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.

抽象的： 背景：随着患有患者的个人，与衰老相关的心血管疾病的风险正在增加 唐氏综合症（DS）的寿命更长。在儿童中诊断为成年的CV疾病危险因素和 引起痴呆和心脏病发作。因为许多CV疾病危险因素都是可修改的，但是，早期 治疗可能会延迟或预防成人疾病。可以使用血管健康的亚临床变化 血管研究，包括脉搏波速度（PWV），颈动脉内膜厚度（CIMT）和颈动脉 扩张性（CD）。每种措施都与未来的血管疾病风险有关。成年人的数据 与个体的结果相比 没有DS。在患有DS的儿童中，CV疾病危险因素数据受到限制，很少有研究评估影响 CV疾病风险因素对血管健康的危险因素。我们旨在确定简历疾病风险因素的流行 患有DS的儿童并评估他们对早期动脉粥样硬化血管标志物的影响。 研究设计和方法：我们提出了对简历疾病风险因素及其的横断面评估 在小儿心脏网络内3个中心进行DS儿童的血管健康的影响 （PHN）。具体目标1：评估DS儿童的简历疾病危险因素。我们将描述常见的简历 DS儿童的疾病风险因素，包括人体测量指标，临床风险因素（饮食；活动； 烟雾暴露；高血压;先天性心脏病的史，睡眠呼吸暂停，癌症；和家族史 早期CV疾病）和血清学危险因素（禁食脂质谱，亚漏液，胰岛素，葡萄糖， DS儿童中的血红蛋白AIC和CRP）。我们将将这些数据与已发布的国家规范进行比较 没有DS的孩子。特定目的2：确定CV疾病风险因素与标记之间的关联 DS儿童早期动脉粥样硬化。我们将对患有DS的儿童进行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。我们将使用特定目标1的调查结果到 进行多变量分析以确定血管疾病风险因素的组合的影响 在其血管研究中具有DS的儿童独有。 职业发展计划：KL2职业发展奖将解决我当前的这些差距 研究能力：1）提高我的理解和评估简历风险因素，预测模型和 结局措施，包括用于介入试验的结果； 2）能够执行和解释高级 血管成像研究； 3）发展研究设计，统计，流行病学和研究方面的专业知识 领导需要对DS儿童进行简历研究。这些弱点将使用 犹他大学强大的KL2计划提供的资源以及推荐的课程和 动手培训以及与国际导师和顾问团队的互动。