The PRIORITY Study: from PRedIctiOn to pReventIon of youth-onset TYpe 2 diabetes

优先研究:从预测到预防青少年发病的 2 型糖尿病

基本信息

  • 批准号:
    10583291
  • 负责人:
  • 金额:
    $ 6.38万
  • 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:
    2023-02-22 至 2029-01-31
  • 项目状态:
    未结题

项目摘要

Project Summary/Abstract Increases in pediatric obesity have led to an increased burden of youth-onset (Yo) type 2 diabetes (T2D), disproportionately affecting vulnerable youth. YoT2D is characterized by extreme insulin resistance, insulin hypersecretion, rapid b cell failure, and increased complications compared to adult T2D, raising concern for significant morbidity very early in life. However, the mechanism(s) and risk factors that cause some adolescents with prediabetes (PreDM) to progress to YoT2D while others do not, remain poorly understood. This proposal will study early pubertal youth at risk for YoT2D, to develop more precise prediction paradigms of progression to YoT2D, and to investigate pathophysiologic drivers. YoT2D disproportionately affects racial and ethnic minorities, often with multiple socioeconomic stressors, and the impact of social determinants of health (SDoH) on progression to YoT2D must be clarified. Dr. Sheela N. Magge (PI) has assembled a highly- experienced team from Johns Hopkins sites in Baltimore and Florida, including primary care pediatricians (Perrin, Polk, Showell, Hernandez) at clinics serving large Black and Hispanic populations with socioeconomic disadvantage. Participation in research by minoritized groups is influenced by the trustworthiness of the health system, and study recruitment will be aided by leveraging these trusted care providers. Dr. Magge proposes an innovative approach, recruiting from 3 distinct sources: 1. pediatric subspecialty clinics (endocrinology and obesity), 2. general pediatric clinics serving low-income children of color, and 3. offspring of adults with early onset (£40yrs) T2D. The study will longitudinally follow this cohort (total N=2250) of 9-13 year old girls and 10- 14 year old boys (site n=150) with BMI ≥ 85%ile and PreDM, as defined by HbA1c, fasting glucose, and/or 2-hr glucose on oral glucose tolerance test (OGTT), over 3 years or diagnosis of T2D, whichever occurs first. They will collect anthropometric, cardiovascular, behavioral, and genetic risk factors, as well as SDoH measures. Physiologic testing, including mathematical modelling of insulin kinetics and free fatty acid flux (FFA) using a 3- hour OGTT, in vivo continuous glucose monitoring (CGM), and body composition, will be collected. Aims: 1) To develop reliable estimates of YoT2D risk in youth with PreDM, overall and according to risk factor profiles that differentiate groups based on their risk of progression to YoT2D, 2) To characterize the early pathophysiologic drivers of YoT2D. a. To study differences in insulin kinetics (secretion, sensitivity, clearance), FFA flux, CGM, ectopic fat (visceral, hepatic), and cardiovascular risk between youth who progress to YoT2D and those who do not. b. To determine whether these pathophysiologic differences differ by risk factor groups identified in Aim 1. This proposal employs a multidisciplinary team with a novel mix of expertise in SDoH, stakeholder engagement, and metabolic pathophysiology, an innovative recruitment approach, and cutting-edge, novel methodologies to investigate the risk factors and pathophysiologic drivers that predict and cause YoT2D, in order to inform future prevention and treatment strategies.
项目总结/文摘

项目成果

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SHEELA NATESH MAGGE其他文献

SHEELA NATESH MAGGE的其他文献

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{{ truncateString('SHEELA NATESH MAGGE', 18)}}的其他基金

Cardiometabolic Health in Adolescents of South Asian Ancestry - the CHAriSmA study
南亚血统青少年的心脏代谢健康 - CHARiSmA 研究
  • 批准号:
    10337807
  • 财政年份:
    2018
  • 资助金额:
    $ 6.38万
  • 项目类别:
Cardiometabolic Health in Adolescents of South Asian Ancestry - the CHAriSmA study
南亚血统青少年的心脏代谢健康 - CHARiSmA 研究
  • 批准号:
    10428356
  • 财政年份:
    2018
  • 资助金额:
    $ 6.38万
  • 项目类别:
Cardiometabolic Health in Adolescents of South Asian Ancestry - the CHAriSmA study
南亚血统青少年的心脏代谢健康 - CHARiSmA 研究
  • 批准号:
    10190921
  • 财政年份:
    2018
  • 资助金额:
    $ 6.38万
  • 项目类别:
Cardiometabolic Health in Adolescents of South Asian Ancestry - the CHAriSmA study
南亚血统青少年的心脏代谢健康 - CHARiSmA 研究
  • 批准号:
    9980384
  • 财政年份:
    2018
  • 资助金额:
    $ 6.38万
  • 项目类别:
Dyslipidemia and CV Risk Factors in Pediatric Obesity and Type 2 Diabetes
儿童肥胖和 2 型糖尿病中的血脂异常和心血管危险因素
  • 批准号:
    7492896
  • 财政年份:
    2007
  • 资助金额:
    $ 6.38万
  • 项目类别:
Dyslipidemia and CV Risk Factors in Pediatric Obesity and Type 2 Diabetes
儿童肥胖和 2 型糖尿病中的血脂异常和心血管危险因素
  • 批准号:
    7299340
  • 财政年份:
    2007
  • 资助金额:
    $ 6.38万
  • 项目类别:
Dyslipidemia and CV Risk Factors in Pediatric Obesity and Type 2 Diabetes
儿童肥胖和 2 型糖尿病中的血脂异常和心血管危险因素
  • 批准号:
    7623446
  • 财政年份:
    2007
  • 资助金额:
    $ 6.38万
  • 项目类别:
Dyslipidemia and CV Risk Factors in Pediatric Obesity and Type 2 Diabetes
儿童肥胖和 2 型糖尿病中的血脂异常和心血管危险因素
  • 批准号:
    7857956
  • 财政年份:
    2007
  • 资助金额:
    $ 6.38万
  • 项目类别:
GLUCOSE TOLERANCE AND INSULIN SENSITIVITY IN OBESE SIBLINGS OF TYPE 2 DIABETICS
2 型糖尿病肥胖兄弟姐妹的葡萄糖耐量和胰岛素敏感性
  • 批准号:
    7207752
  • 财政年份:
    2005
  • 资助金额:
    $ 6.38万
  • 项目类别:

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