Insulin Resistance, Pre-Diabetes, and Diabetes in Obesity-Associated Asthma

肥胖相关哮喘中的胰岛素抵抗、糖尿病前期和糖尿病

• 批准号: 10614589
• 负责人: Tianshi David Wu
• 金额: $ 20.71万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-15 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10614589
• 关键词: Address; Asthma; Big Data; Biometry; Blood Glucose; Body mass index; Clinical; Clinical Data; Clinical Research; Cohort Analysis; Cohort Studies; Critical Care; Data; Data Collection; Development; Development Plans; Diabetes Mellitus; Disease; Electronic Health Record; Enrollment; Environment; Epidemiologist; Epidemiology; Experimental Designs; Faculty; Fasting; Fellowship; General Population; Glycosylated hemoglobin A; Goals; Health; Health system; Human; Human Subject Research; Individual; Insulin Resistance; Investigation; Knowledge; Level of Evidence; Literature; Longitudinal Studies; Lung; Measurement; Measures; Medicine; Mentors; Mentorship; Metformin; Methodology; Modification; Morbidity - disease rate; Natural experiment; Obesity; Observational Study; Outcome; Participant; Pathologic; Pathway interactions; Patients; Persons; Pharmaceutical Preparations; Pharmacoepidemiology; Phenotype; Physicians; Pliability; Population; Postoperative Period; Prediabetes syndrome; Productivity; Prospective cohort; Pulmonary Function Test/Forced Expiratory Volume 1; Questionnaires; Recording of previous events; Reporting; Research; Research Activity; Research Proposals; Respiratory Signs and Symptoms; Risk; Risk Factors; Role; Scientist; Severities; Severity of illness; Spirometry; Sulfonylurea Compounds; Techniques; Testing; Time; Training; Translating; United States; Universities; asthma exacerbation; bariatric surgery; career; career development; clinical phenotype; cohort; comparison control; design; disability; disorder control; epidemiology study; evidence base; glucose metabolism; glycemic control; high body mass index; improved; innovation; insight; lung health; modifiable risk; novel; obese person; obesity risk; obesity-associated asthma; patient oriented; patient oriented research; prospective; pulmonary function; reduce symptoms; research study; skills

PROJECT SUMMARY AND ABSTRACT Asthma and obesity are prevalent conditions in the United States. Obese individuals with asthma are at risk for obesity-associated asthma, a distinct phenotype that is more severe and exacerbation prone. Insulin resistance, pre-diabetes, and diabetes, a spectrum of disorders in glucose metabolism that is enriched in obesity, have been implicated as contributing to the excess morbidity observed in obesity-associated asthma. In general populations, these conditions have been associated with diminished lung function and respiratory symptoms, supporting a pathologic role in pulmonary health. However, there are significant limitations in literature, and its relevancy to asthma control and severity in humans, and among individuals with obesity, is uncertain. In this application, we propose to examine the association of insulin resistance, pre-diabetes, and diabetes with asthma exacerbations, asthma control, and lung function, as well as effect modification of this association by obesity. We will perform this analysis in two complementary aims, (1) a “big data” applied epidemiology project leveraging the electronic health record of two major health systems in the United States, combining cohort analyses with pharmaco-epidemiologic techniques to investigate the hypothesized pathway, and (2) a prospectively enrolled cohort study of obese participants with asthma who undergo bariatric surgery, with repeated measurements of insulin resistance, lung function, and patient-reported asthma outcomes. The results of these analyses will build evidence for a deleterious role of insulin resistance, pre-diabetes, and diabetes within obesity-associated asthma. This is especially important, as this common asthma phenotype has few specific treatment options. This project proposal will provide mentored training for the applicant to develop skills in the conduct of a patient-oriented clinical study, pharmacoepidemiology, EHR analytic techniques, and biostatistics. These skills will be pivotal toward the applicant's goal of becoming an independent physician-scientist and clinical epidemiologist with expertise in asthma and obesity-associated asthma. He is overseen by a mentorship team comprised of experts in asthma, patient-oriented research, EHR epidemiology, and biostatistics. The career development plan is a natural continuation of research activities in fellowship and serves to establish an expertise distinct from his principal mentor. The research strategy and career development plan will be operationalized within the Division of Pulmonary and Critical Care Medicine at the Johns Hopkins University, leveraging a collaborative and productive research environment with a strong history of successful development of junior faculty.

项目总结与摘要

项目成果

Metformin Use and Risk of Asthma Exacerbation Among Asthma Patients with Glycemic Dysfunction.

• DOI: 10.1016/j.jaip.2021.07.007
• 发表时间: 2021-11
• 期刊: The journal of allergy and clinical immunology. In practice
• 作者: Wu TD;Fawzy A;Akenroye A;Keet C;Hansel NN;McCormack MC
• 通讯作者: McCormack MC

Obesity, tidal volume, and pulmonary deposition of fine particulate matter in children with asthma.

• DOI: 10.1183/13993003.00209-2021
• 发表时间: 2022-03
• 期刊: The European respiratory journal
• 作者: Afshar-Mohajer N;Wu TD;Shade R;Brigham E;Woo H;Wood M;Koehl R;Koehler K;Kirkness J;Hansel NN;Ramchandran G;McCormack MC
• 通讯作者: McCormack MC

Obesity and asthma: A focused review.

• DOI: 10.1016/j.rmed.2022.107012
• 发表时间: 2022-11
• 期刊: RESPIRATORY MEDICINE
• 影响因子: 4.3
• 作者: Tooba, Rubabin;Wu, Tianshi David
• 通讯作者: Wu, Tianshi David

Association of School Infrastructure on Health and Achievement Among Children With Asthma.

哮喘儿童健康和成就学校基础设施协会。

• DOI: 10.1016/j.acap.2022.10.007
• 发表时间: 2023
• 期刊: Academic pediatrics
• 影响因子: 3.1
• 作者: Wu,TianshiDavid;Zaeh,Sandra;Eakin,MichelleN;Koehler,Kirsten;Davis,MeghanF;Wohn,Chris;Diibor,Ike;Psoter,KevinJ;Cronister,Curt;Connolly,Faith;Stein,Marc;McCormack,MeredithC
• 通讯作者: McCormack,MeredithC

Clinical Outcomes Associated With Overestimation of Oxygen Saturation by Pulse Oximetry in Patients Hospitalized With COVID-19.

• DOI: 10.1001/jamanetworkopen.2023.30856
• 发表时间: 2023-08-01
• 期刊: JAMA network open
• 影响因子: 13.8