Diabetic Complications and Genetic Variants in the Million Veterans Program

百万退伍军人计划中的糖尿病并发症和遗传变异

• 批准号: 10268156
• 负责人: LAWRENCE S PHILLIPS
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-10-01 至 2021-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10268156
• 关键词: Adult; African; Age; Albuminuria; Alleles; Atherosclerosis; Blood Pressure; Body mass index; Cardiovascular system; Clinical; Complications of Diabetes Mellitus; Custom; Data; Databases; Development; Diabetes Mellitus; Electronic Health Record; Emergency department visit; End stage renal failure; Ethnic Origin; European; Eye; Frequencies; Gene Frequency; Genes; Genetic; Genetic Databases; Genotype; Glaucoma; Glucose; Glycosylated hemoglobin A; Health; Healthcare; Heart failure; Hospitalization; Hypoglycemia; Infrastructure; Insulin-Dependent Diabetes Mellitus; Kidney; Link; Lipids; Logistic Regressions; Measurement; Measures; Medicare; Metabolic; Methods; Minor; Modeling; Non-Insulin-Dependent Diabetes Mellitus; Organ; Outcome; Outcome Assessment; Outpatients; Participant; Pharmaceutical Preparations; Pharmacology; Phenotype; Population; Positioning Attribute; Prevalence; Race; Recording of previous events; Records; Research Personnel; Resources; Retinal Diseases; Risk; Risk Factors; Role; Source; Validation; Variant; Veterans; Visit; biobank; cost; demographics; design; diabetic; ethnic minority population; genetic risk factor; genetic variant; genome wide association study; genome-wide; genome-wide analysis; improved; insertion/deletion mutation; multi-ethnic; personalized care; predictive modeling; programs; racial and ethnic; rare variant; time use; trait; virtual

We propose to undertake analyses within the Million Veterans Program (MVP) database to Assess Associations between Diabetic Complications and Genetic Variants. Aim 1 involves Database Development that will create a virtual baseline examination linking MVP data to VAMC outpatient visits, and, when appropriate, VAMC hospitalizations, using the electronic health record. We will conduct cutting edge Genome Wide Association Studies (GWAS) of common (CVAS) and rare (RVAS) variants. The outcomes investigated are diabetic eye, kidney, and cardiovascular complications, and hypoglycemia. Aim 2 is Diabetes Complications Analyses concerning outcome risks using time-integrated longitudinal measures of risk factors (RFs) to include both genetic variants and traditional RFs considering both single and multiple assessments of outcomes with cross-sectional and period prevalence estimates. We will analyze organ-specific and metabolic complications according to type 1 and type 2 diabetes status using EHR data in VA records. Specific outcomes investigated: Ocular (retinal disease, glaucoma), Renal (micro- and macro-albuminuria, and decreased eGFR [CKD stages and ESRD), Cardiovascular (cardiac failure), and Hypoglycemia (emergency department visits and hospitalizations, adjusted for HbA1c and glucose levels, and use of glycemic medications [from the EHR]). Aim 3 will develop Diabetic Complications Risk Scores. Both traditional RF and separate genetic prediction models will be compared using logistic regression for each outcome. Models will evaluate the role of RFs and pharmacologic therapy for abnormal blood pressure, lipids, and glucose. We will use an outcome-specific genetic score as a potential reclassification variable.

我们建议在百万退伍军人计划（MVP）中进行分析