This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Similar to the U.S. population, cardivascular disease (CVD) is the leading cause of death for adults with mental retardation (MR). However, adults with Down syndrome (DS) possess significantly less atherosclerotic plaque and are less likely to die from CVD events than others with or without MR and subsequently have been labeled as 'atheroma free'. The previous reports that identifying adults with DS as possessing littleatherosclerotic plaque only included institutionalized middle-aged adults with DS who may be less likely to develop atherosclerotic plaque than older adults with DS. The life expectancy of adults with DS hs now increased to 65-70 years, increasing the risk for CVD. Additionally, more adults with DS are now residing in the community with less health behavior supervision, also leading to an increased risk for CVD. Investigating atherosclerotic plaque in adults with DS provides an opportunity to study a unique model of atherogenesis that deviates from typical disease progression.
The aims of the proposed research are to 1) determine whether community-based adults with DS possess a reduced level of atherosclerotic plaque compared to age-, gender-and raced-matched controls with and without MR and 2) to determine the relationship between atherosclerotic plaque and CVD risk factors in the unique DS population. Methods: The proposed study will measure atherosclerotic plaque (intima-media thickness via B-mode ultrasound) in the carotid arteries, fasting insulin, blood pressure, abdominal fat, lipid profiles, homocysteine, a marker of immflamation (C-reactive protein), and health behaviors in 100 adults with DS and age-, gender-, race-matched adults with and without MR (100ea.).Analyses of covariance will determine whether adults with Down syndrome continue to possess lower atherosclerotic burden than the comparison groups after adjusting for potential confounding factors between groups. Pearson's PM correlations will be used to determine which risk factors are most highly associated with AP. Objectives: By quantifying atherosclerotic plaque differences and identifying risk factor associations with atherosclerotic plaque (which differ in this unique DS pop.) future longitudinal interventions will focus on modifying identified protective risk factors and known health behaviors with the intent of reducing the progression of CVD in the unique DS and MR populations. Dr.Draheim and Mr. Williamson (project coordinator) will recruit and consent all participants along with conducting the questionnaire interviews, anthropometric measurements, and ultrasounds (located at the GCRC). The GCRC staff will do the DEXA scans, blood draws, and blood analyses.
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