Preventing Obesity in Preterm Infants

项目摘要 本研究项目的目的是确定脂肪组织发育的指标， 代谢是识别处于儿童肥胖风险中的早产儿的候选生物标志物， 心脏代谢异常中度早产婴儿，胎龄在32- 36周之间， 与足月出生的人相比，成年后肥胖和心脏代谢疾病的几率高出20%。 中度早产占所有出生的8%，或在美国出生的大约30万名儿童 每年的国家。可能导致早产儿肥胖风险的因素包括发育障碍， 由于围产期暴露于产妇肥胖和糖尿病，初步数据显示， 患有糖尿病的母亲的中度早产儿在平均9天内有更大的住院生长 在校正胎龄、性别和种族后，与非糖尿病母亲的婴儿进行比较。加速 这些婴儿的生长可能是由于脂肪的发育、代谢和定位的改变， 组织.在中度早产儿的前瞻性队列中，本项目的目的是： 母亲肥胖和妊娠期糖尿病对足月校正年龄肥胖症发展的影响， 其与出生时脂肪组织代谢生物标志物的相关性（目的1），并确定早期身体的作用， 出生时通过磁共振成像和脂肪组织代谢生物标志物进行的组成评估 在预测儿童早期生长发育和2岁时肥胖和心脏代谢异常方面 年（目标2）。这些围产期生物标志物的鉴定对于在新生儿出生时对婴儿进行风险分层的能力至关重要。 肥胖和心脏代谢异常的风险增加，以及未来干预措施的发展 优化早产儿的健康成长并减少肥胖。 博士巴克是一名产科医生，他的长期目标是领导独立的研究，检查围产期风险 影响早产儿的生长发育。本提案的职业发展计划 建立在巴克博士之前的流行病学和临床研究方法的培训，通过研究生水平 纵向研究设计、高级生物统计方法、生物标志物和 身体成分评估和临床试验研究的实施。巴克医生已经召集了一个强大的，忠诚的 在婴儿营养、儿科内分泌学、围产期流行病学、 和生物统计学，以帮助指导她成功过渡到成为一名独立的调查员，优化 早产儿的健康生长和发育，最大限度地减少肥胖症的发展， 心血管代谢异常

PROJECT SUMMARY The objective of this research project is to determine if indicators of adipose tissue development and metabolism are candidate biomarkers to identify preterm infants at risk of childhood obesity and cardiometabolic abnormalities. Infants born moderately preterm, between 32- and 36-weeks of gestational age, have 20% higher odds of obesity and cardiometabolic disease in adulthood compared with those born at term. Moderate preterm birth accounts for 8% of all births, or approximately 300,000 children born in the United States each year. Factors that may contribute to obesity risk among preterm infants include developmental re- programming due to perinatal exposure to maternal obesity and diabetes. Preliminary data shows that moderate preterm infants of mothers with diabetes have greater in-hospital growth over an average of 9 days compared with infants of non-diabetic mothers, after adjustment for gestational age, sex, and race. Accelerated growth in these infants may be due to alterations in the development, metabolism, and localization of adipose tissue. In a prospective cohort of moderately preterm infants, the aims of this project are: To determine the effect of maternal obesity and gestational diabetes on the development of adiposity at term corrected age and its association with adipose tissue metabolism biomarkers at birth (Aim 1) and to identify the role of early body composition assessments by magnetic resonance imaging and adipose tissue metabolism biomarkers at birth in predicting early childhood growth and development of adiposity and cardiometabolic abnormalities at age 2 years (Aim 2). Identification of these perinatal biomarkers is critical in the ability to risk-stratify infants at heightened risk of obesity and cardiometabolic abnormalities, and for the future development of interventions to optimize healthy growth and reduce obesity among preterm infants. Dr. Buck is a neonatologist whose long-term goal is to lead independent research examining perinatal risks that influence growth and development among preterm infants. The career development plan for this proposal builds upon Dr. Buck's prior training in epidemiology and clinical research methods through graduate-level coursework and mentored training in longitudinal study design, advanced biostatistical methods, biomarker and body composition assessment, and clinical trial study conduction. Dr. Buck has assembled a strong, committed team of mentors and advisors with expertise in infant nutrition, pediatric endocrinology, perinatal epidemiology, and biostatistics to help guide her successful transition to becoming an independent investigator, optimizing healthy growth and development of preterm infants and minimizing the development of obesity and cardiometabolic abnormalities in this vulnerable population.