Growth and Cardiometabolic Risk Among In Utero Drug Exposed Children

描述(由申请者提供)：这个K01奖项将允许候选人Sarah Messiah博士获得成为一名独立调查员所需的技能、知识和经验。利用迈阿密产前可卡因研究(MFCS，首席调查员Emmaree Bandstra博士)的数据，Messiah博士将研究16-18岁非裔美国儿童宫内可卡因暴露、人体生长发育和心脏代谢性疾病风险因素发展之间的关系。MPC已经收集了先前关于400多名婴儿及其母亲/候补照料者青春期早期的11波多域数据，现在正在开始另外两波16-18岁的数据收集。拟议的指导性研究有三个具体目标：(1)使用先前建立的和特征良好的NIDA队列，纵向比较产前接触可卡因的城市、非裔美国儿童和青少年的人体测量指标(身高、体重、体重指数、腰围和身体成分)；(2)使用先前建立的和特征良好的NIDA队列，对产前接触可卡因的城市、非裔美国青少年的心脏代谢风险因素(空腹血糖、胰岛素、血脂、C反应蛋白、血压)进行横向比较；以及(3)在控制影响因素(尼古丁、酒精和大麻的接触、儿童和母亲的压力、焦虑和抑郁)对(A)超重和肥胖、(B)体重不足和(C)心脏代谢危险因素(通常称为“代谢综合征”)的影响的多因素分析中，确定产前和出生后接触可卡因的具体影响。为了实现这项研究和她的职业发展目标，Messiah博士将遵循迈阿密大学米勒医学院的职业发展计划，旨在提供4项核心能力(HFE病程，特别强调宫内可卡因暴露、纵向/潜伏性生长分析方法、胚胎学和心脏代谢性疾病风险因素在儿童时期的发展以及随后成人发病的慢性病风险)方面的知识、技能和经验。拟议研究的广泛、长期目标是阐明因果关系和非因果关系，特别关注宫内可卡因暴露如何改变人体测量凹陷的发生和轨迹，以及随后心脏代谢性疾病风险因素的发展。这项调查的结果应该为物质使用和心血管研究领域提供关于后代在怀孕期间摄入可卡因的后续风险的信息。公共卫生相关性：这项研究将对宫内接触可卡因儿童的长期心血管健康影响进行重要的潜伏期影响分析。这项调查的结果应该为物质使用和心血管研究领域提供关于后代在怀孕期间摄入可卡因的后续风险的信息。

DESCRIPTION (provided by applicant): This K01 award will allow the candidate, Dr. Sarah Messiah, to gain the skills, knowledge and experience required to become an independent investigator. Using data from the Miami Prenatal Cocaine Study (MFCS, Dr. Emmalee Bandstra, Principal Investigator), Dr. Messiah will examine the relationship between in utero cocaine exposure, anthropometric growth and development of cardiometabolic disease risk factors in African American children at ages 16-18. The MPCS has collected 11 prior waves of multi-domain data on over 400 infants and their mothers/alternate caregivers through early adolescence and is now embarking on 2 additional waves of data collection at ages 16 -18 years. The proposed mentored research has three specific aims: (1) To longitudinally compare anthropometric measures (height, weight, body mass index, waist circumference, and body composition) among urban, African American children and adolescents who were or were not prenatally exposed to cocaine using a previously established and well-characterized NIDA cohort; (2) To compare cardiometabolic risk factors (fasting glucose, insulin, lipids, CRP, blood pressure) cross-sectionally among urban, African American adolescents who were or were not exposed prenatally to cocaine using a previously established and well-characterized NIDA cohort; and (3) To determine the specific effects of both prenatal and postnatal exposures of cocaine in a repeated measures multivariate analysis, controlling for effect modifiers (nicotine, alcohol and marijuana exposure, stress, anxiety and depression in children and mothers) on: (a) Overweight and obesity, (b) Underweight, and (c) > 3 cardiometabolic risk factors (often referred to as "metabolic syndrome"). To achieve this research and her career development goals, Dr. Messiah will follow a career development plan at the University of Miami Miller School of Medicine, designed to provide knowledge, skills, and experience in 4 core competencies (hfe course of disease, with particular emphasis on in utero cocaine exposure, longitudinal/latent growth analytical methods, embryology, and cardiometabolic disease risk factor development in childhood and subsequent risk for adult onset chronic disease). The broad, long-term goal of the proposed research is to elucidate causal and non-causal links with a specific focus upon how in utero cocaine exposure might alter the occurrence and trajectories of anthropometric grovrth, and subsequent development of cardiometabolic disease risk factors. Findings from this investigation should inform both the fields of substance use and cardiovascular research about subsequent risks of cocaine ingestion during pregnancy in offspring. PUBLIC HEALTH RELEVANCE: This study will provide important latency affect analysis of the long-term cardiovascular health implications among in utero cocaine exposed children. Findings from this investigation should inform both the fields of substance use and cardiovascular research about subsequent risks of cocaine ingestion during pregnancy in offspring.