Biopsychosocial Determinants of Adolescent Obesity/Cardiovascular Risk

描述(申请人提供)：青少年肥胖症在美国和拉丁美洲非常普遍。虽然食物和自然环境的剧烈环境变化与风险增加有关，但对防止肥胖发展的个人、家庭和社区层面的因素仍然缺乏充分的了解。需要进一步的研究来了解导致低收入和西班牙裔/拉美裔青年肥胖风险不同的机制。这项拟议的为期5年的项目旨在阐明与青少年肥胖以及日后发展为2型糖尿病和心血管疾病的风险相关的相互关联的生物学和社会途径。这项应用涉及大约620名智利青少年，他们在婴儿期、3至5岁和10岁进行评估，作为NIH支持的关于在婴儿时期预防缺铁性贫血的行为和发育影响的队列研究的一部分(n=1645)。因此，收集了与生长、健康和发展有关的详细纵向数据。16至17岁的青少年将参与活动、睡眠和饮食模式的研究，使用活动记录和对饮食行为的实验室评估。此外，我们还将测量人体测量、脂肪和肌肉质量(DXA)、空腹血糖、胰岛素(HOMA IR)、血脂、瘦素、Ghrelin、脂联素、食欲素、C反应蛋白和肿瘤坏死因子α。还将收集有关家族史、吸烟、健康和心理社会功能的详细信息。社区层面的因素，如犯罪、步行能力、身体活动资源和健康食品属性将被评估。此外，一个相当大的子集(n=237)，具有多个时间点的睡眠神经生理学和活动记录，将在16岁时参与两晚多导睡眠研究。 在生命历程方法的指导下，我们建议调查三个具体目标： 具体目标1-评估肥胖和相关代谢障碍的生物学和心理社会决定因素，对一组青少年进行跟踪调查，从婴儿早期开始。 具体目标2--评估肥胖/肥胖与肥胖相关代谢障碍的生物标记物之间的关系。 具体目标3-评估体力活动、睡眠和饮食行为的昼夜节律模式对肥胖和相关代谢障碍的作用。 智利大学营养与技术研究所和密歇根大学人类生长与发展中心之间的长期合作为研究拉丁美洲低收入到中等收入青年中青少年肥胖的生物学和心理社会决定因素提供了一个出色的环境，这些青年的肥胖风险与美国的同类青年非常相似。我们期望进一步了解饮食和活动的发育模式如何受到早期生活因素的影响，进而影响肥胖和相关代谢障碍的发展。我们的研究在纵向心理社会和生物学数据的深度和广度上是独一无二的。我们建议进行跨越学科界限的研究，并有可能为未来的干预研究揭示青少年肥胖的重要决定因素。与公众热度相关：青少年肥胖是在童年时期因生物因素和社会条件而发展起来的。虽然遗传等生物因素很难改变，但社会因素可以成为预防工作的目标。我们希望进一步了解与高危城市、拉美裔/拉丁裔人口肥胖发展相关的环境和社会条件。我们感兴趣的是儿童如何形成与饮食、睡眠和活动相关的昼夜节律，以及随后这些模式如何导致肥胖。我们的目标是揭示可改变的条件，以预防肥胖和相关疾病，包括心血管疾病和糖尿病。

DESCRIPTION (provided by applicant): The prevalence of adolescent obesity is high in the U.S., and in Latin America. While dramatic environmental changes in the food and physical environment are associated with increased risk, there continues to be inadequate understanding of the individual, family and community level factors that protect against the development of obesity. Further research is needed to understand the mechanisms leading to disparate risk for obesity in low-income and Hispanic/Latino youth. The proposed 5-year project aims to elucidate interconnected biological and social pathways associated with adolescent obesity and risk for later development of type 2 diabetes and cardiovascular disease. This application involves approximately 620 Chilean adolescents, assessed in infancy, 3 to 5 years and 10 years as part of a NIH-supported cohort study of the behavioral and developmental effects of preventing iron deficiency anemia in infancy (n = 1645). As such, detailed longitudinal data related to growth, health and development have been collected. At 16 to 17 years, the youth will participate in study of activity, sleep and eating patterns using actigraphic recording and laboratory assessment of eating behavior. In addition, we will measure anthropometry, fat and muscle mass (DXA), fasting glucose, insulin (HOMA IR), lipids, leptin, ghrelin, adiponectin, orexin, CRP, and TNF alpha. Detailed information about family history, smoking, health, and psychosocial functioning will also be collected. Neighborhood level factors such as crime, walk ability and resources for physical activity and healthful food attributes will be assessed. Furthermore, a sizeable subset (n = 237) with sleep neurophysiology and actigraphic recordings at multiple time points will participate in 2-night polysmnographic sleep study at 16 years. Guided by a life-course approach, we propose to investigate three Specific Aims: Specific Aim 1 - To evaluate biological and psychosocial determinants of obesity and related metabolic disturbance in a cohort of adolescents followed since early infancy. Specific Aim 2 - To assess associations between obesity/adiposity and biomarkers of adiposity-related metabolic disturbance in this sample of Chilean adolescents. Specific Aim 3 - To assess the role of circadian patterns of physical activity, sleep and eating behavior on adiposity and related metabolic disturbance. The long standing collaboration between the Institute for Nutrition and Technology at the University of Chile and the Center for Human Growth and Development at the University of Michigan provides an outstanding environment to study biological and psychosocial determinants of adolescent obesity in a low- to middle-income cohort of Latin American youth who are very similar in obesity risk to comparable U.S. youth. We expect to advance understanding of how developmental patterns of eating and activity are influenced by early life factors and in turn influence the development of obesity and related metabolic disturbance. Our study is unique in the depth and breadth of longitudinal psychosocial and biological data. We propose research that crosses disciplinary boundaries and has the potential to reveal important determinants of adolescent obesity for future intervention research. PUBLIC HEATLH RELEVANCE: Adolescent obesity develops during childhood in response to biological factors and social conditions. While biological factors such as genetic inheritance are difficult to change, social factors could be targets for preventive efforts. We expect to further understanding of the environmental and social conditions related to the development of obesity in a high risk urban, Hispanic/Latino population. We are interested in how children develop circadian rhythms related to eating, sleeping and activity, and subsequently how these patterns lead to obesity. Our goal is to unveil modifiable conditions in order to prevent obesity and related diseases including cardiovascular disease and diabetes.