ADOLESCENT RISK FACTORS AND YOUNG ADULT CARDIAC RISK

朱莉娅·斯坦伯格博士是明尼苏达大学的儿科心脏病专家和儿科助理教授。候选人的长期目标是发展一项结合临床研究和临床医学的独立职业生涯。候选人感兴趣的是通过调查儿童和青少年的危险因素以及影响他们发展为成人动脉粥样硬化性心脏病的机制来预防心血管疾病。她对这一领域的兴趣是在团契期间发展起来的，当时她对肥胖、左心室重量(LVM)、胰岛素抵抗和血脂之间的关系产生了兴趣。拟议的职业发展计划结合了一个多学科计划，旨在提供紧张的、密切指导的、以患者为导向的研究经验，并与全面结构的流行病学教学课程相结合。在艾伦·西奈科博士和大卫·雅各布斯博士的指导下，候选人将在攻读流行病学系硕士学位课程的同时，研究青春期心血管风险因素对青年时期心血管风险建立的影响。这项研究将检验体脂、胰岛素抵抗、血脂和左心室肥厚之间的流行病学关系，并将检验青春期体脂和胰岛素抵抗预测青春期肥胖症、胰岛素抵抗、血脂、左心室重量和收缩压水平的假设。这项研究将在200名受试者中进行，受试者的平均年龄为13岁，他们来自普通人群中血压分布最高的15%，并在17岁时进行重新评估。之前在这个队列中13岁的研究表明，男性和女性在LVM对体型增加的反应方面存在差异；对17岁的队列及其父母进行的分离分析推断，存在一个影响空腹胰岛素水平的主基因。因此，这项研究的第二个目标将是确定青年时期左心室重量与青春期心血管危险因素之间的性别差异；第三个目标是确认当参与者是年轻人并且较少与父母分享童年家庭环境时的遗传结果。

Dr. Julia Steinberger is a pediatric cardiologist and Assistant Professor in Pediatrics at the University of Minnesota. The candidate's long-term goal is to develop an independent career combining clinical research with clinical medicine. The candidate is interested in the prevention of cardiovascular disease by investigating risk factors in children and adolescents and mechanisms that influence their progress to adult atherosclerotic heart disease. Her interests in this field developed during fellowship when she became interested in the relations among obesity, left ventricular mass (LVM) insulin resistance, and lipids. The proposed career development plan incorporates a multi-disciplinary program designed to provide an intense, closely mentored, patient-oriented research experience in association with a comprehensively structured didactic curriculum in epidemiology. Under the mentorship of Dr. Alan Sinaiko and Dr. David Jacobs, the candidate will investigate the effect of cardiovascular risk factors in adolescence on establishment of cardiovascular risk in young adulthood, while enrolled in a master's degree program in the Division of Epidemiology. This research will examine epidemiologic associations of body fatness, insulin resistance, lipids, and LVM and will test the hypothesis that body fatness and insulin resistance during adolescence predict levels of adiposity, insulin resistance, lipids, left ventricular mass, and systolic blood pressure in young adulthood. The study will be conducted in a cohort of 200 subjects recruited at mean age 13 years from the top 15 percent of the blood pressure distribution in a general population, and reevaluated at age 17 years. Previous studies in this cohort at age 13 have shown a difference between males and females in the response of LVM to increases in body size; and a segregation analysis in the cohort at age 17 and their parents has inferred the presence of a major gene influencing the levels of fasting insulin. Therefore, a second objective of this research will be to define gender differences in the association of left ventricular mass in young adulthood with cardiovascular risk factors in adolescence; and a third objective is to confirm the genetic results when the participants are young adults and share less of the childhood familial environment with their parents.