CENTRAL OBESITY AND ALBUMIN EXCRETION IN TYPE I DIABETES

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 在糖尿病患者中，微量白蛋白尿可预测终末期肾病和临床显著的心血管疾病。尽管在过去几十年中肾脏和心血管并发症的发生率有所下降，但仍有相当数量的患者进展为终末期肾病，糖尿病肾病是终末期肾病的主要原因。 心血管疾病是这些患者死亡的主要原因，并且随着微量白蛋白尿的出现，风险开始加速。 一些研究表明，肾病、胰岛素抵抗、增加的体重-髋关节比和冠状动脉疾病可通过I型糖尿病和肾病受试者的家庭追踪。 在非I型糖尿病受试者的研究中，中心性肥胖增加了心血管疾病的风险，并提高了AER。 本提案将评估IAF质量在I型糖尿病受试者白蛋白排泄升高和血脂异常中的作用。 更好地理解中心性肥胖和DN早期之间关系的机制可能会改善肾脏和心血管疾病的结局。 从这项工作中获得的见解可能会导致I型糖尿病的改善，个性化治疗。 这些研究是在一组特征非常明确的I型糖尿病受试者中进行的，其中一些受试者表现出许多2型患者共有的特定表型（强化治疗和IAF增加时体重增加的趋势）。 所获得的答案将适用于一些患有2型疾病的受试者，特别是具有中心性肥胖高患病率的美洲原住民和西班牙裔人群。 GCRC支持请求：该项目将以明尼苏达大学为中心，但也将涉及华盛顿大学、马约诊所和明尼苏达州明尼阿波利斯市的国际糖尿病中心。 根据受试者偏好和可用设施，招募参与3个明尼苏达EDIC队列横断面研究的受试者将在明尼苏达大学GCRC或其常规研究中心（明尼苏达大学、国际糖尿病中心或马约诊所）进行定期EDIC研究访视。 招募的所有体重减轻干预受试者将在MN GCRC的U进行观察。 本研究将使用GCRC代谢厨房、研究营养师和护理人员。 没有糖尿病的对照人群将提供比较数据。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. In subjects with diabetes microalbuminuria predicts both end-stage renal disease and clinically significant cardiovascular disease. Despite decreases in renal and cardiovascular complication rates over the past few decades, a significant number of patients still progress to endstage renal disease and diabetic nephropathy is the leading cause of endstage renal disease. Cardiovascular disease is the leading cause of death in these patients and the risk begins to accelerate with microalbuminuria. Some studies have shown that nephropahty, insulin resistance, increase weight-hip ratio, and corornary artery disease track through the families of subjects with type I diabetes and nephropathy. In studies of subjects without type I diabetes, central obesity confers increased risk of cardiovascualr disease and elevates AER. This proposal will evaluate the role of IAF mass in the development of elevated albumin excretion and dyslipidemia in subjects with type I diabetes. A better understanding of mechanisms which underlie the relationship between central obesity and the earliest stages of DN may lead to improved outcomes in renal and cardiovascular disease. The insights gained from this work may lead to improved, individualized therapy in type I diabetes. These studies are being done in a group of very well-characterized subjects with type I diabetes, some of whom exhibit a specific phenotype shared by many type 2 patients (tendency to weight gain with intensive therapy and increased IAF). The answers obtained will be applicable to some subjects with type 2 disease, particularly Native American and Hispanic populations which have a high prevelence of central obesity. GCRC support request: This project will be centered at the University of Minnesota, but will also involve the University of Washington, the Mayo Clinic, and the International Diabetes Center in Minneapolis, Minnesota. Subjects recruited for participation in the cross-sectional study of the 3 Minnesota EDIC cohorts will be seen at the University of Minnesota GCRC or at their usual site (Univ. of MN, International Diabetes Center, or Mayo Clinic), based on subject preference and available facilities, for their regularly scheduled EDIC study visit. All subjects recruited for the weight loss intervention will be seen at the U of MN GCRC. The GCRC metabolic kitchen, research dietitians, and nursing staff will all be utilized for this study. A control population without diabetes will provide comparative data.