Vascular Health and Risk Factors in Children with Down Syndrome

唐氏综合症儿童的血管健康和危险因素

• 批准号: 10117908
• 负责人: MAUREEN A MURTAUGH
• 金额: $ 18.23万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-15 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10117908
• 关键词: Address; Adult; Aging; Atherosclerosis; Blood Vessels; Cancer Family; Cardiovascular Diseases; Cardiovascular system; Child; Childhood; Data; Dementia; Development Plans; Diagnosis; Diet; Disease; Down Syndrome; Early treatment; Evaluation; Family history of; Fasting; Fractionation; Future; Glucose; Health; Heart; Hemoglobin; Hypertension; Individual; Insulin; International; Intervention; Intervention Trial; K-Series Research Career Programs; Leadership; Lipids; Measures; Medial; Mentors; Morbidity - disease rate; Myocardial Infarction; Outcome Measure; Physiologic pulse; Population; Prevalence; Publishing; Recording of previous events; Research; Research Design; Research Methodology; Resources; Risk; Risk Factors; Risk Marker; Serological; Sleep Apnea Syndromes; Smoke; Thick; Training; Universities; Utah; Vascular Diseases; cardiovascular disorder risk; cardiovascular risk factor; career development; clinical risk; congenital heart disorder; epidemiology study; imaging study; improved; mortality; predictive modeling; prevent; programs; statistics

ABSTRACT: Background: The risk of cardiovascular (CV) diseases associated with aging is increasing as individuals with Down syndrome (DS) are living longer. CV disease risk factors diagnosed in children track into adulthood and cause dementia and heart attacks. Because many CV disease risk factors are modifiable, however, early treatment may delay or prevent adult disease. Subclinical changes in vascular health can be measured using vascular studies, including pulse wave velocity (PWV), carotid intimal medial thickness (CIMT), and carotid distensibility (CD). Each measure has been associated with future risk of vascular disease. Data in adults with DS show CV disease risk factor profiles and vascular study results differ compared to results from individuals without DS. In children with DS, CV disease risk factor data are limited with few studies evaluating the impact of CV disease risk factors on vascular health. We aim to determine the prevalence of CV disease risk factors in children with DS and evaluate their effect on vascular markers of early atherosclerosis. Research Design and Methods: We propose a cross-sectional evaluation of CV disease risk factors and their impact on vascular health in children with DS to be performed at 3 centers within the Pediatric Heart Network (PHN). Specific Aim 1: Evaluate CV disease risk factors in children with DS. We will describe common CV disease risk factors in children with DS including anthropometric measures, clinical risk factors (diet; activity; smoke exposure; hypertension; history of congenital heart disease, sleep apnea, cancer; and family history of early CV disease), and serologic risk factors (fasting lipid profiles with sub-fractionation, insulin, glucose, hemoglobin AIc, and CRP) in children with DS. We will compare these data to published national norms of children without DS. Specific Aim 2: Determine the associations between CV disease risk factors and markers of early atherosclerosis in children with DS. We will perform PWV, CIMT, and CD studies in children with DS and compare these data to available data in children without DS. We will use findings from Specific Aim 1 to perform multivariable analysis to determine the influence of combinations of vascular disease risk factors unique to children with DS on their vascular studies. Career Development Plan: The KL2 Career Development Award will address these gaps in my current research abilities: 1) improve my understanding and ability to evaluate CV risk factors, prediction models, and outcome measures including those used in interventional trials; 2) ability to perform and interpret advanced vascular imaging studies; 3) develop the expertise in study design, statistics, epidemiology, and research leadership needed to conduct CV studies in children with DS. These weaknesses will be addressed using the resources provided by the University of Utah's robust KL2 program and through recommended courses and hands-on training as well as interactions with an international team of mentors and advisors.

摘要： 背景：随着年龄的增长，心血管（CV）疾病的风险正在增加， 唐氏综合症（DS）的寿命更长。在儿童中诊断出的CV疾病风险因素可追溯到成年期， 会导致痴呆和心脏病由于许多CV疾病风险因素是可以改变的，因此， 治疗可以延缓或预防成人疾病。血管健康的亚临床变化可以使用 血管研究，包括脉搏波速度（PWV）、颈动脉内膜中层厚度（CIMT）和颈动脉 扩张性（CD）。每一项措施都与未来血管疾病的风险有关。成人数据 DS显示CV疾病风险因素特征和血管研究结果与个体结果不同 没有DS在DS儿童中，CV疾病风险因素数据有限，很少有研究评价其影响 心血管疾病危险因素对血管健康的影响。我们的目的是确定心血管疾病危险因素的患病率， DS儿童，并评估其对早期动脉粥样硬化血管标志物的影响。 研究设计和方法：我们提出了一个横断面评估心血管疾病的危险因素及其 对DS儿童血管健康的影响将在儿科心脏网络的3个中心进行 （菲律宾）。具体目标1：评价DS儿童的CV疾病风险因素。我们将介绍常见的CV DS儿童的疾病危险因素包括人体测量指标，临床危险因素（饮食，活动， 吸烟;高血压;先天性心脏病、睡眠呼吸暂停、癌症病史;以及 早期CV疾病）和血清学风险因素（亚分级空腹血脂谱，胰岛素，葡萄糖， 血红蛋白AIc和CRP）。我们将这些数据与已公布的国家标准进行比较， 没有DS的孩子具体目标2：确定CV疾病风险因素与标志物之间的关联 早期动脉粥样硬化的风险。我们将在DS儿童中进行PWV、CIMT和CD研究 并将这些数据与无DS儿童的可用数据进行比较。我们将利用具体目标1的发现， 进行多变量分析，以确定血管疾病风险因素组合的影响 在血管研究中，DS儿童是唯一的。 职业发展计划：KL 2职业发展奖将解决我目前的这些差距 研究能力：1）提高我对CV风险因素、预测模型的理解和评估能力， 结局指标，包括干预性试验中使用的指标; 2）执行和解释高级 血管成像研究; 3）发展研究设计、统计学、流行病学和研究方面的专业知识 在DS儿童中进行CV研究所需的领导力。这些弱点将使用 由犹他州的强大的KL 2计划，并通过推荐的课程， 实践培训以及与国际导师和顾问团队的互动。