2009 — 2011 |
Groth, Susan W |
K23Activity Code Description: To provide support for the career development of investigators who have made a commitment of focus their research endeavors on patient-oriented research. This mechanism provides support for a 3 year minimum up to 5 year period of supervised study and research for clinically trained professionals who have the potential to develop into productive, clinical investigators. |
Limiting the Phenotypic Effect of Pregnancy Related Weight Gain @ University of Rochester
DESCRIPTION (provided by applicant): The Candidate: Dr Groth is an Assistant Professor of Nursing and a nationally certified women's health nurse practitioner. Her long-term goal is to become an independent investigator in patient oriented research, with the expertise to implement gene-based exercise interventions to prevent obesity in high risk women. This program of research focuses on obesity in women, with an emphasis on the genetic effects on weight gain, especially in the vulnerable time of pregnancy and interventions to prevent and/or limit excessive pregnancy weight gain. The intermediate goals of this career development plan focus on education and research. The educational goal is to acquire skills central to test gene-environment interactions and the implementation of intervention studies in the context of an interdisciplinary team in preparation for a full scale R01. The research goal is to develop expertise as an independent investigator by implementing two projects to develop expertise as an independent involving (a) clarification of the gene-environment interaction of the GNB3 gene and (b) focus groups to elicit the attitudes and beliefs of African-American women about physical activity during pregnancy. The findings will provide a framework for the establishing a foundation for genetic-based behavioral intervention research. These goals are the direct result of the candidate's experiences as a women's health nurse practitioner coupled with training at the NINR summer genetics institute in 2006. Practice as a clinician providing health care to underserved and uninsured women since 1994 has extensively influenced my research goals. This proposed career development plan pulls together discrete areas of research that require very different skill sets. Therefore, an interdisciplinary team of mentors and consultants, with distinct areas of expertise, have been included in this career development team. Environment: The University of Rochester, School of Nursing, a part of the University of Rochester Medical Center, has a long history of nursing research. In 2006 the University of Rochester received a $40 million NIH award to establish a Clinical and Translational Science Institute (CTSI), which has increased support to researchers across the medical center and created an atmosphere conducive to collaborative and interdisciplinary teams for translational research from T1-T4. The candidate received funding from the CTSI for a KL2 scholar award in July 2008, which provides bridging funding for 1-2 years until individual funding can be attained. Given the supportive environment, the early stages of this career development plan recently began under the guidance of this team of experienced NIH funded, nationally recognized mentors, who provide an essential combination of expertise for the identified areas of development: expertise in research design including RCTs and focus groups, cultural competency and recruiting of vulnerable populations, genetics, and exercise in pregnancy. Research: Recent figures indicate three-quarters of all African-American women are overweight or obese. Obesity in African-American women is due, in part, to excessive pregnancy weight gain. Genetic susceptibility and individual behaviors likely interact and contribute to pregnancy weight gain, which then contributes to long- term obesity. Thus, prevention of excessive gestational weight gain would decrease morbidity and mortality in US African-American women. Little is known about gene-environment interactions that contribute to pregnancy weight gain. Seventy percent of the world-wide African-American population carries the GNB3 825T allele, which appears to be associated with increased gestational weight gain, postpartum weight retention, and low birth weight. It is postulated that African-American women who gain and retain excessive pregnancy weight and deliver smaller infants are carriers of the 825T allele--an effect that may be attenuated by physical activity. The overarching goal of this proposal is to establish the foundation to develop, test, and implement a physical activity intervention in high-risk African American women using the essential amount of physical activity, based on genotype, required to limit excessive weight gain/retention in pregnancy. To this end, the research plan has 3 aims: (a) examine the GNB3 825T allele gene-environment interaction during pregnancy;(b) determine the critical levels of physical activity essential to prevent excessive weight gain for women who carry the 825T allele;and (c) identify women's beliefs regarding physical activity during pregnancy and what physical activities African-American women would participate in while pregnant. To accomplish these goals two projects will be conducted: 1) Phase I study--a prospective candidate gene-association study examining the GNB3 825T allele and how it interacts with physical activity during pregnancy and 2) Phase II study--a qualitative, descriptive study that utilizes focus groups to elicit the attitudes and beliefs of African-American women regarding physical activity during pregnancy. The Phase I study, utilizing established interviews and questionnaires for dietary and physical activity measurement, pedometers, weight/height measurement, resting energy expenditure measures, and deoxyribonucleic acid (DNA) was approved by the University of Rochester Research Subjects Review Board. The protocol and procedures are in place and active recruitment has recently commenced. PUBLIC HEALTH RELEVANCE: Obesity in US women, especially African-American women is due, in part, to excessive pregnancy weight gain. Genetic susceptibility and individual behaviors likely interact and contribute to pregnancy weight gain, which then contributes to obesity. Prevention of excessive gestational weight gain would decrease morbidity and mortality in US African-American women.
|
1 |
2018 — 2021 |
Barrett, Emily S (co-PI) [⬀] Groth, Susan W O'connor, Thomas G (co-PI) [⬀] |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Longitudinal Changes in Weight and Biology in the Pregcy-Postpartum Period and Subsequent Cardiometabolic Risk @ University of Rochester
Pregnancy marks a period of extreme physiological change as the maternal immune, endocrine, and metabolic systems rapidly adapt to sustain the growing fetus. It is conventionally assumed that these pregnancy-induced changes (e.g., elevated lipids, insulin resistance, weight gain) reverse by 6-months postpartum. Yet, evidence suggests that for some women physiological changes persist and may confer long-term risk of chronic diseases such as cardiovascular disease (CVD). We have demonstrated, for example, that inflammatory markers that confer risk for CVD may stay elevated above pre-pregnancy levels beyond 6-months postpartum. Thus, characterizing weight and biological changes across pregnancy-postpartum, predicting the women at risk for adverse cardiometabolic profiles, and identifying modifiable factors that mitigate these profiles offer opportunities to create targeted interventions to prevent future chronic disease. To improve our understanding of the nature of biological changes in the pregnancy-postpartum period that may predict cardiometabolic risk, we propose a cost-efficient longitudinal study extending from the first trimester through 3 years postpartum that capitalizes on the infrastructure of an ongoing pregnancy cohort (R01 HD083369). The parent study, which focuses on maternal prenatal biology as it relates to child health outcomes, is currently recruiting a socioeconomically and racially diverse sample of 290 first trimester pregnant women. Blood, saliva, anthropometry, and psychosocial, lifestyle, and health data are collected across pregnancy in the parent study. We will leverage the existing infrastructure and data collected as part of the parent study and expand that existing framework by (1) assessing additional biomarkers from banked prenatal maternal samples and obtaining new maternal biological samples at 6, 12, and 36 months postpartum; (2) examining how maternal weight, immune, endocrine, and metabolic biomarkers from the first trimester through 12 months postpartum predict subsequent cardiometabolic risk in the mother, and (3) identifying modifiable maternal health behaviors that may mitigate adverse cardiometabolic health outcomes. Our over-arching premise is that the immune, endocrine, metabolic, and weight changes of pregnancy can be long-lasting and contribute to an adverse cardiometabolic profile that increases long-term chronic disease risk. The aims are to: (1) identify maternal weight profiles in the pregnancy-postpartum period that predict adverse cardiometabolic risk profiles three years postpartum; (2) describe immune, endocrine, and metabolic biomarker profiles in the pregnancy- postpartum period, and determine their associations with cardiometabolic risk; and (3) determine how modifiable health behaviors are associated with weight and biomarker changes in the postpartum period and predict cardiometabolic risk. The significance of this project is high given the increasing rates of obesity in pregnant women and the need for targeted, biologically and psychosocially informed treatments to prevent cardiometabolic disease in women.
|
1 |