Sleep Duration, Childhood Energy Balance, and Insulin Resistance in Adolescence

儿童肥胖症非常普遍，没有一个年龄段可以幸免，而且对种族/少数民族人口的影响不成比例。儿童时期的肥胖与不良的心脏代谢结果有关，包括高胰岛素血症和胰岛素抵抗，这反过来可能增加许多癌症的风险。预防慢性病的生命过程方法认为，在婴儿期和幼儿期进行正确的影响可能会导致健康的体重和能量平衡轨迹。 越来越多的流行病学证据表明，睡眠时间短是成年人肥胖、胰岛素抵抗、冠心病和各种原因死亡的危险因素，独立于其他危险因素。此外，短期实验研究表明，成年人的睡眠限制与可能增加肥胖和心脏代谢紊乱风险的生理机制有关。然而，主要问题仍然存在。 关于睡眠时间短在多大程度上预示着幼儿肥胖和心脏代谢紊乱，以及这些联系背后的潜在机制。此外，很少有研究考察儿童早期睡眠模式的社会环境背景，这些模式可以为行为干预提供信息，以改善高危人群的睡眠。 这项研究的目的有两个。第一个目标是研究睡眠时间--在第一波TREC项目中确定的肥胖和代谢功能障碍的新风险因素--在婴儿期和儿童期与肥胖和能量平衡，以及在青春期早期出现胰岛素抵抗和其他癌症相关生物标记物之间的关联。我们将在特色完善的范围内开展这部分项目 产前队列研究。万岁计划。这项以美国为基础的研究前瞻性地收集和验证了儿童从早期婴儿期到11岁的睡眠和饮食信息、人体测量和研究质量的生物标记物数据。第二个目标是研究儿童早期睡眠模式的社会文化、行为和环境背景，这些背景可以为行为干预提供信息，以改善睡眠持续时间和质量。 为了实现我们的目标，我们组建了一个由肥胖和睡眠医学流行病学家、行为科学家、临床心理学家、儿科临床研究人员、统计学家和遗传学家组成的跨学科研究团队。这项研究的结果可以加强对儿童睡眠、能量平衡和癌症发生的理解，从微观(遗传)到宏观(环境)水平--儿童是肥胖及其后遗症的高危人群。此外，我们的研究将提供未来干预研究设计所需的关键数据，例如量化导致肥胖和代谢功能障碍风险增加的睡眠阈值水平，确定调节这些关联的关键近邻行为，以及确定社会文化/环境因素作为睡眠改善干预的潜在目标。

Childhood obesity is highly prevalent, spares no age group, and disproportionately affects racial/ethnic minority populations. Obesity in childhood is associated with adverse cardio-metabolic outcomes including hyperinsulinemia and insulin resistance which may, in turn, increase risks for many cancers. The lifecourse approach to chronic disease prevention posits that the right infiuences during infancy and early childhood could entrain healthful trajectories of weight and energy balance for life. Mounting epidemiologic evidence indicates that short duration of sleep is a risk factor for obesity, insulin resistance, coronary heart disease, and all-cause mortality in adults independent of other risk factors. In addition, short-term experimental studies show that sleep restriction in adults is associated with physiologic mechanisms that may increase risk of adiposity and cardio-metabolic disorders. Yet major questions remain regarding the extent to which short sleep duration predicts adiposity and cardio-metabolic disorders in young children, and the potential mechanisms underiying these associafions. Furthermore, few studies have examined the social-environmental context of early childhood sleep patterns that could inform behavioral intervenfions to improve sleep in high-risk groups. The goals of this study are two-fold. The first goal is to examine associafions of sleep duration - a novel risk factor for obesity and metabolic dysfunction identified in the first wave of TREC projects - in infancy and childhood with adiposity and energy balance, and with the emergence of insulin resistance and other cancer related biomarkers in eariy adolescence. We will carry out this part ofthe project within the well-characterized pre-birth cohort study. Project Viva. This US-based study has prospecfively collected and validated sleep and diet information, anthropometry, and research-quality biomarker data in children from eariy infancy through age 11 years. The second goal is to examine the social-cultural, behavioral, and environmental context of early childhood sleep patterns that could inform behavioral interventions to improve sleep duration and quality. To achieve our aims, we have assembled a transdisciplinary research team of obesity and sleep medicine epidemiologists, behavioral scientists, clinical psychologists, pediatric clinical investigators, statisticians, and geneticists. The results of this study could strengthen the understanding of sleep, energy balance, and carcinogenesis from micro- (genetics) to macro- (environment) levels among children - a segment of the population at high risk for obesity and its sequelae. Furthermore, our study will supply key data needed for the design of future intervention studies, such as quantifying threshold levels of sleep that confer increased risk of obesity and metabolic dysfunction, identifying key proximate behaviors that mediate these associations, and identifying socio-cultural/environmental factors as potential targets for sleep improvement interventions.