权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

UroEDIC Bladder: Bladder Dysfunction in Type 1 Diabetes

UroEDIC 膀胱：1 型糖尿病的膀胱功能障碍

基本信息

批准号：
10606540
负责人：
ARUNA V SARMA
金额：
$ 61.94万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-06-01 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10606540
关键词：
Achievement Afferent Neurons Amputation Ancillary Study Autonomic Dysfunction Bladder Bladder Dysfunction Blindness Cells Cessation of life Clinical Clinical Data Complications of Diabetes Mellitus Data Detection Diabetes Mellitus Disease Disease remission Epidemiology Epithelium Esthesia Evaluation Face Frequencies Functional disorder Funding Future Gender Gene Expression Profile Gene Expression Profiling Genetic Transcription Glycosylated hemoglobin A Goals High Prevalence Human Hyperglycemia Impaired cognition Insulin Insulin-Dependent Diabetes Mellitus Intervention Knowledge Laboratories Link Machine Learning Measurement Measures Medical Mental Depression Metabolic Modeling Molecular National Institute of Diabetes and Digestive and Kidney Diseases Natural History Overactive Bladder Participant Pathogenesis Pathway interactions Patients Pattern Persons Phenotype Play Population Prevention Publications Publishing Quality of life Research Research Personnel Residual state Risk Risk Factors Running Severities Signal Transduction Specimen Symptoms Systems Biology Techniques Testing Time United States National Institutes of Health Urinary Incontinence Urine Urologic Diseases Urology Urothelium Variant Woman Work autonomic neuropathy case control cohort design diabetes control diabetic experience follow-up glycemic control incontinence symptom insight lower urinary tract symptoms mechanotransduction member men multidisciplinary novel predictive modeling randomized trial transcriptome sequencing transmission process treatment strategy trial enrollment urinary urologic

项目摘要

PROJECT SUMMARY The Diabetes Control and Complication Trial (DCCT) and its observational follow up Epidemiology of Diabetes Intervention and Complications (EDIC) represent landmark achievements in diabetes research. The DCCT enrolled 1441 men and women with type 1 diabetes (T1D) in a randomized trial of intensive vs. conventional insulin therapy, delaying the onset and progression of diabetic complications and dramatically changing the management of patients worldwide. Implementation of tight glycemic control has reduced the frequency of devastating complications of T1D such as early death, blindness and amputation. Women and men with T1D face new challenges including cognitive decline, autonomic dysfunction and urological disorders. UroEDIC, an ancillary study examining urological complications in the DCCT/EDIC cohort, combines over 25 years of detailed medical information and >90% participation in urological symptom assessment annually since 2010, making it the longest running most extensive urological evaluation of persons with T1D. The previous funding cycle identified lower urinary tract symptoms (LUTS) and urinary incontinence (UI) as urological disorders in men and women with T1D with the highest prevalence and greatest impact on quality of life (QOL). By linking powerful longitudinal urological phenotypes with extensive clinical and laboratory data of the DCCT/EDIC, we can substantially deepen our understanding of diabetes associated urinary complications. Preliminary analyses show that although many patients develop a fixed state of LUTS or UI, many others move in and out of the state over time. Our overall hypothesis is that metabolic, autonomic and epithelial dysfunctions are associated with persistent and reversible subphenotypes of LUTS and UI in men and women with diabetes. Observations also indicate bladder overactivity in both genders is increasing in this cohort. However, there is a lack of understanding of the burden and impact of other diabetic bladder problems, particularly diabetic cystopathy, classically described as decreased bladder sensation, poor contractility and high residual urine volume. The goals of UroEDIC Bladder, therefore, are to 1) characterize the full spectrum of bladder dysfunction in T1D, 2) create risk models that explain the progression and remission of LUTS/UI, and 3) identify mechanistic themes underpinning the persistence of these symptoms. The specific aims of this project are designed to incorporate newly proposed and available longitudinal data on bladder retention, autonomic dysfunction and novel transcriptional signatures with the full range of DCCT/EDIC measurements to gain deeper insight into the longitudinal patterns and mechanisms of LUTS/UI and comprehensively characterize diabetic bladder dysfunction in T1D.

项目总结糖尿病控制和并发症试验(DCCT)及其糖尿病流行病学观察随访干预和并发症(EDIC)是糖尿病研究中的里程碑式成就。DCCT 1441名男性和女性1型糖尿病(T1D)患者参加了强化与常规的随机试验胰岛素治疗，延缓糖尿病并发症的发生和进展，并显著改变管理世界各地的患者。实施严格的血糖控制减少了糖尿病发作的频率 T1D的严重并发症包括早期死亡、失明和截肢。患有T1D的女性和男性面临新的挑战，包括认知能力下降、自主神经功能障碍和泌尿系统疾病。UroEDIC，一个在DCCT/EDIC队列中检查泌尿系并发症的辅助研究，结合了25年提供详细的医疗信息，并每年90%参与泌尿系统症状评估自2010年以来，使其成为对T1D患者进行时间最长、范围最广的泌尿学评估。上一个资助周期将下尿路症状(LUTS)和尿失禁(UI)确定为 T1D患病率最高且对质量影响最大的男性和女性的泌尿系统疾病生命(QOL)。通过将强大的纵向尿路表型与广泛的临床和实验室数据联系起来通过DCCT/EDIC，我们可以大大加深对糖尿病相关泌尿系并发症的了解。初步分析表明，尽管许多患者出现了LUTS或UI的固定状态，但许多其他患者会移动随着时间的推移进进出出这个州。我们的总体假设是新陈代谢、自主神经和上皮性男性和女性LUT和UI的持续性和可逆性亚型与功能障碍相关患有糖尿病。观察还表明，在这一队列中，无论男女，膀胱过度活动都在增加。然而，对其他糖尿病膀胱问题的负担和影响缺乏了解，尤其是糖尿病性膀胱炎，经典的描述是膀胱感觉减弱，收缩能力差和残余尿量高。因此，UroEDIC膀胱的目标是1)表征全谱 2)建立风险模型来解释LUTS/UI的进展和缓解，以及3)确定支撑这些症状持续存在的机械性主题。的具体目标该项目旨在整合最新提出的和可用的关于膀胱的纵向数据保留、自主神经功能障碍和新的转录特征 DCCT/EDIC测量，以更深入地了解 LUTS/UI和T1D中糖尿病膀胱功能障碍的综合特征。