Epidemiology of Diabetes Complications (EDC) Phase II: renewal

糖尿病并发症流行病学 (EDC) 第二阶段：更新

• 批准号: 9266752
• 负责人: TREVOR J. ORCHARD
• 金额: $ 67.33万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 1985
• 资助国家: 美国
• 起止时间: 1985-09-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9266752
• 关键词: Address; Advanced Glycosylation End Products; Affect; Age; Blood Glucose Self-Monitoring; Brain; Childhood; Clinic Visits; Clinical; Cognitive; Collaborations; Colorado; Complex; Complication; Complications of Diabetes Mellitus; Data; Development; Devices; Diabetes Mellitus; Diabetes prevention; Diagnosis; Dose; Employee Strikes; Epidemiology; Equilibrium; Exposure to; Fluorescence Spectrometry; Funding; Glycosylated hemoglobin A; Grant; Health Insurance; Healthcare; High Density Lipoproteins; Home visitation; Immune response; Impaired cognition; Incidence; Individual; Inflammatory; Instruction; Insulin; Insulin Resistance; Insulin-Dependent Diabetes Mellitus; Investigation; Knowledge; Life Expectancy; Magnetic Resonance Imaging; Measurement; Measures; Menopause; Modernization; Morbidity - disease rate; Natural History; Neuropsychological Tests; Non-Insulin-Dependent Diabetes Mellitus; Nurses; Oxidative Stress; Participant; Pathogenesis; Pediatric Hospitals; Peer Review; Periodicity; Phase; Pregnancy loss; Premature Menopause; Prevalence; Process; Progress Reports; Prospective cohort study; Publications; Registries; Reporting; Research Personnel; Risk; Risk Factors; Role; Skin; Stress; Structure; Surveys; TNF gene; Testing; Time; Training; Universities; Washington; Women' s Health; Work; Writing; adiponectin; alpha Tocopherol; base; biological adaptation to stress; cognitive function; cohort; cytokine; follow-up; glycemic control; imaging study; improved; insight; insulin dependent diabetes mellitus onset; mortality; novel strategies; prospective; stressor; study population; treatment group

Unlike type 2 diabetes, where prevention is possible, type 1 diabetes is currently neither preventable nor curable and its Incidence continues to rise approximately 3% per yr. Thus, the continuing investigation of type 1 diabetes complications remains imperative. The Epidemiology of Diabetes Complications (EDC) study has examined the prevalence and incidence of and risk factors contributing to the diabetes complications for 25 yrs. The study population is a well defined cohort of childhood onset type 1 diabetes identified from the Children's Hospital of Pittsburgh Registry (diagnosis: 1950-80). All 658 participants attending a clinical exam at study entry (1986-88) have been subsequently followed for up to 25 yrs, leading to over 150 peer reviewed publications. A number of striking observations were made during the last phase of the study which have given rise to questions and hypotheses this continuation will continue to address. These include the increasingly complex interaction between various pro- and anti-glycoxidative and inflammatory cytokines, as well as the rapidly changing natural history of complications which provides further insight into the interrelationships of, and specific risk factors for, complications, and renders historic data outdated for health care and insurance purposes. The current proposal, therefore, focuses on further assessment of complication development for a total follow up period of 30 yrs, thus allowing reasonably stable estimates of complication development over 40 yrs duration of childhood onset type 1 diabetes. This gives the opportunity to document morbidity risk and to estimate life expectancy in the modern era, i.e. for those diagnosed in 1965-80 and who have had more than half their diabetes duration since the availability of HbA1c testing and self monitoring of blood glucose. The roles of glycemic, oxidative and inflammatory stress, and the host's responses they invoke, on complication development will be another major focus along with women's health issues and continuing a number of collaborations. Finally, we will evaluate skin advanced glycosylation end products as a complication predictor for 232 individuals with at least one such assessment. This will be facilitated by continuing the annual surveys and, at 30 yrs of follow up, a full exam. RELEVANCE (See instructions): Type 1 diabetes is currently neither preventable nor curable and its incidence continues to rise about 3% per yr. Thus, the continuing investigation of type 1 diabetes complications remains imperative. The current proposal will not only provide insight on complication incidence, but also fill gaps in knowledge on T1D women's health issues, and the role of stress and host's response and skin AGE on complications.

与可以预防的2型糖尿病不同，1型糖尿病目前既无法预防也无法治愈，其发病率仍在以每年约3%的速度增长。因此，对1型糖尿病并发症的持续研究仍是当务之急。糖尿病并发症流行病学（EDC）研究调查了25年来糖尿病并发症的患病率和发病率以及导致糖尿病并发症的危险因素。研究人群是从匹兹堡儿童医院登记处（诊断：1950- 1980）确定的儿童发病1型糖尿病的明确队列。在研究开始时（1986- 1988）参加临床检查的所有658名参与者随后被跟踪长达25年，导致150多篇同行评议的出版物。在研究的最后阶段提出了一些引人注目的意见，这些意见引起了一些问题和假设，本报告将继续加以讨论。其中包括各种促糖氧化和抗糖氧化细胞因子和炎症细胞因子之间日益复杂的相互作用，以及并发症快速变化的自然史，这为进一步了解并发症的相互关系和特定风险因素提供了进一步的见解，并使历史数据在医疗保健和保险目的方面过时。因此，目前的建议侧重于在30年的总随访期内进一步评估并发症的发展，从而对儿童期发病的1型糖尿病患者40年的并发症发展进行合理稳定的估计。这提供了记录发病风险和估计现代预期寿命的机会，即那些在1965-80年被诊断出来的人，以及自可用以来糖尿病持续时间超过一半的人