Impact of Sleep Extension on Insulin Sensitivity and Dietary Intake in Adolescents

项目摘要 今天的青少年习惯性地获得远低于建议的每晚8-10小时的睡眠。不足 睡眠与肥胖、胰岛素抵抗和饮食变化的风险增加有关， 导致最近儿童肥胖和2型糖尿病（T2 D）的急剧增加。睡眠是一种 肥胖和T2 D预防的潜在新靶点。然而，目前尚不清楚干预措施是否 延长睡眠时间可以改善胰岛素敏感性和饮食摄入的昼夜节律， 了解肥胖和T2 D青少年的睡眠健康状况。有了这个职业发展 因此，我建议研究睡眠时间增加对胰岛素敏感性和饮食摄入的影响， 典型的睡眠时间短的青少年，并定性评估肥胖和T2 D青年的睡眠感知。 候选人和导师：我是科罗拉多大学的儿科助理教授， 科罗拉多儿童医院，我是一名临床睡眠心理学家，专注于预防糖尿病的研究 和糖尿病并发症。我完成了一项研究奖学金，重点是睡眠限制对 饮食摄入量，并获得试点资金，以检查睡眠和胰岛素敏感性的青少年肥胖。我 我与我的导师团队建立了牢固的关系，其中包括共同导师Kristen Nadeau博士 （儿科内分泌学，肥胖和糖尿病）和肯尼斯赖特博士（成人睡眠健康），谁将监督 建议的培训和研究。 研究和培训：我提出短期的科学、教育和培训目标，这些目标可以理想地实现。 获得了指导研究奖我将建立在我以前的研究与三个研究目标：检查 延长睡眠对1）胰岛素敏感性/分泌和2）饮食摄入的昼夜节律的影响 习惯性睡眠不足的青少年，3）确定关键的看法，障碍和促进因素， 在肥胖和T2 D青少年中获得充足的睡眠，以告知睡眠延长的改进 在这一高危人群中进行操纵。补充培训目标包括：1）IVGTT表现， 建模; 2）昼夜节律; 3）高级能量摄入/消耗评估;以及4）定性 方法论在获奖完成后，我将有能力成为一个成功的独立调查员，并将 寻求资金，以针对代谢疾病谱定制睡眠干预，旨在了解 青少年睡眠、昼夜节律和T2 D之间关系的机制。 睡眠是预防和治疗青少年肥胖和T2 D的新目标。我 总体职业目标是制定干预措施，以改善青少年的睡眠健康，具体目标是 预防与睡眠相关的内分泌和代谢功能障碍的进展，这些功能障碍是肥胖症的前兆 和T2 D。完成这个职业发展奖将支持我发展成为一个独立的 青少年睡眠和代谢研究的临床转化研究者和专家科学家。

PROJECT SUMMARY Today’s adolescents habitually obtain well below the recommended 8-10 hours of sleep per night. Insufficient sleep is associated with increased risk of obesity, insulin resistance, and dietary changes and may be contributing to the recent sharp increases in pediatric obesity and type 2 diabetes (T2D). Sleep is therefore a potential novel target for obesity and T2D prevention. However, it is yet unclear whether interventions to extend sleep duration can improve insulin sensitivity and circadian timing of dietary intake, and we lack understanding of sleep health perceptions of adolescents with obesity and T2D. With this career development award, I propose to examine the effect of increased sleep duration on insulin sensitivity and dietary intake in typically short-sleeping adolescents and qualitatively assess sleep perceptions in youth with obesity and T2D. Candidate and Mentors: I am an Assistant Professor of Pediatrics at the University of Colorado and Children’s Hospital Colorado where I am a clinical sleep psychologist focused on research to prevent diabetes and diabetes complications. I completed a research fellowship focused on the effect of sleep restriction on dietary intake, and obtained pilot funding to examine sleep and insulin sensitivity in adolescents with obesity. I have built strong relationships with my mentorship team, which includes co-mentors Dr. Kristen Nadeau (pediatric endocrinology, obesity and diabetes), and Dr. Kenneth Wright (adult sleep health), who will oversee the proposed training and research. Research and Training: I propose short-term scientific, educational, and training goals that can be ideally met with a mentored research award. I will build upon my prior research with three research aims: examine the effect of extending sleep on 1) insulin sensitivity/secretion and 2) circadian timing of dietary intake among adolescents with habitually insufficient sleep, and 3) identify key perceptions, barriers, and facilitators to obtaining sufficient sleep in adolescents with obesity and T2D, to inform the refinement of a sleep extension manipulation in this at-risk population. Complementary training aims include: 1) IVGTT performance and modelling; 2) circadian rhythms; 3) advanced energy intake/expenditure assessment; and 4) qualitative methodology. At award completion, I will have the skills to be a successful independent investigator and will pursue funding to tailor a sleep intervention across the spectrum of metabolic disease aimed at understanding mechanisms in the relationship between sleep, circadian rhythms, and T2D in adolescents. Summary: Sleep is a novel target in the prevention and treatment of obesity and T2D in adolescents. My overall career goal is to develop interventions to improve sleep health in adolescents with a specific goal of preventing progression of sleep-related endocrine and metabolic dysfunction as known precursors to obesity and T2D. Completion of this career development award will support my development into an independent clinical translational investigator and expert scientist in adolescent sleep and metabolism research.