Biopsychosocial Determinants of Adolescent Obesity/Cardiovascular Risk

描述（由申请人提供）：美国青少年肥胖症的患病率很高，和 在拉美虽然食物和物理环境的剧烈环境变化是 随着风险的增加，对个人、家庭和社会的了解仍然不足， 和社区层面的因素，防止肥胖的发展。进一步的研究 需要了解导致低收入人群肥胖风险不同的机制， 西班牙裔/拉丁裔青年。拟议的5年项目旨在阐明相互关联的生物和 与青少年肥胖和以后发展为2型糖尿病风险相关的社会途径 和心血管疾病。这项申请涉及大约620名智利青少年， 在婴儿期、3至5岁和10岁时进行评估，作为NIH支持的队列研究的一部分， 预防婴儿期缺铁性贫血的行为和发育影响（n = 1645）。作为 已经收集了与成长、健康和发展有关的详细纵向数据。在16 到17岁，青少年将参与使用活动记录仪研究活动，睡眠和饮食模式 饮食行为的记录和实验室评估。此外，我们将测量人体测量， 脂肪和肌肉质量（DXA），空腹血糖，胰岛素（HOMA IR），脂质，瘦素，生长素释放肽，脂联素， 食欲素CRP和TNF α有关家族史、吸烟、健康和 还将收集心理社会功能。邻里水平的因素，如犯罪，步行能力 将评估用于体力活动和健康食品属性的资源。而且有 在多个时间点进行睡眠神经生理学和活动记录的相当大的子集（n = 237） 将在16岁时参加2晚多导睡眠研究。 在生命过程方法的指导下，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的生物和心理社会决定因素 从婴儿早期就开始跟踪的青少年队列中的干扰。 具体目标2-评估肥胖/肥胖症与肥胖相关的生物标志物之间的关联 智利青少年的代谢紊乱。 具体目标3-评估身体活动、睡眠和饮食行为的昼夜节律模式的作用 肥胖症和相关代谢紊乱。 美国营养与技术研究所（Institute for Nutrition and Technology at the 智利大学和密歇根大学人类成长与发展中心 提供了一个优秀的环境，研究生物和心理社会的决定因素，青少年 肥胖在低收入到中等收入的拉丁美洲青年队列中， 美国年轻人比较我们希望能进一步了解饮食的发展模式 和活动受到早期生活因素的影响，反过来又影响肥胖的发展， 相关代谢紊乱。我们的研究在纵向心理社会学的深度和广度上是独一无二的。 和生物数据。我们提出的研究跨越学科界限，并有可能 揭示青少年肥胖的重要决定因素，为今后的干预研究提供依据。

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.