Investigating the impact of physical activity in modulating PCOS risk among peripubertal females

项目摘要 多囊卵巢综合征（PCOS）是一种常见的妇科疾病。虽然PCOS 其主要特征是月经不规律和高雄激素血症， 患有多种合并症-包括糖尿病，心血管疾病，抑郁症， 不孕症-导致大量发病率和保健费用。复杂的相互作用 肥胖、胰岛素敏感性降低和雄激素浓度升高之间的关系 是多囊卵巢综合征的病理生理学基础。这些迹象通常首先出现在青春期早期， 这是预防性干预的一个重要机会。虽然体力活动是一个有前途的 针对PCOS发展的潜在因素的策略，有一个重要的文献 在PCOS预防中使用有效策略的差距。本提案的目的是 确定女性胰岛素动力学和雄激素浓度变化的时间过程 从童年中期到青春期， 青少年对这些终点（目标1），并使用实施科学的方法来完善 (Aim 2）在青春期周围进行有针对性的循证体育活动干预 在评估干预措施的可行性，可接受性， 与体力活动水平、胰岛素敏感性和雄激素相关的初步疗效 浓度（目标3）。这项研究的结果将为发展、传播、 和实施有效和可扩展的预防性干预措施，这是联合国 NIDDK。此外，通过专门针对有后期代谢疾病风险的年轻女性， 这项建议以终身的方式预防慢性病。私家侦探乌顿博士 是一名早期职业临床研究人员和儿科内分泌学家，以及卫生服务 研究员她将利用这一职业发展奖，以建立她的技能，在（1）纵向 流行病学队列分析，（2）行为干预的设计和实施 通过实施科学方法提供信息，以及（3）收集和衡量 客观的行为和生理结果，对于评估干预至关重要 功效Whooten博士将与多学科指导和咨询团队密切合作 具有流行病学、健康行为客观测量、 内分泌生理结果，实施科学和生物统计学，以执行她 明确的职业目标和具体目标。

PROJECT ABSTRACT Polycystic Ovary Syndrome (PCOS) affects 1 out of 10 women worldwide. While PCOS is primarily characterized by menstrual irregularity and hyperandrogenemia, it is also associated with multiple comorbidities – including diabetes, cardiovascular disease, depression, and infertility – that lead to substantial morbidity and health care costs. A complex interaction between adiposity, decreased insulin sensitivity, and increased androgen concentrations underlies the pathophysiology of PCOS. These signs often first appear in early adolescence, representing a key opportunity for preventive interventions. While physical activity is a promising strategy for targeting the factors underlying PCOS development, there is a significant literature gap regarding effective strategies for use in PCOS prevention. The goal of this proposal is to identify the time course of changes in insulin dynamics and androgen concentrations in females from mid-childhood through adolescence and the impact of physical activity during early adolescence on these endpoints (Aim 1) and use implementation science methods to refine (Aim 2) and pilot a targeted and evidence-based physical activity intervention in peripubertal girls ages 8-10 at risk for PCOS while assessing the interventions’ feasibility, acceptability, and preliminary efficacy in relation to physical activity levels, insulin sensitivity, and androgen concentrations (Aim 3). The findings from this study will inform the development, dissemination, and implementation of effective and scalable preventive interventions, a high priority area for the NIDDK. Additionally, by specifically targeting young females at risk for later metabolic disease, this proposal takes a life-course approach to chronic disease prevention. The PI, Dr. Whooten, is an early career clinician investigator and pediatric endocrinologist, as well as health services researcher. She will use this career development award to build her skills in (1) the longitudinal analysis of epidemiological cohorts, (2) design and implementation of behavioral interventions informed by an implementation science approach, and (3) collection and measurement of objective behavioral and physiologic outcomes which will be essential for evaluating intervention efficacy. Dr. Whooten will work closely with a multidisciplinary mentorship and advisory team with expertise in epidemiology, objective measurement of health behaviors, measurement of endocrine physiologic outcomes, implementation science, and biostatistics to carry out her stated career objectives and specific aims.