The Impact of Combined Hormonal Contraceptive Use on Weight Loss in Pre-Menopausal Women Enrolled in a Behavioral Weight Loss Trial

联合激素避孕药的使用对参加行为减肥试验的绝经前女性减肥的影响

• 批准号: 10189503
• 负责人: Adnin Zaman
• 金额: $ 8.16万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2023-08-25
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10189503
• 关键词: Address; Adherence; Age; Androgens; Animals; Behavioral; Binge Eating; Body Composition; Body Weight; Body Weight decreased; Calories; Cognitive; Colorado; Consumption; Contraceptive Usage; Data; Data Analyses; Desire for food; Development; Diet; Dietary Fats; Dietary intake; Disinhibition; Eating Behavior; Effectiveness; Endocrinology; Energy Intake; Energy Metabolism; Enrollment; Environment; Estrogens; Exhibits; Exposure to; Fatty acid glycerol esters; Feces; Female; Future; Goals; Health; Hormonal; Hormones; Human; Hunger; Insulin; Intake; Intervention; Intervention Trial; Leptin; Link; Measures; Medical; Medicine; Mentors; Mentorship; Methods; Obesity; Oral; Oral Contraceptives; Outcome; Overweight; Patient Self-Report; Peptide YY; Physical activity; Physicians; Premenopause; Productivity; Progesterone; Progestins; Public Health; Publications; Recommendation; Research; Research Training; Rest; Risk; Risk Factors; Satiation; Scientist; Synthetic Progestogens; Testing; Training; Treatment outcome; United States; Universities; Vaginal Ring; Weight; Weight Gain; Woman; Women' s Health; aged; cardiometabolic risk; career; dietary; dietary adherence; doubly-labeled water; emotional eating; energy balance; experience; food craving; ghrelin; gut microbiome; gut microbiota; hormonal contraception; improved; increased appetite; insight; knowledge base; men; microbiota; obesity treatment; offspring; pill; reproductive; reproductive axis; reproductive hormone; research study; restraint; secondary analysis; sex; skill acquisition; skills; statistics; total energy expenditure; training opportunity; trend; weight loss intervention; weight loss program; xenoestrogen

PROJECT SUMMARY/ABSTRACT Nearly half of the 61 million women of reproductive age (15-44 years) in the United States are overweight or obese, placing them and their offspring at elevated risk for adverse health outcomes. Notably, 15-20% of reproductive-age women use combined hormonal contraceptives (CHCs), including the combined estrogen and progestin oral pill, transdermal patch, or vaginal ring. While studies to date have not demonstrated a conclusive link between CHCs and weight gain, no studies have evaluated the impact of CHCs on weight loss in women with overweight/obesity who are actively trying to lose weight. Preliminary data suggests that CHC use may adversely impact weight loss within a behavioral weight loss program, with CHCs users losing 6 kg less than non-users. The overall objective of this mentored F32 proposal is to evaluate the impact of CHC use on weight loss, dietary adherence, and physical activity (PA) adherence in pre-menopausal women with overweight/obesity enrolled in an ongoing behavioral weight loss trial (R01 DK111622). The overall hypothesis is that CHC use will be associated with reduced adherence to diet and lower weight loss at 1 year, but no difference in adherence to PA. In Aim 1, changes in body weight and composition will be compared between CHC users and non-users. In Aim 2, adherence to diet and PA will be compared between groups using objective measures of these parameters. In Exploratory Aim 3, we will evaluate the impact of CHC use on eating behaviors, hormones related to hunger and satiety, stool microbiota, and components of energy expenditure (EE). The applicant, Adnin Zaman MD, is currently a third year endocrinology fellow whose long-term goal is to establish a research career at the interface of women’s health and obesity medicine, and to develop more effective obesity treatments for reproductive-aged women. To build upon her previous research experience and develop a line of research distinct from that of her mentor, Dr. Zaman and her mentorship team have developed a comprehensive training plan. The primary training objectives include 1) gaining further experience with weight loss interventional trials, 2) developing research skills in the assessment of free-living energy intake and eating behaviors, 3) developing research skills in the assessment of free-living EE and PA, 4) expanding knowledge base in the impact of reproductive hormones on energy balance, 5) evaluating the impact of CHC use on gut microbiome, 6) enhancing skills in quantitative data analysis and statistics, and 7) maturing professional development skills, grantsmanship, and publication productivity. This research and training will take place under the guidance of an experienced mentorship team at the University of Colorado Anschutz Medical Campus – an environment that will provide Dr. Zaman exceptional opportunities to gain valuable skills and expertise. Successful completion of this proposal will result in several first-authored publications and will generate critical preliminary data needed to support a competitive K23 application. This F32 proposal will serve as both a superb training opportunity and as an original and meaningful scientific contribution to launch Dr. Zaman’s career as an academic physician-scientist.

项目概要/摘要 美国 6100 万育龄妇女（15-44 岁）中近一半超重或 肥胖，使他们及其后代面临不良健康后果的更高风险。值得注意的是，15-20% 育龄妇女使用复合激素避孕药 (CHC)，包括复合雌激素和 孕激素口服药、透皮贴剂或阴道环。虽然迄今为止的研究尚未证明确凿的 CHC 与体重增加之间存在联系，但没有研究评估 CHC 对女性减肥的影响 超重/肥胖者正在积极尝试减肥。初步数据表明 CHC 的使用可能 对行为减肥计划中的减肥产生不利影响，CHC 使用者减重 6 公斤，比 非用户。该指导性 F32 提案的总体目标是评估 CHC 使用对体重的影响 超重/肥胖绝经前女性的损失、饮食依从性和体力活动 (PA) 依从性 参加了一项正在进行的行为减肥试验（R01 DK111622）。总体假设是 CHC 的使用将 与一年后饮食依从性降低和体重减轻较低有关，但对饮食的依从性没有差异 宾夕法尼亚州。在目标 1 中，将比较 CHC 使用者和非使用者之间体重和成分的变化。在 目标 2，将使用这些客观指标来比较各组对饮食和 PA 的坚持情况 参数。在探索性目标 3 中，我们将评估 CHC 使用对饮食行为、激素相关的影响 饥饿和饱腹感、粪便微生物群以及能量消耗 (EE) 的组成部分。申请人阿德宁 Zaman 医学博士，目前是内分泌学三年级研究员，其长期目标是建立研究生涯 结合女性健康和肥胖医学，并开发更有效的肥胖治疗方法 育龄妇女。以她之前的研究经验为基础并开发一系列研究 与她的导师不同，Zaman 博士和她的导师团队开发了一套全面的培训 计划。主要培训目标包括 1) 获得减肥干预试验的进一步经验， 2) 发展评估自由生活能量摄入和饮食行为的研究技能，3) 发展 评估自由生活的 EE 和 PA 的研究技能，4）扩大影响的知识库 生殖激素对能量平衡的影响，5) 评估 CHC 使用对肠道微生物组的影响，6) 增强 定量数据分析和统计技能，以及 7) 成熟的专业发展技能、资助能力、 和出版生产力。这项研究和培训将在经验丰富的专家的指导下进行 科罗拉多大学安舒茨医学校区的导师团队——一个将为博士提供的环境 Zaman 获得宝贵技能和专业知识的绝佳机会。圆满完成本次提案 将产生几份第一作者的出版物，并将产生支持所需的关键初步数据 有竞争力的K23应用程序。这个 F32 提案既可以作为一个绝佳的培训机会，也可以作为一个原创 并为开启扎曼博士作为学术医师科学家的职业生涯做出了有意义的科学贡献。