Long-term changes in weight and adipokines and the associations with genetic vari

描述（由申请人提供）：近46%的女性和33%的男性报告试图减肥。然而，体重循环-有意减肥之后反弹至少10磅。-在减肥的成年人中约有80%发生；50%的体重反弹发生在一年内。候选人的主要研究重点是行为和技术策略，以改善长期减肥维持。在以患者为导向的研究（K24）的职业生涯中期研究者奖的支持下，候选人将把研究重点扩展到与减肥失败和随后的体重恢复有关的生物行为过程的研究。拟议的研究将建立在一项正在进行的随机临床试验（SMART研究）的基础上，并在24个月的行为减肥干预期间每6个月收集一次样本，以便候选人和她的多学科团队能够前瞻性地研究体重减轻和恢复至少10磅的个体子集。在研究过程中。该研究的3个目标是：(1)描述从基线到24个月体重减轻和恢复的模式及其对胰岛素抵抗（血浆胰岛素）、脂肪因子（TNFalpha、IL-6、脂联素、IL-10）、胃饥饿素和瘦素的影响；(2)描述与能量摄入和能量消耗相关的行为，并探讨其与体重减轻和体重增加的时间关联；(3)探讨与体重变化相关的基因变异是否与血清脂肪因子水平的变化以及与体重减轻和恢复相关的行为有关。导师计划将重点关注候选人（PI）和与她一起工作的多学科骨干学员。在K24奖的支持下，Burke博士将与一个跨学科团队合作，推进她对体重反弹可能发生的炎症过程的了解，这可能提供肥胖、胰岛素抵抗、动脉粥样硬化和心血管疾病之间的联系；此外，她将专注于遗传学在这些生物行为过程中的可能作用。她将利用她正在进行的研究来指导学生、研究员和初级教师发展行为干预，在干预和测量中使用技术，进行临床试验，以及炎症和遗传学在减肥和恢复中的作用。她将制定一项指导计划，该计划遵循NINR的战略，整合生物和行为科学以改善健康，并采用新技术以改善卫生保健。拟议的研究和指导战略将放在新战略研究所强调的一个领域的背景下，即促进健康和预防疾病，因为它涉及一种非常普遍的慢性疾病——超重和肥胖。

DESCRIPTION (provided by applicant): Nearly 46% of women and 33% of men report attempts to lose weight. However, weight cycling - intentional weight loss followed by regain of at least 10Ibs. - occurs in approximately 80% of adults who lose weight; 50% of the weight regain occurs within a year. A major focus of the candidate's research is on behavioral and technological strategies to improve long-term weight loss maintenance. With the support of the Midcareer Investigator Award in Patient-Oriented Research (K24), the candidate will expand this focus to an investigation of the biobehavioral processes involved in the failure to maintain a loss and the subsequent weight regain. The proposed study will build on an ongoing randomized clinical trial (SMART study) and collect specimens every 6 months during the 24-month behavioral, weight loss intervention so that the candidate and her multidisciplinary team can prospectively study the subset of individuals who lose and regain at least 10Ibs. during the study. The study's 3 aims are: (1) describe the patterns of weight loss and regain from baseline to 24 months and their effect on insulin resistance (plasma insulin), adipokines (TNFalpha, IL-6, adiponectin, IL-10), and ghrelin and leptin; (2) describe the behaviors related to energy intake and energy expenditure and explore their temporal associations with weight loss and weight gain; and (3) explore whether variation in genes implicated in weight change are related to change in serum level of adipokines and to the behaviors related to weight loss and regain. The mentorship plan will focus on the candidate (PI) and a multidisciplinary cadre of mentees who have been working with her. With the support of the K24 Award, Dr. Burke will work with an interdisciplinary team to advance her knowledge of the inflammatory processes that may occur with weight regain, which may provide the link between obesity, insulin resistance, atherosclerosis and cardiovascular disease; additionally, she will focus on the possible role of genetics in these biobehavioral processes. She will use her ongoing studies to mentor students, fellows and junior faculty on the development of behavioral interventions, the use of technology in interventions and measurement, the conduct of clinical trials, and the role of inflammation and genetics in weight loss and regain. She will develop a mentoring program that follows NINR's strategies for integrating biological and behavioral science for better health, and adopting new technologies for better health care. The proposed study and mentoring strategies will be placed in the context of an area of NINR emphasis - promoting health and preventing disease as it addresses a highly prevalent chronic disorder - overweight and obesity.