Epidemiologic studies of maternal and early life metabolic risk

National Institute Of Diabetes And Digestive And Kidney Diseases

Investigators

Linked publications, trials & patents

Abstract

Prior research conducted at NIDDK, Phoenix, have shown that approximately 50% of Pima Indian children from diabetic pregnancies develop T2D by 25 years of age (Pettitt DJ, et al. NEJM, 1983). Since intrauterine exposure to diabetes leads to a higher risk of diabetes in the offspring, the risk might be greatly diminished by preventing diabetes during pregnancy or ameliorating its effects. Standard prenatal and obstetrical care has not been able to abolish this excess risk in the Pima Indians, which has remained unchanged from the 1940s to the early 1990s (Lindsay RS, et al. Diabetes 2000). The ETCHED study, supported by the NIDDK Division of Intramural Research Program, plans to recruit approximately 150 pregnant mothers per year for 5-years (750 maternal/child dyads) and follow them through pregnancy, childbirth, and until the offsprings 18th birthday. The study is approved by the NIH IRB and registered at https://clinicaltrials.gov/ct2/show/NCT03481829. We are ready to begin enrollment at Valleywise Health Medical Center, the largest public health system in Maricopa County, AZ pending a study initiation visit and approval. The planned total duration of the study is 23-years. In the past year, our ETCHED study team has continued with preparation for this complex and long-term study. This included staff recruitment and training, staff credentialing, preparation of standard operating procedures for collection, processing, and storage of various biospecimens, development of data forms, and setting up of a comprehensive electronic database for data storage and data mapping. It also included establishment of a new NIDDK research clinic at the Valleywise Health campus and obtaining various regulatory approvals. In addition, we continue to set up several collaborations to examine novel areas of scientific research leveraging the ETCHED study. In collaboration with the University of Colorado, we propose to study associations between the activity of key placental signaling pathways and nutrient transporters with cardiometabolic outcomes in children. We also plan to explore the power of placental omics to predict cardiometabolic outcomes in children. In collaboration with Joslin Diabetes Center, Boston, MA, we plan to perform shotgun metagenomic analysis of both maternal and infant stools and changes in gut microbial diversity with breastfeeding and infant dietary changes in this unique population. In collaboration with University of Colorado, we plan to explore the metabolic composition of breast milk changes during the period of lactation. Recent studies have shown changes in breast milk metabolomics in mothers with gestational diabetes, but few studies have examined these changes in our study population.