Effects of Vitamin D and Omega-3 on Cerebrovascular Disease

 描述(申请人提供)：我的长期目标是成为心血管流行病学的独立研究员，专注于与脑血管疾病，特别是中风相关的发病率负担。我将利用这个指导职业发展奖(K01)来完成一系列的培训目标，这些目标建立在我先前技能的基础上，同时也在实现我的长期目标所必需的方式上扩展我的专业知识。这些技能包括：学习测量和分析纵向卒中结果数据；培养通过磁共振成像(MRI)扫描评估、表征和测量脑白质高强度体积(WMHV)和脑微出血(CMBS)的技能；学习随机临床试验的设计、实施和分析；以及掌握中介分析技术技能。为了实现我的培训目标，我组建了一支全面的、相辅相成的指导团队，他们一起工作并与我一起工作了多年。我的培训目标还将使我能够发展在本次获奖期间正在进行的研究中建立新数据集所需的技能。这些子队列对于实现K01的研究目标是必要的，并将为未来独立研究基金的赠款申请提供初步数据。在这个K01奖项中，我将把我的训练应用到几个重要的研究问题上。最近，人们对维生素D和omega-3脂肪酸在心血管疾病事件的发展中所起的作用越来越感兴趣。鉴于中风的高发病率负担，确定这些补充剂对中风预后的影响是非常重要的。NIH赞助的维生素D和omega-3试验(VITAL)是一项正在进行的随机双盲试验，测试维生素D3和omega-3脂肪酸补充剂在癌症和心血管疾病一级预防中的作用。我将利用这项正在进行的试验，收集有关中风结果的额外数据，否则父母研究不会收集这些数据。此外，人们越来越有兴趣通过WMHV和CMBS来衡量大脑中总体亚临床脑血管疾病负担的危险因素。由于WMHV和CMBS与卒中预后相关，了解缺血性卒中患者与WMHV和CMBS相关的危险因素可能会确定减少卒中发病率负担的策略。我将收集作为缺血性中风参与者常规医疗护理的一部分进行的MRI扫描，以在VITAL和妇女健康研究(WHS)中创建WMHV和CMBS的数据库，这是一项关于低剂量阿司匹林和维生素E在心血管疾病和癌症一级预防中的作用的完整试验，并正在进行观察跟踪。通过使用VITAL和WHS的数据，我将有独特的机会研究各种心血管疾病风险因素如何影响中风患者的WMHV和CMBS。这个K01奖项提供的培训、指导、研究经验和建立新的子队列的机会将使我实现我成为心血管疾病流行病学独立研究人员的长期职业目标。

 DESCRIPTION (provided by applicant): My long-term goal is to become an independent researcher in cardiovascular epidemiology with a focus on the morbidity burden associated with cerebrovascular diseases, particularly stroke. I will use this Mentored Career Development award (K01) to fulfill a series of training objectives which build upon my prior skills, but also expand my expertise in ways which are essential to accomplishing my long-term goal. These include: learning to measure and analyze longitudinal stroke outcomes data; developing skills to assess, characterize, and measure white matter hyperintensity volume (WMHV) and cerebral microbleeds (CMBs) from magnetic resonance imaging (MRI) scans; learning about the design, conduct, and analysis of randomized clinical trials; and acquiring skills in mediation analysis techniques. To achieve my training objectives, I have assembled a comprehensive and complementary mentorship team which has worked together and with me for many years. My training objectives will also allow me to develop the skills needed to establish new datasets within ongoing studies during this award period. These subcohorts are necessary to achieve the research goals of the K01 and will provide preliminary data for future grant applications for independent research funding. I will apply my training to several important research questions during this K01 award. Recently, there has been growing interest in the role that vitamin D as well as omega-3 fatty acids play in the development of cardiovascular disease events. Given the high morbidity burden of stroke, determining the effect of these supplements on stroke outcomes is very important. The NIH sponsored VITamin D and OmegA-3 TriaL (VITAL) is an ongoing randomized, double blind trial testing vitamin D3 and omega-3 fatty acid supplementation in the primary prevention of cancer and cardiovascular disease. I will leverage this ongoing trial and collect additional data on stroke outcomes that would not otherwise be collected by the parent study. In addition, there is growing interest in discovering risk factors fr overall subclinical cerebrovascular disease burden in the brain as measured by WMHV and CMBs. Because WMHV and CMBs are associated with stroke outcomes, understanding risk factors associated with WMHV and CMBs in ischemic stroke patients may identify strategies to reduce the morbidity burden of stroke. I will collect MRI scans performed as part of routine medical care in participants with an ischemic stroke to create a database of WMHV and CMBs in VITAL and the Women's Healthy Study (WHS), a completed trial of the effects of low dose aspirin and vitamin E in the primary prevention of cardiovascular disease and cancer with ongoing observational follow-up. By using data from both VITAL and WHS, I will have the unique opportunity to study how a wide variety of cardiovascular disease risk factors impact WMHV and CMBs in stroke patients. The training, mentorship, research experience, and opportunity to establish new subcohorts provided by this K01 award will allow me to achieve my long-term career goal of becoming an independent research in cardiovascular disease epidemiology.