Kidney and Cardiovascular Disease in American Indians

描述(由申请人提供)：肾功能障碍和心血管系统异常经常同时发生，可能具有共同的病理生理学。影响一种疾病状态进展的因素被认为影响另一种疾病状态的进展。心脏强健研究(SHS)提供了一个独特的机会来研究美国印第安人(AI)的肾功能变化、心血管疾病风险因素、亚临床心血管疾病以及临床事件。人工智能是一个健康差距很大的人群，因为他们的糖尿病和糖尿病并发症的发生率非常高。我建议(1)进行二次数据分析，以检验SHS中AI中肾脏和心血管疾病的共同进展，以及(2)进行一项初步研究，涉及测量与AI中肾脏和心血管疾病进展相关的氧化应激标记物。具体地说，我建议进行一系列横断面、生存期和重复测量分析，涉及肾小球滤过率以及临床(M1，CHD)和亚临床(颈动脉粥样硬化，超声心动图)心血管疾病的测量，以更好地确定AI中肾脏和CVD的共同进展。此外，我建议对CVD病例和对照进行一项初步研究，在该研究中，我将使用SHS的存储样本来检测F2-异前列腺素和8-羟基鸟嘌呤的水平，这两个指标是氧化应激的标志。这些目标的实现，以及本申请表中描述的其他培训活动，以及Resnick博士和UMans提供的结构化指导，将为我提供技能、知识和方向，帮助我开始开发专注于肾脏疾病健康差异的研究计划。我的长期职业目标是开发一个受资助的研究项目，处理少数族裔人群中的肾脏疾病。

DESCRIPTION (provided by applicant): Renal dysfunction and abnormalities of the cardiovascular system often occur simultaneously and may share common pathophysiology. Factors influencing progression of one disease state are thought to influence progression of the other. The Strong Heart Study (SHS) provides a unique opportunity to study changes in renal function, CVD risk factors, subclinical CVD as well as clinical events in American Indians (AI). AI are a health disparity population due to their extremely high rates of diabetes and diabetic complications. I propose to (1) perform secondary data analyses to examine the co-progression of renal and cardiovascular disease in AI in the SHS and (2) conduct a pilot study involving measurement of oxidative stress markers in relation to progression of renal and cardiovascular disease in AI. Specifically, I propose to conduct a series of cross-sectional, survival and repeated measures analyses involving glomerular filtration rate and measures of clinical (Ml, CHD) and subclinical (carotid atherosclerosis, echocardiography) cardiovascular disease to better define the co-progression of renal and CVD in AI. Further, I propose to conduct a pilot study of CVD cases and controls in which I will use stored specimens from the SHS to examine levels of F2-isoprostane and 8- hydroxyguanine, two markers of oxidative stress. Achievement of these aims, along with the other training activities described in this application, and the structured mentoring offered by Drs. Resnick and Umans will provide me with the skills, knowledge and direction that will help me begin developing a research program focused in health disparities in renal disease. My long term professional objective is to develop a funded research program dealing with renal disease in minority populations.