Effect of protein supplementation during weight loss on older adult bone health

减肥期间补充蛋白质对老年人骨骼健康的影响

• 批准号: 10322131
• 负责人: Ashley Weaver
• 金额: $ 13.38万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-02-15 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10322131
• 关键词: 3-Dimensional; Adipocytes; Adipose tissue; Affect; Aging; American; Ancillary Study; Animal Model; Applications Grants; Assessment tool; Attenuated; Award; Biomedical Engineering; Body Composition; Body Weight decreased; Body mass index; Bone Density; Bone Marrow; Bone structure; Carbohydrates; Clinical; Clinical Research; Clinical Trials; Complement; Conduct Clinical Trials; Consumption; Data; Development; Diagnostic; Diet; Dietary Proteins; Dual-Energy X-Ray Absorptiometry; Elderly; Elements; Engineering; Exercise; Femur; Fracture; Geriatrics; Gerontology; Hip region structure; Image; Infrastructure; Intervention; Knowledge; Lead; Measurement; Measures; Medical Imaging; Mentored Research Scientist Development Award; Mentors; Modeling; Musculoskeletal; Nutritional; Nutritional Science; Obesity; Osteoporosis; Osteoporosis prevention; Outcome; Overweight; Participant; Persons; Pharmacotherapy; Phase; Phenotype; Physical Function; Population; Protein-Restricted Diet; Proteins; Radiology Specialty; Randomized; Recommendation; Recommended Dietary Allowance; Recording of previous events; Regulation; Research; Research Personnel; Resources; Risk; Scanning; Supplementation; Techniques; Testing; Thick; Thinness; Training; Trauma; United States National Institutes of Health; Vertebral column; Weight; Woman; X-Ray Computed Tomography; adult obesity; aging nutrition; base; bone; bone health; bone loss; bone mass; bone metabolism; bone preservation; bone quality; bone strength; career; design; experience; follow-up; forest; fracture risk; high risk; improved; innovation; medical schools; men; multidisciplinary; nutrition; osteoporosis with pathological fracture; prevent; prognostic tool; protein intake; research and development; spine bone structure; tool; translational study; weight maintenance

Project Summary. Dr. Weaver seeks this K25 mentored training award to expand her bioengineering research background in medical imaging and finite element modeling of trauma towards pursuit of an independent research career focused on reducing osteoporosis and fracture in older adults. Weight loss poses an increased risk of bone loss and fracture in older adults. The proposed research will test the overall hypothesis that higher dietary protein intake during and following weight loss will attenuate bone loss in older adults with obesity. Guided by an accomplished multidisciplinary mentoring team with expertise in aging, clinical trials, bone metabolism, nutrition, and radiology, the PI will: (1) Develop knowledge of gerontology and geriatric medicine, (2) Acquire training in the design and execution of clinical trials, 3) Obtain in-depth knowledge on bone metabolism and structure, including the influence of nutrition and weight loss, and 4) Develop expertise in dual-energy computed tomography (CT) acquisition and post-processing to measure volumetric bone mineral density, cortical thickness, and bone marrow adipose tissue. Dr. Weaver's training and research will take place at Wake Forest School of Medicine which has a strong history of clinical research in aging and an exceptional radiology infrastructure. The partnership with her co-mentor at Rutgers within the Department of Nutritional Sciences will provide additional resources and expertise related to the nutritional regulation of bone metabolism. The proposed ancillary study to the ongoing clinical trial, UPLIFT: Utilizing Protein During Weight Loss to Impact Physical Function, will examine bone health over 6 months of active weight loss, followed by 12 months of weight maintenance. Musculoskeletal phenotypes will be compared in older adults with obesity randomized to either: (1) a lower protein diet for weight loss and follow-up, (2) a higher protein diet for weight loss only, or (3) a higher protein diet for weight loss and follow-up. The ancillary study expands the UPLIFT trial by adding dual-energy CT scans of the lumbar spine and proximal femur at baseline, 6 months, and 18 months to compare the influence of a higher versus lower protein intake on: vertebral and femoral trabecular volumetric bone mineral density and cortical thickness (Primary Aim), bone marrow adiposity which may alter the trabecular matrix and affect bone strength (Secondary Aim 1), and bone strength and fracture risk predicted with subject-specific finite element modeling (Secondary Aim 2). The study will test if a higher protein diet improves bone outcomes during active weight loss (evaluated at 6 months), and if maintaining higher protein intake during weight maintenance further preserves bone (evaluated at 18 months). The proposed training and research plan will launch Dr. Weaver's career as an independent investigator focused on applying bioengineering techniques to: 1) develop translational tools for fracture prediction, and 2) assess osteoprotective interventions in clinical trials—ultimately leading to improved diagnostics, prognostic tools, clinical recommendations, and therapies for preventing osteoporosis and fracture in older adults.

项目摘要。Weaver博士寻求K25指导培训奖来扩大她的生物工程研究 在医学影像和创伤有限元建模的背景下追求独立 研究生涯专注于减少老年人的骨质疏松症和骨折。减肥带来了更多的 老年人有骨丢失和骨折的风险。这项拟议的研究将检验总体假设，即 在减肥期间和之后摄入膳食蛋白质将减轻肥胖老年人的骨丢失。引导式 由一支经验丰富的多学科指导团队提供，他们在衰老、临床试验、骨代谢、 营养学、放射学：(1)发展老年学和老年医学知识；(2)获得 临床试验设计和执行方面的培训，3)深入了解骨代谢和 结构，包括营养和减肥的影响，以及4)发展双能源计算的专业知识 体层摄影术(CT)采集和后处理以测量体积骨密度，皮质厚度， 和骨髓脂肪组织。韦弗博士的培训和研究将在维克森林学院进行 医学，它在衰老方面有很强的临床研究历史和卓越的放射学基础设施。这个 与她在罗格斯大学营养科学部的共同导师合作将提供额外的 与骨代谢的营养调节相关的资源和专业知识。拟议的附属研究 对于正在进行的临床试验Uplift：在减肥过程中利用蛋白质来影响身体功能，将 在积极减肥6个月后，再保持12个月的体重，检查骨骼健康状况。 肥胖老年人的肌肉骨骼表型将随机分为以下两组：(1)较低 用于减肥和后续的蛋白质饮食，(2)仅用于减肥的高蛋白饮食，或(3)高蛋白饮食 用于减肥和后续治疗。辅助研究通过增加双能量CT扫描扩大了Uplift试验 比较腰椎和股骨近端在基线、6个月和18个月时的影响较高 对比低蛋白质摄入量：椎骨和股骨骨小梁体积骨密度和皮质骨 厚度(主要目标)、可能改变骨小梁基质并影响骨强度的骨髓肥胖症 (次要目标1)，以及用特定于对象的有限元模型预测骨强度和骨折风险 (次要目标2)。这项研究将测试在积极减肥期间，高蛋白饮食是否会改善骨骼结果 (评估时间为6个月)，如果在体重维持期间保持较高的蛋白质摄入量，则进一步保持 骨(在18个月时评估)。拟议的培训和研究计划将启动韦弗博士的职业生涯 独立研究人员专注于应用生物工程技术：1)开发翻译工具 骨折预测，以及2)在临床试验中评估骨保护干预措施-最终导致改善 预防骨质疏松症和骨折的诊断、预后工具、临床建议和治疗 在老年人身上。