Childhood Obesity and Type 2 Diabetes Trends: A Life Course Analysis

这项提议将为Joyce Lee博士提供分析技能和研究经验，使其成为 独立研究人员将重点放在了肥胖和2型糖尿病的一生中。李博士将在此基础上 作为儿科内分泌学家和儿科健康服务研究员，她接受了独特的培训，计划 高级课程侧重于流行病学、应用建模和儿童健康方面的量化技能 政策。她卓有成效的指导团队包括威廉·赫尔曼博士、医学硕士和加里·弗里德博士。 公共卫生和资源，如密歇根糖尿病研究和培训中心，儿童健康 评估和研究单位和密歇根大学公共卫生学院。有了这个 项目中，李博士提出了一种新的生命过程方法来理解 儿童肥胖与2型糖尿病风险的关系。随着时间的推移，儿童肥胖率正在加速上升， 随着肥胖率和肥胖度的大幅增加，以及肥胖症发病的更早。尽管如此 趋势，基于人群的研究表明，儿童中的T2D比率尚未增加 基本上，这可能反映了肥胖开始和T2D发展之间的潜伏期， 这可以持续10年以上。因此，儿童肥胖的流行可能会导致 年轻人中T2D的大幅增加，这是非常令人担忧的，因为心血管疾病的发生率更高 以及病程较长的终末期并发症。在这份提案中，李博士将评估 应用年龄周期队列研究青壮年儿童肥胖与T2D的流行病学联系 分析并将研究超重BMI的程度和早期肥胖的持续时间如何影响这一比率 和T2D的发病年龄。然后，她将开发一个状态转换模型，以预测T2D的未来趋势 这是最近儿童肥胖症增加的原因。最后，她将确定她的政策含义 流行病学研究和国家过渡模型的研究结果，以确定和优先处理 将儿童肥胖症作为一种慢性病解决所需的儿童健康政策和保健服务 危险因素起源于童年，一直延续到成年。

This proposal will provide Dr. Joyce Lee with the analytic skills and research experience for becoming an independent researcher focused on obesity and type 2 diabetes over the life course. Dr. Lee will build on her unique training as a pediatric endocrinologist and pediatric health services researcher with a program of advanced courseworkfocused on quantitative skills in epidemiology, applied modeling, and child health policy. Her accomplished mentoring team includes Dr. William Herman, MD, MPH, and Dr. Gary Freed MD, MPH, and resources such as the Michigan Diabetes Research and Training Center, the Child Health Evaluation and Research Unit, and the School of Public Health at the University of Michigan. With this project, Dr. Lee proposes a novel life course approach for understanding the long-term consequences of childhood obesity with regard to type 2 diabetes risk. Rates of childhood obesity are accelerating over time, with large increases in prevalence and magnitude of obesity, as well as earlier onset of obesity. Despite this trend, population-based studies suggest that rates of T2D among children have not yet increased substantially, which may reflect the latency period between the onset of obesity and the development of T2D, which can last upwards of 10 years of more. Therefore, the epidemic of childhood obesity may result in large increases in T2D among young adults, which is of great concern due to higher rates of cardiovascular and end-stage complications from a longer duration of disease. In this proposal, Dr. Lee will evaluate the epidemiologic link between childhood obesity and T2D among young adults using age-period-cohort analyses, and will examine how both degree of excess BMI and duration of obesity early in life affect the rate and age at onset of T2D. She will then develop a state transition model to project future trends in T2D which account for recent increases in childhood obesity. Finally she will identify the policy implications of her findings from the epidemiologic studies and the state transition model to identify and prioritize changes in child health policy and health care delivery needed for addressing childhood obesity as a chronic disease risk factor originating in childhood and extending into adulthood.