Biopsychosocial Determinants of Adolescent Obesity/Cardiovascular Risk

描述(申请人提供)：美国青少年肥胖率很高， 在拉丁美洲。虽然食物和物理环境的戏剧性环境变化 与风险增加相关的是，对个人、家庭 和社区层面的因素，防止肥胖的发展。进一步的研究是 需要了解导致低收入和低收入人群肥胖风险不同的机制 西班牙裔/拉美裔青年。拟议的为期5年的项目旨在阐明相互关联的生物学和 与青少年肥胖和日后患2型糖尿病风险相关的社会途径 和心血管疾病。这项申请涉及大约620名智利青少年， 作为美国国立卫生研究院支持的队列研究的一部分，在婴儿期、3至5岁和10岁进行评估 预防婴幼儿缺铁性贫血对行为发育的影响(n=1645)。AS 收集了这些与生长、健康和发展有关的详细纵向数据。在16岁时 17岁至17岁的青少年将参与活动、睡眠和饮食模式的研究 对进食行为进行记录和实验室评估。此外，我们还将测量人体测量学， 脂肪和肌肉质量(DXA)，空腹血糖，胰岛素(HOMA IR)，血脂，瘦素，生长激素，脂联素， 食欲素、C反应蛋白和肿瘤坏死因子α。有关家族史、吸烟、健康和 心理社会功能也将被收集。社区层面的因素，如犯罪率、行走能力 并将评估用于体育活动和健康食品属性的资源。此外，a 具有多个时间点的睡眠神经生理学和活动记录的相当大的子集(n=237) 将在16岁时参加为期2晚的多导睡眠研究。 在生命历程方法的指导下，我们建议调查三个具体目标： 具体目标1--评估肥胖和相关代谢的生物学和心理社会决定因素 从婴儿早期起，一群青少年就出现了骚乱。 具体目标2-评估肥胖/肥胖与肥胖相关生物标记物之间的关系 这组智利青少年样本中的代谢紊乱。 具体目标3--评估身体活动、睡眠和饮食行为的昼夜节律模式的作用 肥胖症和相关的代谢紊乱。 营养与技术研究所之间的长期合作 智利大学和密歇根大学人类生长与发展中心 为研究青少年的生物学和心理社会决定因素提供了良好的环境 拉丁美洲低收入至中等收入青年的肥胖风险非常相似，他们的肥胖风险 可比的美国青年。我们希望推动对饮食发育模式的理解 和活动量受早期生活因素的影响，进而影响肥胖的发展和 相关的代谢紊乱。我们的研究在纵向心理社会的深度和广度上是独一无二的 和生物数据。我们提出了跨越学科界限的研究，并有可能 为今后的干预研究揭示青少年肥胖的重要决定因素。

DESCRIPTION (provided by applicant): The prevalence of adolescent obesity is high in the U.S., and in Latin America. While dramatic environmental changes in the food and physical environment are associated with increased risk, there continues to be inadequate understanding of the individual, family and community level factors that protect against the development of obesity. Further research is needed to understand the mechanisms leading to disparate risk for obesity in low-income and Hispanic/Latino youth. The proposed 5-year project aims to elucidate interconnected biological and social pathways associated with adolescent obesity and risk for later development of type 2 diabetes and cardiovascular disease. This application involves approximately 620 Chilean adolescents, assessed in infancy, 3 to 5 years and 10 years as part of a NIH-supported cohort study of the behavioral and developmental effects of preventing iron deficiency anemia in infancy (n = 1645). As such, detailed longitudinal data related to growth, health and development have been collected. At 16 to 17 years, the youth will participate in study of activity, sleep and eating patterns using actigraphic recording and laboratory assessment of eating behavior. In addition, we will measure anthropometry, fat and muscle mass (DXA), fasting glucose, insulin (HOMA IR), lipids, leptin, ghrelin, adiponectin, orexin, CRP, and TNF alpha. Detailed information about family history, smoking, health, and psychosocial functioning will also be collected. Neighborhood level factors such as crime, walk ability and resources for physical activity and healthful food attributes will be assessed. Furthermore, a sizeable subset (n = 237) with sleep neurophysiology and actigraphic recordings at multiple time points will participate in 2-night polysmnographic sleep study at 16 years. Guided by a life-course approach, we propose to investigate three Specific Aims: Specific Aim 1 - To evaluate biological and psychosocial determinants of obesity and related metabolic disturbance in a cohort of adolescents followed since early infancy. Specific Aim 2 - To assess associations between obesity/adiposity and biomarkers of adiposity-related metabolic disturbance in this sample of Chilean adolescents. Specific Aim 3 - To assess the role of circadian patterns of physical activity, sleep and eating behavior on adiposity and related metabolic disturbance. The long standing collaboration between the Institute for Nutrition and Technology at the University of Chile and the Center for Human Growth and Development at the University of Michigan provides an outstanding environment to study biological and psychosocial determinants of adolescent obesity in a low- to middle-income cohort of Latin American youth who are very similar in obesity risk to comparable U.S. youth. We expect to advance understanding of how developmental patterns of eating and activity are influenced by early life factors and in turn influence the development of obesity and related metabolic disturbance. Our study is unique in the depth and breadth of longitudinal psychosocial and biological data. We propose research that crosses disciplinary boundaries and has the potential to reveal important determinants of adolescent obesity for future intervention research.