolic processes, the timing during childhood when impacts are observed, and the protective factors that foster resilience, is necessary to optimize interventions to prevent the development of cardiovascular and metabolic diseases. The proposed study will address this knowledge gap using a unique cohort of 534 racially/ethnically diverse, low income children who participated in a two-arm randomized controlled obesity prevention trial and have been followed since 2-4 years of age [The NET-Works Trial (U01HD068890; Sherwood/French PIs), part of the COPTR consortium (Child Obesity Prevention and Treatment Research, NIH/NHLBI/DCVS/PPSP)]. The goal of this prospective study is to characterize the emergence of dysregulation in cardiometabolic processes in this high-risk cohort of children at 7-9 years of age, and identify malleable factors that mitigate the deleterious impact of early environmental stressors on later cardiometabolic risk. State-of-the-art measures of environmental stressors (objective and perceived neighborhood and home environment), child and parent behavior patterns (gold standard measures of children's health behaviors, executive functioning skills, and parenting factors) and physiological mediators (cortisol levels from hair samples), have already been obtained at four time points during early childhood. New measurements at ages 7-9 will allow the most cutting-edge assessment of cardiometabolic risk, including cardiovascular and metabolic parameters, body composition, pubertal stage, and oxidative stress/inflammation. Specifically, this study will (1) examine whether longitudinal patterns of children's health behavior, executive functioning, and parenting practices during early childhood buffer the relationship between early environmental stressors and emerging cardiometabolic risk, (2) examine whether HPA-axis regulation is on the pathway to emerging cardiometabolic risk, and determine the extent to which child and parenting factors exert a buffering effect through modulating children's cortisol levels, and (3) explore whether participation in a multi-level behavioral obesity prevention intervention can enhance the buffering effects of children's health behaviors, executive functioning, and parenting factors on cardiometabolic risk by altering the trajectories of these modifiable factors. This approach is innovative, because it represents a substantial departure from the status quo by focusing on the pathways through which early environmental stressors give rise to cardiometabolic risk during middle childhood and the protective factors which buffer against this risk, and significant because it is expected to have direct implications for optimizing interventions for young children living in stressful early environments to prevent cardiovascular and metabolic diseases.