Early Environmental Stressors and Emerging Cardiometabolic Risk

项目摘要/摘要 在美国，心脏病是主要的死亡原因，而肥胖是一个重要的风险因素。而当 心脏代谢性疾病在成年时发病率最高，心脏代谢性风险的评估 在儿童时期的过程是关键的，以确定有助于发展的早期因果因素 这将有助于预防慢性病，并确定潜在的预防途径。此前的研究表明， 传统的心脏代谢危险因素(如高血压)从童年一直延续到成年。 社会经济劣势和心理社会压力也与儿童时期的肥胖和 以后患心血管疾病的风险。然而，在理解如何做到这一点上仍然存在一个重大的知识差距 环境、行为和生物环境相互作用影响发育过程中的心脏代谢风险 并影响以后的疾病结果。这项拟议的研究将考察早期与 环境应激源和新出现的心脏代谢风险：扩大534人的独特队列 种族/民族多样化，主要是低收入儿童，从他们 2-4岁[网络试验(U01HD068890；舍伍德/法国PI)，COPTR的一部分 联盟(儿童肥胖防治研究联盟，NIH/NHLBI/DCVS/PPSP)]。这个 这项拟议研究的总体目标是描述出现的调控失调的特征 7-9岁高危儿童的心脏代谢过程，并阐明 早期环境应激源影响心脏代谢风险的途径。现有的四个 测量时间点提供有关儿童家庭和家庭中的心理社会压力源的丰富信息 社区，儿童压力的生理测量(头发样本中的皮质醇水平)，以及 儿童的健康行为。7-9岁儿童的新数据收集将增加一个全面的 最先进的心脏代谢评估。具体地说，这项研究将(1)建立和量化 早期家庭与邻里环境应激源的独立影响及相互作用 童年对儿童期中期心脏代谢风险的影响以及(2)研究儿童健康行为的作用 (例如，体力活动、饮食摄入量和屏幕时间)和皮质醇水平在新出现的心脏代谢风险中， 并确定健康行为和皮质醇是否在环境之间的关系中起中介作用 应激源和心脏代谢风险。这种前瞻性的、多组件的早期测量方法 处于发育阶段的环境应激源和新出现的心脏代谢风险过程 可以开始观察到心脏代谢性疾病的前兆，但在显性疾病出现之前， 将帮助我们确定早期的因果因素，为以后成人慢性病的发展奠定基础。

Project Summary/Abstract Heart disease is a leading cause of death in the US and obesity is an important risk factor. While cardiometabolic diseases have peak prevalence in adulthood, the assessment of cardiometabolic risk processes in childhood is critical in order to define the early causal factors that contribute to the development of chronic disease and to identify potential pathways for prevention. Previous studies have shown that traditional cardiometabolic risk factors (e.g., hypertension) track from childhood into adulthood. Socioeconomic disadvantage and psychosocial stressors have also been linked to obesity in childhood and to later risk of cardiovascular disease. However, a major knowledge gap remains in understanding how environmental, behavioral, and biological contexts interact to influence cardiometabolic risk in the developing child and influence later disease outcomes. The proposed study will examine the relationship between early environmental stressors and emerging cardiometabolic risk by extending a unique cohort of 534 racially/ethnically diverse, predominantly low income children who have been studied longitudinally since they were 2-4 years of age [The NET-Works Trial (U01HD068890; Sherwood/French PIs), part of the COPTR consortium (Child Obesity Prevention and Treatment Research Consortium, NIH/NHLBI/DCVS/PPSP)]. The overall goal of the proposed study is to characterize the emergence of dysregulation in cardiometabolic processes in a high-risk cohort of children at 7-9 years of age, and elucidate the pathways through which early environmental stressors influence cardiometabolic risk. Four existing measurement time points provide rich information about psychosocial stressors in children's homes and neighborhoods, physiological measures of children's stress (cortisol levels from hair samples), and patterns of children's health behavior. New data collection when children are 7-9 years of age will add a comprehensive state-of-the-science cardiometabolic assessment. Specifically, this study will (1) establish and quantify the independent influence of and interaction between home and neighborhood environmental stressors in early childhood on cardiometabolic risk in middle childhood and (2) examine the role of children's health behaviors (i.e., physical activity, dietary intake, and screen time) and cortisol levels in emerging cardiometabolic risk, and determine whether health behaviors and cortisol mediate the relationship between environmental stressors and cardiometabolic risk. This prospective, multi-component approach to measuring early environmental stressors and emerging cardiometabolic risk processes, at a developmental stage when precursors of cardiometabolic disease can begin to be observed but before the manifestation of overt disease, will help us define early causal factors that set the stage for later development of adult chronic conditions.