Understanding, Predicting and Preventing Type 2 Diabetes in Youth, Boston Clinical Center (UPP Study)
了解、预测和预防青少年 2 型糖尿病,波士顿临床中心(UPP 研究)
基本信息
- 批准号:10583740
- 负责人:
- 金额:$ 16.68万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-03-10 至 2029-01-31
- 项目状态:未结题
- 来源:
- 关键词:AddressAdolescentAdrenal GlandsAdultAffectAgeAndrogensAreaB-LymphocytesBasal metabolic rateBeta CellBiologicalBlood VesselsBody CompositionBody mass indexBostonCOVID-19 pandemicCell physiologyCharacteristicsChildChildhoodClinicalClinical ResearchClinical assessmentsCollaborationsColorCommunitiesContinuous Glucose MonitorDataData CollectionDetectionDevelopmentDiabetes MellitusDiagnosisDiet SurveysDiseaseDual-Energy X-Ray AbsorptiometryEarly DiagnosisEnvironmental Risk FactorEpigenetic ProcessEvaluationEvolutionFamily history ofFatty acid glycerol estersFecesFutureGeneral HospitalsGenomicsGeographyGlucoseGlycosylated hemoglobin AGonadal HormonesGrowthHairHand StrengthHepaticHomeHormonalHormonesHyperglycemiaImpairmentIncidenceInsulin ResistanceInsulin-Like Growth Factor ILightMassachusettsMeasurableMeasuresMediatorMetabolicNeighborhood Health CenterNeighborhoodsNon-Insulin-Dependent Diabetes MellitusObesityOralParticipantPathogenesisPediatric HospitalsPeripheral Blood Mononuclear CellPhenotypePhysical activityPhysiologicalPlasmaPrediabetes syndromePreventionPubertyPublic HealthResearchRiskRisk FactorsRisk ReductionRunningSamplingShapesSomatotropinStressSystems BiologyTechniquesTestingTriglyceridesUltrasonographyUrineVO2maxVisceral fatYouthactigraphybiobankblood glucose regulationclinical centercohortcommunity settingdata repositorydiabetes pathogenesisfasting plasma glucosefitnesshigh body mass indexhigh riskincretin hormoneindexinginsulin secretioninsulin sensitivitymacrovascular diseasemarginalized communitymarginalized populationmetabolomicsmodifiable riskmultiple omicspredictive markerpredictive modelingpreventprogression markerprogression riskrecruitremote assessmentrepositorysample collectionsocial factorssocial health determinantstrendtype 2 diabetes in childrenultrasoundwaist circumferencewearable device
项目摘要
Project Summary / Abstract
Rising obesity has led to an unprecedented increase in pre-diabetes (preD) and type 2 diabetes (T2D) incidence
in children and adolescents, a worrisome trend amplified by the COVID 19 pandemic. Based on current evidence,
it remains difficult to predict whether children and adolescents with preD will progress to T2D. Our proposal aims
to address key questions in the pathogenesis of T2D, focusing on modifiable risk factors. Leveraging a
collaboration between Boston Children’s Hospital, Joslin Diabetes Center, and Massachusetts General Hospital,
in partnership with community health centers in the Greater Boston area, we propose to recruit a diverse cohort
of early pubertal youth (ages 7-15, n=300) with preD, elevated BMI (≥95th percentile), a positive family history of
diabetes, and one or more additional risk factors. We propose to combine rigorous annual clinical studies with
convenient remote assessments, to gain a granular understanding of metabolic, hormonal and environmental
factors contributing to T2D pathogenesis. In Aim 1, we will test whether measures of glucose homeostasis and
beta cell function differ between youth with preD who progress to T2D versus those who revert to normoglycemia
or remain preD. We propose to analyze glycemia and beta cell function using oral GTT and incretin hormone
levels, and assessments adaptable to community settings, e.g., continuous glucose monitors and home A1c kits.
In Aim 2, we will test whether fitness level and amount of physical activity differ between youth with preD who
progress to T2D versus those who revert to normoglycemia or remain preD. We propose to evaluate fitness level
using detailed clinical assessments, including VO2 max, assessments adaptable to community settings including
grip strength, and free-living assessments using wearables and app-based activity tracking. In Aim 3, we will test
whether evolution of body composition during growth and puberty predicts progression to T2D. We propose to
analyze body composition (total and visceral fat) using DXA, and hepatic fat using echography-based
assessments, gonadal hormones, adrenal androgens, and mediators of growth hormone action, as well as
assessments adaptable to community settings, e.g., BMI and app-based dietary surveys. As secondary aims,
we propose to create a data repository to allow evaluation of social and environmental factors contributing to
T2D onset at a consortium level, with measures including social determinants of health, neighborhood and
geographic characteristics (using geocoding techniques), and the environmental exposome. We also propose
the creation of a biological repository to allow multi-omics studies to identify genomic, epigenetic, and/or
metabolomic markers for progression from preD to T2D in youth at a consortium level. We propose to collect a
rich biorepository of longitudinal samples (i.e., plasma, PBMCs, urine, stool, hair) from all participants that will
set the stage for future systems biology-driven studies. Together, these studies will permit development of a
predictive model based on variables easily measurable at the community level, which can then be applied to the
detection and treatment of youth at highest risk of T2D.
项目总结/摘要
肥胖症的增加导致糖尿病前期(preD)和2型糖尿病(T2 D)发病率空前增加
在儿童和青少年中,COVID 19大流行加剧了这一令人担忧的趋势。根据目前的证据,
仍然难以预测患有preD的儿童和青少年是否会进展为T2 D。我们的提案旨在
解决T2 D发病机制中的关键问题,重点是可改变的风险因素。利用一个
波士顿儿童医院、乔斯林糖尿病中心和马萨诸塞州总医院之间的合作,
我们与大波士顿地区的社区卫生中心合作,计划招募一个多样化的队列,
青春期早期青年(7-15岁,n=300),preD,BMI升高(≥第95百分位数),
糖尿病和一个或多个其他风险因素。我们建议将联合收割机严格的年度临床研究与
方便的远程评估,以获得代谢,激素和环境的颗粒状了解
导致T2 D发病的因素。在目标1中,我们将测试葡萄糖稳态的测量和
发展为T2 D的preD青年与恢复正常的preD青年之间的β细胞功能不同
或保持preD。我们建议使用口服GTT和肠促胰岛素激素分析血糖和β细胞功能
水平和评估适应社区环境,例如,动态血糖监测仪和家用糖化血红蛋白试剂盒。
在目标2中,我们将测试健康水平和体育活动量是否在患有preD的青少年之间存在差异,
与那些恢复正常或保持preD的人相比,我们建议评估健身水平
使用详细的临床评估,包括最大摄氧量,适应社区环境的评估,包括
握力,以及使用可穿戴设备和基于应用程序的活动跟踪的自由生活评估。在目标3中,我们将测试
生长和青春期身体组成的演变是否可预测T2 D的进展。我们建议
使用DXA分析身体成分(总脂肪和内脏脂肪),使用基于超声心动图的肝脏脂肪
评估,性腺激素,肾上腺雄激素和生长激素作用的介质,以及
适应社区环境的评估,例如,BMI和基于应用程序的饮食调查。作为次要目标,
我们建议建立一个数据储存库,以便评估有助于
T2 D发病在财团水平,措施包括健康的社会决定因素,邻里和
地理特征(使用地理编码技术)和环境问题。我们亦建议
创建生物储存库,以允许多组学研究识别基因组、表观遗传和/或
代谢组学标志物的进展,从preD到T2 D的青年在财团的水平。我们建议收集
纵向样品的丰富生物贮藏库(即,血浆、PBMC、尿液、粪便、毛发),
为未来系统生物学驱动的研究奠定基础。这些研究将共同促进开发一种
预测模型基于社区一级容易测量的变量,然后可以应用于
检测和治疗T2 D风险最高的青年。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Amy Debra Fleischman其他文献
Amy Debra Fleischman的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Amy Debra Fleischman', 18)}}的其他基金
Intensive Exercise to Improve Mitochondrial Dysfunction in Pediatric Obesity
强化运动可改善儿童肥胖症的线粒体功能障碍
- 批准号:
7841930 - 财政年份:2009
- 资助金额:
$ 16.68万 - 项目类别:
Intensive Exercise to Improve Mitochondrial Dysfunction in Pediatric Obesity
强化运动可改善儿童肥胖症的线粒体功能障碍
- 批准号:
7707756 - 财政年份:2009
- 资助金额:
$ 16.68万 - 项目类别:
EVALUATION OF GLUCOSE METABOLISM, BONE HEALTH & OVARIAN CONGENITAL ADRENAL
葡萄糖代谢、骨骼健康的评估
- 批准号:
7380750 - 财政年份:2006
- 资助金额:
$ 16.68万 - 项目类别:
EVALUATION OF GLUCOSE METABOLISM, BONE HEALTH & OVARIAN CONGENITAL ADRENAL
葡萄糖代谢、骨骼健康的评估
- 批准号:
7204734 - 财政年份:2005
- 资助金额:
$ 16.68万 - 项目类别:
相似海外基金
Exploring the mental health and wellbeing of adolescent parent families affected by HIV in South Africa
探讨南非受艾滋病毒影响的青少年父母家庭的心理健康和福祉
- 批准号:
ES/Y00860X/1 - 财政年份:2024
- 资助金额:
$ 16.68万 - 项目类别:
Fellowship
Scaling-up co-designed adolescent mental health interventions
扩大共同设计的青少年心理健康干预措施
- 批准号:
MR/Y020286/1 - 财政年份:2024
- 资助金额:
$ 16.68万 - 项目类别:
Fellowship
Shared Spaces: The How, When, and Why of Adolescent Intergroup Interactions
共享空间:青少年群体间互动的方式、时间和原因
- 批准号:
ES/T014709/2 - 财政年份:2024
- 资助金额:
$ 16.68万 - 项目类别:
Research Grant
Social Media Mechanisms Affecting Adolescent Mental Health (SoMe3)
影响青少年心理健康的社交媒体机制 (SoMe3)
- 批准号:
MR/X034925/1 - 财政年份:2024
- 资助金额:
$ 16.68万 - 项目类别:
Fellowship
Parent-adolescent informant discrepancies: Predicting suicide risk and treatment outcomes
父母与青少年信息差异:预测自杀风险和治疗结果
- 批准号:
10751263 - 财政年份:2024
- 资助金额:
$ 16.68万 - 项目类别:
The Impact of Online Social Interactions on Adolescent Cognition
在线社交互动对青少年认知的影响
- 批准号:
DE240101039 - 财政年份:2024
- 资助金额:
$ 16.68万 - 项目类别:
Discovery Early Career Researcher Award
Adolescent sugar overconsumption programs food choices via altered dopamine signalling
青少年糖过度消费通过改变多巴胺信号来影响食物选择
- 批准号:
BB/Y006496/1 - 财政年份:2024
- 资助金额:
$ 16.68万 - 项目类别:
Research Grant
Resilience Factors, Pain, and Physical Activity in Adolescent Chronic Musculoskeletal Pain
青少年慢性肌肉骨骼疼痛的弹性因素、疼痛和体力活动
- 批准号:
10984668 - 财政年份:2024
- 资助金额:
$ 16.68万 - 项目类别:
Usefulness of a question prompt sheet for onco-fertility in adolescent and young adult patients under 25 years old.
问题提示表对于 25 岁以下青少年和年轻成年患者的肿瘤生育力的有用性。
- 批准号:
23K09542 - 财政年份:2023
- 资助金额:
$ 16.68万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
Evaluating the impact of changes in the proximity and density of vape retailers around secondary schools in Ontario on adolescent vaping behaviours
评估安大略省中学周围电子烟零售商的距离和密度变化对青少年电子烟行为的影响
- 批准号:
500515 - 财政年份:2023
- 资助金额:
$ 16.68万 - 项目类别:
Operating Grants