Cortical Complications of Perimenopause and Obstructive Sleep Apnea in Underrepresented Middle-Aged Women with Type 2 Diabetes

摘要 美国有超过3400万人患有2型糖尿病(DM)。属于的成年女性 代表不足的种族和族裔群体最受相关风险和并发症的负面影响 糖尿病，包括认知和感觉运动动作的功能障碍。之前的工作，了解 糖尿病患者的皮质并发症(包括血管性痴呆的发展)已成为关注的焦点 关于独立的风险因素，如睡眠不足和炎症。糖尿病并发症也一直是 与阻塞性睡眠呼吸暂停(OSA)和更年期过渡期间性激素变化有关； 然而，大多数研究只包括非西班牙裔白人。正因为如此，我们对 皮质健康不良的多因素原因，包括糖尿病、性激素影响、炎症和阻塞性睡眠呼吸暂停 在受影响最大的人群中，与糖尿病代表不足的妇女一起生活。在这个项目中，我们 试图通过厘清性激素(雌激素和睾酮)、炎症和阻塞性睡眠呼吸暂停综合症如何填补这一关键空白 共同促进代表不足的糖尿病患者的皮质并发症的发病机制。 这个拟议的项目是我们最近工作的合乎逻辑的扩展，提供了对 绝经和炎症对脑皮质并发症和功能损害的复合作用 患有糖尿病的妇女代表性不足。这项研究的发现将促进对皮质健康不良的理解 作为性激素变化、炎症和阻塞性睡眠呼吸暂停综合征的综合作用，在代表性不足的中年人 女性糖尿病患者。这一信息超越了对糖尿病、睡眠不足、 炎症，以及少数族裔地位被低估为VD发展的独立危险因素。这 该项目与NHLBI预防心肺、血液和睡眠疾病的目标和优先事项保持一致 妇女健康、睡眠障碍、健康差距和痴呆症。

Abstract More than 34 million individuals in the U.S. are living with Type 2 Diabetes (DM). Adult females who belong to underrepresented racial and ethnic groups are most negatively impacted by risks and complications associated with DM, including functional impairment in cognitive and sensorimotor actions. Prior work in understanding the cortical complications in persons with DM (including the development of vascular dementia (VD)) has focused on independent risk factors such as insufficient sleep and inflammation. DM complications have also been linked to obstructive sleep apnea (OSA) and sex-hormone changes during the transition to menopause; however, most studies have included only white non-Hispanic persons. Due to this, we have limited insight into the multifactorial causes of poor cortical health including DM, sex-hormone influences, inflammation, and OSA in the most dramatically impacted population living with DM—underrepresented women. In this project, we seek to fill this critical gap by clarifying how sex-hormones (estrogen and testosterone), inflammation, and OSA contribute together to the pathogenesis of cortical complications in underrepresented women living with DM. This proposed project is a logical extension of our recent work that provides mechanistic insight into the compound contributions of menopause and inflammation to cortical complications and functional impairment in underrepresented women with DM. Findings from this study will advance understanding of poor cortical health as a combined function of sex-hormone changes, inflammation, and OSA in underrepresented middle-aged women with DM. This information pushes forward beyond the knowledge of DM, insufficient sleep, inflammation, and underrepresented minority status as independent risk factors for VD development. This project aligns with NHLBI objectives of prevention of heart, lung, blood, and sleep diseases and priorities in in women’s health, sleep disorders, health disparities, and VD.