Social and Dietary Determinants of Kidney Stone Risk

肾结石风险的社会和饮食决定因素

• 批准号: 10643740
• 负责人: Joseph James Crivelli
• 金额: $ 18.42万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-25 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10643740
• 关键词: Adopted; Adult; Affect; Behavior; Biology; Biometry; Black Populations; Black race; Body mass index; Calcium Oxalate; Chronic; Chronic Disease; Clinical Investigator; Clinical Sciences; Clinical Trials; Cohort Analysis; Cohort Studies; Consumption; Coronary Artery Risk Development in Young Adults Study; DASH diet; Data; Development; Diabetes Mellitus; Diet; Diet Modification; Dietary Assessment; Dietary Factors; Dietary Practices; Dietetics; Disadvantaged; Disease; Disparity population; Economics; Education; Enrollment; Environment; Environmental Risk Factor; Epidemiology; Ethnic Origin; Event; Family Study; Foundations; Funding; Future; Goals; Grant; Health; Health Care Costs; Heart; Hispanic Community Health Study/Study of Latinos; Hispanic Populations; Hour; Human; Hypertension; Incidence; Income; Individual; Institution; Jackson Heart Study; Kidney Calculi; Life Style; Link; Low Prevalence; Measures; Medical; Mentored Patient-Oriented Research Career Development Award; Mentors; Modification; Multi-Ethnic Study of Atherosclerosis; National Institute of Diabetes and Digestive and Kidney Diseases; Not Hispanic or Latino; Nutritional Study; Observational Study; Outcome; Participant; Patients; Pattern; Population; Population Heterogeneity; Prevalence; Prevention; Preventive care; Productivity; Public Health; Quality of life; Race; Randomized; Recording of previous events; Reporting; Research; Research Personnel; Resources; Risk; Risk Factors; Science; Secondary Prevention; Standardization; Testing; Time; Training; Training Programs; Translational Research; Urinary Calculi; Urine; Work; career development; clinical center; cohort; data harmonization; dietary; disease heterogeneity; disorder prevention; disorder risk; efficacy testing; ethnic diversity; ethnic minority; ethnic minority population; experience; follow-up; good diet; health disparity; health inequalities; healthy lifestyle; improved; insight; modifiable risk; nutrition; patient oriented; prevent; primary outcome; prospective; racial diversity; racial minority; racial minority population; sex; social; social factors; social health determinants; social influence; structural determinants; systemic barrier; western diet

Kidney stone disease (KSD) results in billions of dollars in healthcare costs per year, creates large economic losses due to decreased work productivity, and negatively impacts quality of life. Black and Hispanic individuals historically have a lower prevalence of KSD compared to White individuals; however, the rate of increase in the prevalence of KSD among Black and Hispanic individuals is greater than that among White individuals. There is evidence that KSD risk is influenced by social determinants of health (SDOH), potentially contributing to the disproportionate rise in KSD risk in racial and ethnic minority populations who bear the greatest burden of adverse SDOH; however, the extent to which SDOH associate with kidney stone risk in diverse populations has been understudied. Diet and lifestyle clearly influence KSD risk. It is important to describe how all of these factors, as well as their temporal changes, contribute to KSD risk in racial and ethnic minority groups. The overall objective of this project is to assess associations of SDOH with KSD risk in racially and ethnically diverse populations, the contribution of dietary quality to these associations, and the effect of adopting a healthy dietary pattern on KSD risk. To achieve this objective, we aim to: 1) Identify risk factors for KSD prevalence in a racially and ethnically diverse pooled cohort from five observational studies; 2) Measure the associations of temporal changes in risk factors (e.g., dietary pattern, anthropometrics, SDOH, and associated chronic medical conditions) with KSD incidence among participants of Coronary Artery Risk Development in Young Adults (CARDIA; a cohort of Black and White adults with over 30 years of follow-up); and 3) Determine the extent to which adopting a healthy dietary pattern, namely a Dietary Approaches to Stop Hypertension (DASH)-style diet, improves 24-hour urinary stone risk parameters among individuals with KSD through a controlled diet study enrolling CARDIA participants. The proposed research leverages key resources at our institution, including the Birmingham Field Center for CARDIA and the Bionutrition Unit of the Center for Clinical and Translational Science (CCTS). We expect to elucidate the magnitude of the social and dietary determinants of KSD risk in racially and ethnically diverse cohorts, and determine the effect of a DASH-style diet on urinary stone risk factors. We also expect that this will provide the foundation for future independent grant efforts to develop more effective preventive care strategies for disadvantaged patients with KSD. This K23 award will provide the PI with training in biostatistics/epidemiology, SDOH, nutrition/dietetics, and patient-oriented kidney stone research, which will be critical for his career development and long-term goal of becoming an independent investigator. Career development activities will include a Masters of Science in Public Health in Applied Epidemiology, which will incorporate coursework in health inequities and nutrition research; the Clinical Investigator Training Program which offers training on clinical trial oversight; and regular interactions with a team of mentors and collaborators with complementary expertise in SDOH, nutrition, analysis of cohort studies and clinical trials, and KSD epidemiology/prevention.

肾结石疾病（KSD）每年导致数十亿美元的医疗费用，由于工作效率降低而造成巨大的经济损失，并对生活质量产生负面影响。历史上，黑人和西班牙裔个体的KSD患病率低于白色个体;然而，黑人和西班牙裔个体中KSD患病率的增加率高于白色个体。有证据表明，KSD风险受健康的社会决定因素（SDOH）的影响，可能导致KSD风险在种族和少数民族人群中不成比例的上升，这些人群承受着最大的不利SDOH负担;然而，在不同人群中，SDOH与肾结石风险相关的程度尚未得到充分研究。饮食和生活方式明显影响KSD风险。重要的是要描述所有这些因素，以及它们的时间变化，有助于KSD风险的种族和少数民族群体。该项目的总体目标是评估种族和民族多样化人群中SDOH与KSD风险的关联，饮食质量对这些关联的贡献，以及采用健康饮食模式对KSD风险的影响。为了实现这一目标，我们的目标是：1）从五项观察性研究中确定种族和种族多样性汇总队列中KSD患病率的风险因素; 2）测量风险因素的时间变化（例如，饮食模式、人体测量学、SDOH和相关慢性疾病）与年轻成人冠状动脉风险发展参与者中KSD发生率的关系（CARDIA;随访超过30年的黑人和白色成年人队列）;以及3）确定采用健康饮食模式，即停止高血压饮食方法（DASH）式饮食，通过纳入CARDIA参与者的控制饮食研究，改善KSD患者的24小时尿结石风险参数。拟议的研究利用了我们机构的关键资源，包括伯明翰CARDIA现场中心和临床和转化科学中心（CCTS）的生物营养素单位。我们希望阐明在种族和民族多样化的队列中KSD风险的社会和饮食决定因素的大小，并确定DASH风格的饮食对尿结石危险因素的影响。我们还希望这将为未来的独立赠款工作奠定基础，为处境不利的KSD患者制定更有效的预防护理策略。该K23奖项将为PI提供生物统计学/流行病学，SDOH，营养/饮食学和以患者为导向的肾结石研究方面的培训，这对他的职业发展和成为独立研究者的长期目标至关重要。职业发展活动将包括应用流行病学公共卫生科学硕士学位，其中将纳入健康不公平和营养研究课程;临床研究者培训计划，提供临床试验监督培训;与导师和合作者团队定期互动，他们在SDOH，营养，队列研究和临床试验分析以及KSD流行病学/预防方面具有互补的专业知识。