The Impact of Zinc Intake on Nutritional Status and Brain Development Among Preterm Infants

摘要 这份K23提案描述了一项为期五年的研究和培训计划，以促进凯瑟琳·贝尔博士的过渡 成为新生儿营养领域的独立内科医生兼科学家。贝尔医生是一位新生儿科医生，他有很强的 以病人为中心的研究基础。新生儿重症监护病房期间发生的营养缺乏 新生儿重症监护病房(NICU)住院损害早产儿发育关键期生长发育 身体和大脑，对长期神经发育结果产生不利影响。必需的微量营养素 锌对婴儿生长和大脑发育至关重要，但早产儿的最佳锌摄入量是 未知的和当前的防御工事战略可能是不够的。准确评估儿童的营养状况 通过区分反映器官生长和成熟的瘦体重，早产儿更容易接受治疗 胖的。这项建议的目标是确定NICU中锌摄入量与瘦体重之间的关联 累积率(作为营养状况的标志)，并评估锌摄入量的变化对 同时大脑发育和后来的神经发育结果。假设更多的锌摄入量 结果是更多的瘦体重积累，促进大脑的生长和成熟，并改善神经发育 将通过3个具体目标进行测试：1)确定NICU中锌摄入量与瘦体重的关系 在同等年龄段时。2)确定NICU中锌摄入量与大脑发育和 成熟。3)测定2岁时新生儿锌摄入量对神经发育结局的影响。这 这项研究对新生儿营养领域具有重要意义，因为从这项研究中获得的知识将有助于 确定早产儿的最佳锌摄入量，并为营养策略的设计提供信息，以确保 为所有早产儿提供充足的微量营养素。贝尔博士的指导团队-贝尔福博士(主要导师) 和Duggan博士(共同导师)-提供早产儿营养和微量营养素方面的补充专业知识 对儿童的要求分别是。贝尔博士还将接受杰出科学家的指导， 与这项工作有关的关键领域的专门知识，包括微量营养素生物化学、母乳成分、 儿童时期的神经发育评估，以及疾病的发育起源。培训 布里格姆妇女医院、塔夫茨·弗里德曼营养科学学院、 和哈佛医学院是求职者职业发展的理想环境。候选人的 该机构坚定地致力于她的成功。贝尔博士详细的职业发展计划包括 研究，教学课程，包括营养科学的正式学位，研讨会和演讲 科学会议。她提出了完成研究目标和为未来做准备的时间表 R01应用程序。从K23奖项中获得的知识和培训将使贝尔博士能够开发 开展专注于设计微量营养素的独立研究事业所需的技能和专业知识 优化早产儿生长和长期健康结局的干预措施。

ABSTRACT This K23 proposal describes a five-year research and training plan to facilitate Dr. Katherine Bell’s transition into an independent physician-scientist in the field of neonatal nutrition. Dr. Bell is a neonatologist with a strong foundation in patient-oriented research. Nutrient deficits occurring during the neonatal intensive care unit (NICU) hospitalization impair preterm infants’ growth and maturation during a critical period for development of the body and brain, adversely impacting long-term neurodevelopmental outcomes. The essential micronutrient zinc is crucial for infant growth and brain development, but the optimal zinc intake for preterm infants is unknown and current fortification strategies may be insufficient. Accurate assessment of nutritional status in preterm infants is facilitated by distinguishing lean mass—which reflects organ growth and maturation—from fat. The goal of this proposal is to determine the association between zinc intake in the NICU and lean mass accrual (as a marker of nutritional status) and to evaluate the clinical impact of variabilities in zinc intake on concurrent brain development and later neurodevelopmental outcomes. The hypothesis that greater zinc intake results in greater lean mass accrual, improved brain growth and maturation, and improved neurodevelopment will be tested through 3 specific aims: 1) Determine the association of zinc intake in the NICU with lean mass at term equivalent age. 2) Determine the association between zinc intake in the NICU and brain growth and maturation. 3) Determine the impact of neonatal zinc intake on neurodevelopmental outcomes at 2 years. This research is significant for the field of neonatal nutrition, as knowledge gained from this study will help determine optimal zinc intake for preterm infants and inform the design of nutritional strategies to ensure adequate micronutrient provision to all preterm infants. Dr. Bell’s mentoring team—Dr. Belfort (primary mentor) and Dr. Duggan (co-mentor)—provide complementary expertise in preterm infant nutrition and micronutrient requirements in children, respectively. Dr. Bell will also receive mentorship from distinguished scientists with expertise in key areas related to this work, including micronutrient biochemistry, breastmilk composition, neurodevelopmental assessment in childhood, and the developmental origins of disease. The training opportunities and resources at Brigham and Women’s Hospital, Tufts Friedman School of Nutrition Science, and Harvard Medical School are an ideal environment for the candidate’s career development. The candidate’s institution is strongly committed to her success. Dr. Bell’s detailed career development plan includes mentored research, didactic coursework including a formal degree in nutrition science, seminars, and presentations at scientific meetings. She presents a timeline for completion of the research aims and preparation of a future R01 application. The knowledge and training gained from this K23 award will enable Dr. Bell to develop the skills and expertise required to launch an independent research career focused on designing micronutrient interventions to optimize growth and long-term health outcomes for preterm infants.