Sleep and cardio-metabolic risk factors: a prospective study of adolescents

睡眠和心脏代谢危险因素：青少年的前瞻性研究

• 批准号: 8064807
• 负责人: Edward O. Bixler
• 金额: $ 56.4万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8064807
• 关键词: 12 year old; Address; Adolescence; Adolescent; Adult; Affect; Age; Age Distribution; Alcohol consumption; Ancillary Study; Arrhythmia; Atrial Premature Complexes; Blood Pressure; Cardiac; Cardiovascular Diseases; Cause of Death; Central obesity; Child; Childhood; Circadian Rhythms; Clinical; Collaborations; Communication; Complex; Conflict (Psychology); Coronary heart disease; Data; Data Analyses; Data Collection; Data Quality; Development; Disease; Dual-Energy X-Ray Absorptiometry; Electronic Mail; Electrophysiology (science); Elements; Emotional Stress; Epidemic; Epidemiologic Studies; Epidemiologist; Evaluation; Frequencies; Funding; Gender; Health; Heart Diseases; Height; Home environment; Hydrocortisone; Hypertension; Impairment; Inflammation; Insulin; Insulin Resistance; Intervention; Investigation; Ischemia; Knowledge; Laboratories; Life; Measures; Metabolic; Metabolic Diseases; Metabolic Syndrome Pathway; Metabolic stress; Metabolic syndrome; Minority; Modification; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Obesity; Outcome; Parents; Participant; Patient Self-Report; Pattern; Perception; Performance; Physical activity; Population; Population Study; Positioning Attribute; Prevalence; Problem Solving; Prospective Studies; Public Health; Reporting; Research; Research Personnel; Research Project Grants; Resources; Risk; Risk Factors; Sampling; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleep disturbances; Sleeplessness; Smoking; Socioeconomic Status; Stress; Stroke; System; Telephone; Time; Ventricular Premature Complexes; age related; aged; base; cohort; data sharing; early adolescence; early childhood; experience; fasting glucose; follow-up; high risk; hypothalamic-pituitary-adrenal axis; meetings; member; mortality; multidisciplinary; neurobehavioral; neurobehavioral disorder; novel; obesity in children; obesity risk; population based; prospective; psychosocial; public health relevance; skills; sleep abnormalities; success; young adult

DESCRIPTION (provided by applicant): We propose to conduct an 8-year follow-up examination of a population-based sample of 700 young adolescents. The recruitment and baseline exam of this cohort was conducted when they were 5-12 years old. Our overall objective is to assess a wide range of risk factors for and subclinical and clinical consequences of early childhood obesity and sleep problems. Specifically, we propose to evaluate the following three specific aims: 1) the prospective relationships between childhood sleep related factors and obesity in young adulthood; 2a) the longitudinal association between baseline obesity and cardiometabolic, sleep and neurobehavioral outcomes at follow-up; 2b) cross-sectional association between obesity and relevant clinical and subclinical cardiometabolic and sleep abnormalities at follow-up; and 3) whether SDB in adolescence is age-dependent. We plan to assess the independent associations between independent variables in the obesity and sleep domains and three inter-related health outcomes involving cardiometabolic, sleep and neurobehavioral systems. Obesity both in adults and children has become epidemic and is a major public health problem given its association with CVD, the leading cause of death, and other metabolic diseases. However, there are limited data assessing the risk factors for, and outcomes of, childhood obesity. Recent data from our group and others are supportive of a systematic prospective investigation of our hypotheses, and these evidences include: (1) Sleep duration has been recently identified as a novel risk factor for obesity, and the association is modified by factors such as age, gender, stress, physical activity, and socioeconomic status. In our data, we observed a cross-sectional association between sleep duration and obesity based on subjective but not objective reports; (2) Obese adults that are stressed frequently have mild hypercorticolism and are at risk for stress-induced visceral obesity and metabolic syndrome. Our data, from the child and adult samples, support this hypothesis; (3) Obesity in adults is a strong risk factor for cardiovascular disease. In our child sample, we have reported that obesity and SDB are strong and independent risk factor for higher levels of BP and impairment of cardiac autonomic modulation; (4) In adults it is hypothesized that obesity leads to higher risk of CVD via metabolic syndrome pathway and there is increasing concern that metabolic factors are elevated in obese children as well. We and others have reported that SDB in adults is associated with increased risk of the metabolic syndrome. In our child data, SDB was cross-sectionally associated with an increased risk for several metabolic abnormalities; (5) We and others have reported that impaired autonomic modulation is significantly associated with CVD mortality and morbidity. In our children sample, we have reported significant synergistic interactions between SDB-HRV and obesity-HRV on elevated BP, indicative of complex inter-relationships between sleep, obesity, and cardiometabolic health occurring early in life. Finally, in our child data the age distribution of SDB suggested a possible age-dependent relationship within adolescence. PUBLIC HEALTH RELEVANCE: Obesity in childhood has become an epidemic and a major public health problem. This prospective study will assess a wide range of novel risk factors for and subclinical and clinical consequences of early childhood obesity and sleep problems. The knowledge gained from this study will better position our intervention strategies to reduce the public health burden of childhood obesity.

描述（由申请人提供）：我们建议对 700 名青少年进行为期 8 年的跟踪检查。该队列的招募和基线检查是在他们5-12岁时进行的。我们的总体目标是评估儿童早期肥胖和睡眠问题的各种危险因素以及亚临床和临床后果。具体来说，我们建议评估以下三个具体目标：1）儿童睡眠相关因素与青年期肥胖之间的前瞻性关系； 2a）基线肥胖与随访时心脏代谢、睡眠和神经行为结果之间的纵向关联； 2b）随访时肥胖与相关临床和亚临床心脏代谢和睡眠异常之间的横断面关联； 3）青春期的SDB是否与年龄有关。我们计划评估肥胖和睡眠领域的自变量与涉及心脏代谢、睡眠和神经行为系统的三个相互关联的健康结果之间的独立关联。成人和儿童的肥胖已成为一种流行病，并且由于其与主要死亡原因心血管疾病和其他代谢性疾病的关联而成为一个主要的公共卫生问题。然而，评估儿童肥胖的危险因素和结果的数据有限。我们小组和其他人的最新数据支持了我们的假设的系统前瞻性调查，这些证据包括：（1）睡眠时间最近被确定为肥胖的一个新的危险因素，并且这种关联会受到年龄、性别、压力、体力活动和社会经济地位等因素的影响。在我们的数据中，我们根据主观而非客观的报告观察到睡眠持续时间与肥胖之间的横断面关联； (2)经常承受压力的肥胖成年人有轻度皮质醇增多症，有患压力诱发内脏性肥胖和代谢综合征的风险。我们来自儿童和成人样本的数据支持了这一假设； (3)成人肥胖是心血管疾病的重要危险因素。在我们的儿童样本中，我们发现肥胖和 SDB 是导致血压升高和心脏自主调节受损的重要且独立的危险因素； (4) 在成人中，假设肥胖通过代谢综合征途径导致更高的 CVD 风险，并且越来越多的人担心肥胖儿童的代谢因素也会升高。我们和其他人已经报道，成人 SDB 与代谢综合征风险增加有关。在我们的儿童数据中，SDB 与多种代谢异常风险增加存在横向相关性。 (5) 我们和其他人报告说，自主神经调节受损与 CVD 死亡率和发病率显着相关。在我们的儿童样本中，我们报告了 SDB-HRV 和肥胖 HRV 之间对血压升高的显着协同相互作用，表明睡眠、肥胖和生命早期发生的心脏代谢健康之间存在复杂的相互关系。最后，在我们的儿童数据中，SDB 的年龄分布表明青春期内可能存在年龄依赖性关系。 公共卫生相关性：儿童期肥胖已成为一种流行病和一个主要的公共卫生问题。这项前瞻性研究将评估早期儿童肥胖和睡眠问题的各种新风险因素以及亚临床和临床后果。从这项研究中获得的知识将更好地定位我们的干预策略，以减轻儿童肥胖的公共健康负担。