The Impact of Zinc Intake on Nutritional Status and Brain Development Among Preterm Infants

摘要 这份K23提案描述了一项为期五年的研究和培训计划，以促进凯瑟琳贝尔博士的过渡 成为新生儿营养领域的独立医生兼科学家。贝尔博士是一位精神病学家， 以病人为中心的研究基础。新生儿重症监护病房发生的营养缺乏 新生儿重症监护病房（NICU）住院会损害早产儿在发育的关键时期的生长和成熟， 身体和大脑，对长期神经发育结果产生不利影响。必需微量营养素 锌对婴儿的生长和大脑发育至关重要，但早产儿的最佳锌摄入量是 未知的和当前的强化策略可能是不够的。准确评估儿童的营养状况 通过区分瘦体重（反映器官生长和成熟）和 胖了本提案的目的是确定新生儿重症监护病房锌摄入量与瘦体重之间的关系 增加（作为营养状况的标志），并评估锌摄入量的变化对 同时大脑发育和后来的神经发育结果。更高的锌摄入量 导致更大的瘦体重增加，改善大脑生长和成熟，并改善神经发育 将通过3个具体目标进行测试：1）确定NICU中锌摄入量与瘦体重的相关性 在同等的年龄。2)确定NICU中锌摄入量与大脑发育之间的关系， 成熟3)确定新生儿锌摄入量对2岁时神经发育结果的影响。这 这项研究对新生儿营养领域具有重要意义，因为从这项研究中获得的知识将有助于 确定早产儿的最佳锌摄入量并为营养策略的设计提供信息，以确保 为所有早产儿提供充足的微量营养素。贝尔博士的导师团队--贝尔福特博士（初级导师） 和Duggan博士（共同导师）-提供早产儿营养和微量营养素方面的补充专业知识 对儿童的要求，分别。贝尔博士还将获得杰出科学家的指导， 与这项工作有关的关键领域的专门知识，包括微量营养素生物化学，母乳成分， 儿童期神经发育评估和疾病的发育起源。培训 布里格姆妇女医院，塔夫茨弗里德曼营养科学学院的机会和资源， 和哈佛医学院是候选人职业发展的理想环境。候选人的 该机构致力于她的成功。贝尔博士详细的职业发展计划包括指导 研究、教学课程，包括营养科学正式学位、研讨会和演讲 科学会议。她提出了一个时间轴完成的研究目标和未来的准备 R 01应用程序。从K23奖项中获得的知识和培训将使Bell博士能够开发 启动专注于设计微量营养素的独立研究事业所需的技能和专业知识 干预措施，以优化早产儿的生长和长期健康结果。

ABSTRACT This K23 proposal describes a five-year research and training plan to facilitate Dr. Katherine Bell’s transition into an independent physician-scientist in the field of neonatal nutrition. Dr. Bell is a neonatologist with a strong foundation in patient-oriented research. Nutrient deficits occurring during the neonatal intensive care unit (NICU) hospitalization impair preterm infants’ growth and maturation during a critical period for development of the body and brain, adversely impacting long-term neurodevelopmental outcomes. The essential micronutrient zinc is crucial for infant growth and brain development, but the optimal zinc intake for preterm infants is unknown and current fortification strategies may be insufficient. Accurate assessment of nutritional status in preterm infants is facilitated by distinguishing lean mass—which reflects organ growth and maturation—from fat. The goal of this proposal is to determine the association between zinc intake in the NICU and lean mass accrual (as a marker of nutritional status) and to evaluate the clinical impact of variabilities in zinc intake on concurrent brain development and later neurodevelopmental outcomes. The hypothesis that greater zinc intake results in greater lean mass accrual, improved brain growth and maturation, and improved neurodevelopment will be tested through 3 specific aims: 1) Determine the association of zinc intake in the NICU with lean mass at term equivalent age. 2) Determine the association between zinc intake in the NICU and brain growth and maturation. 3) Determine the impact of neonatal zinc intake on neurodevelopmental outcomes at 2 years. This research is significant for the field of neonatal nutrition, as knowledge gained from this study will help determine optimal zinc intake for preterm infants and inform the design of nutritional strategies to ensure adequate micronutrient provision to all preterm infants. Dr. Bell’s mentoring team—Dr. Belfort (primary mentor) and Dr. Duggan (co-mentor)—provide complementary expertise in preterm infant nutrition and micronutrient requirements in children, respectively. Dr. Bell will also receive mentorship from distinguished scientists with expertise in key areas related to this work, including micronutrient biochemistry, breastmilk composition, neurodevelopmental assessment in childhood, and the developmental origins of disease. The training opportunities and resources at Brigham and Women’s Hospital, Tufts Friedman School of Nutrition Science, and Harvard Medical School are an ideal environment for the candidate’s career development. The candidate’s institution is strongly committed to her success. Dr. Bell’s detailed career development plan includes mentored research, didactic coursework including a formal degree in nutrition science, seminars, and presentations at scientific meetings. She presents a timeline for completion of the research aims and preparation of a future R01 application. The knowledge and training gained from this K23 award will enable Dr. Bell to develop the skills and expertise required to launch an independent research career focused on designing micronutrient interventions to optimize growth and long-term health outcomes for preterm infants.