Obesity development and CVD risk factor clustering in Filipino women & offspring

描述（由申请人提供）：拟议的研究旨在确定正在经历营养转变的亚洲人群中体重增加和心血管疾病危险因素发展的决定因素。该研究基于在菲律宾第二大都会区宿务进行的纵向健康和营养调查（CLHNS）。这项以社区为基础的调查在1983-84年间招募了孕妇，我们在过去的二十年里研究了这些妇女和她们的索引孩子。从生命历程的角度来看，我们使用两代样本来检查年轻人危险因素的童年前因和成年后心血管疾病危险因素水平的成年早期前因。我们将重点放在风险因素如何在代内和代之间聚集的异质性上，作为确定病因的一种手段。CLHNS在所有调查年份收集了详细的纵向社区、家庭和个人水平数据，使我们能够建立因果模型。在1998-2005年的调查中测量了血压。1998年在一部分青年和2005年在所有青年及其母亲中收集的空腹血液样本提供了与慢性疾病相关的广泛生物标志物。我们将对出生队列中从童年到成年的体重、肥胖和腰围的决定因素以及他们的成年母亲在20年的时间内进行建模。我们关注的是宿务快速的社会经济变化和现代化带来的饮食（如脂肪和软饮料消费的增加）和身体活动（如久坐的职业和休闲活动的增加）的巨大变化的影响。然后，我们将确定包括代谢综合征（动脉粥样硬化脂质谱、空腹血糖升高、胰岛素抵抗、血压升高）和其他心血管疾病风险因素（同型半胱氨酸、CRP和脂联素）在内的风险因素在成年女性及其年轻成年后代中的共同发生的流行程度和模式，确定风险因素在两代人中的聚集方式的异同。最后，我们将对母亲和后代中CVD危险因素聚集的决定因素进行建模，重点关注先前的体重和肥胖轨迹，先前和当前的饮食组成和身体活动，以及成年女性危险因素发生与身体功能的关系。

DESCRIPTION (provided by applicant): The proposed research aims to identify determinants of weight gain and development of cardiovascular disease risk factors in an Asian population undergoing the nutrition transition. The research is based on the Cebu Longitudinal Health and Nutrition Survey (CLHNS), conducted in the second largest metro area of the Philippines. This community-based survey recruited pregnant women in 1983-84, and we have studied the women and their index child for the past two decades. Taking a life course perspective, we use the two- generation sample to examine childhood antecedents of risk factors in young adults and early adult antecedents of later adult levels of CVD risk factors. We focus on heterogeneity in how risk factors cluster within and between generations as a means to identify etiology. The CLHNS collected detailed longitudinal community, household, and individual level data in all survey years, allowing us to develop causal models. Blood pressure was measured in the 1998-2005 surveys. Fasting blood samples collected in a subset of youth in 1998, and in all youth and their mothers in 2005 provide a wide range of biomarkers related to chronic disease. We will model the determinants of weight, adiposity, and waist circumference from childhood young adulthood in the birth cohort, and in their adult mothers over a 20 year time period. We focus on the effects of large changes in diet (e.g. increased fat and soft drink consumption) and physical activity (e.g. increased sedentary occupational and leisure activity) that have accompanied rapid socioeconomic changes and modernization in Cebu. We will then determine the prevalence and patterns of co-occurrence of risk factors that comprise the metabolic syndrome (atherogenic lipid profiles, elevated fasting blood glucose, insulin resistance, raised blood pressure) and other CVD risk factors (homocysteine, CRP, and adiponectin) in adult women and their young adult offspring, identifying similarities and differences in how risk factors cluster in the 2 generations. Finally, we will model determinants of CVD risk factor clustering in mothers and offspring, focusing on prior weight and adiposity trajectories, and prior and current diet composition and physical activity, and for adult women, the relationship of occurrence of risk factors to physical functioning.