Obesity Clinical Trial
Official title:
Contribution of Diabetes and Its Causes to Signs of Brain Aging in a Young-to-Middle Age Cohort
Background:
- The Coronary Artery Risk Development in Young Adults (CARDIA) study is an investigation of
cardiovascular risk factors among African-American and white young adults between 18 and 30
years of age, first recruited in 1985 86 from Birmingham, AL; Chicago, IL; Minneapolis, MN;
and Oakland, CA. The study has examined a wide variety of risk factors, including insulin
resistance, obesity, and diabetes. Based on 20 years of followup, the data provide evidence
of an increase in the prevalence of many cardiovascular risk factors, as well as other
factors that may lead to brain disease. To further evaluate these changes, the CARDIA Year 25
Exam will include a brain imaging component to study brain structure and function in a subset
of CARDIA participants.
Objectives:
- To conduct brain magnetic resonance imaging as part of a 25-year followup study on
participants in the original CARDIA study of heart disease risk factors in young adults.
Eligibility:
- Existing CARDIA study participants in the Minneapolis, MN, and Oakland, CA regions.
Design:
- Participants will be screened with a full medical history and physical examination. -
Participants will have an MRI scan at the 25-year followup examination for the CARDIA
study.
- No additional testing or treatment will be required for this protocol.
The Coronary Artery Risk Development in Young Adults (CARDIA) Study is a prospective,
epidemiologic investigation of the determinants and evolution of cardiovascular risk factors
among 5,115 African American and white young to middle age adults 18-30 years of age at
baseline in 1985-86. Participants were recruited from the populations of four geographic
locations (Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA). The study
population was approximately balanced according to sex (54% women), ethnicity (52% African
American), and education (40% with less than equal to 12 years of education) at each center
(Friedman). After the 1984 baseline, additional examinations were undertaken at years 2
(1987-88), 5 (1990-91), 7 (1992-93), 10 (1995-96), 15 (2000-01) and 20 (2005-06). To date,
72% of the total baseline cohort is still active in the study.
Based on 20 years of follow-up, the longitudinal data on this cohort provide clear evidence
of an increase in the prevalence of many cardiovascular risk factors, including obesity and
diabetes. Therefore, the study presents an ideal and unique opportunity to study change in
cardiovascular risk factors beginning at an age we hypothesize may be critical in determining
future trajectories of brain disease. Furthermore, the trends in CV-RF reflect general trends
in the US population. Thus, CARDIA participants are ideal to study now because the cohort
reflects the characteristics of the next generation of older persons.
This is an ancillary study of MRI-evident neurodegenerative and vascular brain changes in a
subset of 719 CARDIA participants who participate in the Year 25 Exam. Specifically, we will
study the relations of timing length of exposure and levels of cardiovascular risk factors to
presence of sub-clinical brain lesions and cognitive impairments. Participants were recruited
from the CARDIA field sites at Birmingham, AL (PI: Cora E. Lewis, MD, MSPH- University of
Lalbama, Nirmingham), Minneapolis, MN (PI: Pamela Schreiner, PhD, MS- University of
Minnesota) and Oakland, CA (PI: Steve Sidney, MD, mPH- Kaiser Permanente).
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