Arterial stiffness in mother/infant dyads: Life course approach to prevent cardiovascular disease

母婴二人的动脉僵硬度：预防心血管疾病的生命全程方法

• 批准号: 10581158
• 负责人: Kim A Boggess
• 金额: $ 17.76万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10581158
• 关键词: Abdomen; Address; Adipose tissue; Aging; Alabama; Biological; Blood Vessels; Body Composition; Body fat; Body mass index; Cardiovascular Diseases; Cohort Studies; Complement; Data; Data Collection; Development; Disease Management; Dual-Energy X-Ray Absorptiometry; Enrollment; Fatty acid glycerol esters; Female; General Population; Goals; Health; Hour; Infant; Knowledge; Learning; Life Cycle Stages; Maternal Health; Measures; Medical; Medicine; Mentors; Mentorship; Minority Women; Mothers; North Carolina; Not Hispanic or Latino; Obesity; Overweight; Pattern; Perinatal; Perinatal Care; Physiologic pulse; Positioning Attribute; Postpartum Period; Postpartum Women; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy Rate; Pregnant Women; Prevalence; Proxy; Race; Reporting; Research; Research Personnel; Research Project Grants; Risk; Risk Factors; Scanning; Site; Technology; Time; Ultrasonography; United States; Universities; Visceral; Visceral fat; Visit; Woman; abdominal fat; arterial stiffness; black women; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; career; clinical practice; cohort; design; diet and exercise; disorder risk; ethnic diversity; ethnic minority; experience; gestational weight gain; health care availability; high body mass index; high risk population; improved; innovation; lifestyle intervention; modifiable risk; multidisciplinary; parent grant; pregnancy hypertension; pregnant; prenatal; prevent; racial disparity; racial diversity; racial minority; response; risk stratification; social; vascular inflammation

ABSTRACT Greater than 45% of women in the United States experience excessive gestational weight gain (GWG) leading to increased cardiovascular disease (CVD) risk during pregnancy, postpartum and beyond (≥10 years). Excess fat accumulation and specific fat distribution patterns, such as abdominal visceral fat, accelerate vascular aging in the general population. However, the composition of GWG is scarcely reported. Therefore, a knowledge gap exists in understanding whether the vascular aging response is associated with changes in body composition and fat distribution during pregnancy and postpartum. This proposal supplements the Mother and Infant Determinants of vascular Aging Study (MIDAS; R01HL157075). The MIDAS study will enroll 840 racially and ethnically diverse healthy and medically complicated mother/infant dyads between 34-40 weeks gestation. At 34-40 weeks gestation, within 48 hours of delivery, and at 6 and 12 months postpartum, the MIDAS study will assess vascular aging and CVD risk by measuring pulse wave velocity (PWV), and examine relationships among biologic, personal, social, and ecological disease risk factors with PWV. The objective of this proposal is to elucidate how body composition (Aim 1) and fat distribution (Aim 2) changes during and following pregnancy impact postpartum CVD risk. Although obesity, defined by body mass index, is a proposed modifiable risk factor, body composition (i.e., %fat) and fat distribution (i.e., visceral adipose tissue) were not a focus of the parent grant. Therefore, this proposal will complement the existing MIDAS study by leading the data collection and in-depth analysis of gestational and postpartum body composition. The study specific aims are: 1) determine the association between the trajectory of %fat from 34-40 weeks gestation to 12 months postpartum and PWV at 12 months postpartum in 840 racially and ethnically diverse pregnant women, and 2) determine the association between the change in fat distribution from 6 to 12 months postpartum with PWV at 12 months postpartum in a subset of women (n=280). We will also explore whether race moderates the proposed associations in Aims 1 and 2; racial and ethnic minority women have a greater prevalence of obesity and are at a greater risk for pregnancy complications and CVD compared with non-Hispanic white women. This time sensitive supplement leverages access to a large, diverse cohort of pregnant and postpartum women and a multi-disciplinary team of mentors with expertise in CVD risk and maternal health. As a result, we are well positioned to complete the proposed aims. Additionally, this supplement will enable an early career investigator to: 1) gain experience conducting a well-defined research project evaluating CVD risk in pregnant women, 2) develop her grantsmanship and, 3) expand her research network and learn from a successful mentorship team. This supplement will be an integral component to the MIDAS study by focusing on adiposity- related risk to maternal cardiovascular health and it will provide an early career investigator with support to advance her career trajectory and establish an independent, fundable research line.

摘要 在美国，超过45%的女性经历过过度的妊娠期体重增加（GWG）， 妊娠期、产后及以后（≥10年）心血管疾病（CVD）风险增加。过量 脂肪积累和特定的脂肪分布模式，如腹部内脏脂肪，加速血管老化 在普通人群中的比例。然而，GWG的组成很少报道。因此，知识差距 存在于了解血管老化反应是否与身体成分的变化有关 和产后的脂肪分布。这一建议补充了《母婴 血管老化决定因素研究（MIDAS; R 01 HL 157075）。MIDAS研究将招募840名种族和 种族多样的健康和医学复杂的母亲/婴儿二对之间的34-40周妊娠。在 妊娠34-40周，分娩48小时内，产后6个月和12个月，MIDAS研究将 通过测量脉搏波速度（PWV）评估血管老化和CVD风险，并检查相关性 生物、个人、社会和生态疾病危险因素与PWV。本提案的目的 是为了阐明如何身体组成（目标1）和脂肪分布（目标2）的变化， 怀孕影响产后CVD风险。虽然肥胖，定义为身体质量指数，是一个建议， 可改变的风险因素，身体组成（即，%脂肪）和脂肪分布（即，内脏脂肪组织）不是一个 家长补助金的重点。因此，这项建议将通过领导 数据收集和深入分析妊娠期和产后身体成分。研究的具体目标 是：1）确定从妊娠34-40周到12个月的%脂肪轨迹之间的关联 840名不同种族和民族的孕妇的产后和产后12个月的PWV，以及2） 确定产后6至12个月的脂肪分布变化与PWV之间的相关性， 在一个妇女子集中产后12个月（n=280）。我们还将探讨种族是否会缓和 目标1和2中的拟议关联;种族和少数民族妇女的肥胖率更高 与非西班牙裔白色妇女相比，她们患妊娠并发症和心血管疾病的风险更大。 这种对时间敏感的补充剂利用了大量不同的孕妇和产后妇女群体 以及一个多学科的导师团队，他们具有心血管疾病风险和孕产妇健康方面的专业知识。因此，我们 很好地完成了提出的目标。此外，这种补充将使早期的职业生涯 研究者：1）获得进行明确定义的研究项目的经验，评估孕妇的CVD风险 妇女，2）发展她的granitarian和，3）扩大她的研究网络，并从一个成功的学习 导师团队该补充将是MIDAS研究的一个组成部分，重点关注肥胖症- 它将为早期职业研究者提供支持， 推进她的职业轨迹，并建立一个独立的，可资助的研究线。