# Project 3 Yoshida

> **NIH NIH P20** · TULANE UNIVERSITY OF LOUISIANA · 2024 · $340,261

## Abstract

The overall goal of this proposal is to provide Dr. Yilin Yoshida, a project leader of the Tulane COBRE in Sex-
Based Precision Medicine (SPM), with indispensable training to develop expertise in precision epidemiology,
improve understanding of the sex disparities of diabetic cardiovascular disease (CVD) with a life-course
perspective, and optimize diabetic cardiovascular risk prediction. Women’s excessive CVD risk in type 2 diabetes
(T2D) relative to men is poorly understood. Potential mechanisms for this “female disadvantage” have been
primarily tested in middle-aged cohorts without adequately accounting for the cumulative burden of early-onset
T2D. In the past three decades, the greatest relative increases in T2D incidence and prevalence were observed
in young adults and adolescents triggered by escalating obesity rates. Notably, early-onset T2D exhibits a female
predominance in incidence and a more aggressive prognosis than late-onset T2D. A higher lifetime exposure to
risk factor clustering in women compared to men with early-onset T2D, compounded by the aggressive disease
course, may accelerate CVD risk in women in midlife. T2D is a heterogeneous disease with variable disease
progression, which is illustrated by the sex disparity in the risk of diabetic CVD. Emerging machine learning-
based research has sought to classify T2D patients to improve the prediction of complications but has not
incorporated sex-specific pathophysiological characteristics. This knowledge gap is concerning, as evidence
demonstrates that sex-specific mechanisms, partly driven by sex hormones, are instrumental in atherosclerosis,
adiposity, inflammation, and endothelial dysfunction, underscoring sex-based differences in diabetic CVD.
Women with T2D also face greater metabolic and reproductive challenges than men across the lifespan, which
is implicated in women’s higher CVD risk. The phenotypic heterogeneities in T2D and CVD between men and
women warrant the consideration of sex in predicting CVD risk. In this study, the candidate proposes to
investigate the role of female sex in the deleterious influence of early-onset T2D on CVD using two intensively
phenotyped longitudinal cohorts. The Specific Aims are to 1) quantify the cumulative burden of T2D on CVD risk
in women compared to men and 2) identify sex-specific subgroups of individuals with T2D at high CVD risk. The
candidate has generated impactful preliminary findings for this proposal through support from her two-year K12
award. The candidate has identified critical next steps in this line of research and training areas to complement
her experience, including the pathophysiology of CVD and T2D, machine learning, health disparities research,
and sophisticated epidemiological methods for bias reduction. The candidate has successfully leveraged a
carefully coordinated set of resources, including a strong mentor team and applied learning activities closely
aligned with her training objectives and Specific Aims. Thi...

## Key facts

- **NIH application ID:** 10770674
- **Project number:** 1P20GM152305-01
- **Recipient organization:** TULANE UNIVERSITY OF LOUISIANA
- **Principal Investigator:** Yilin X Yoshida
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $340,261
- **Award type:** 1
- **Project period:** 2024-02-01 → 2028-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10770674

## Citation

> US National Institutes of Health, RePORTER application 10770674, Project 3 Yoshida (1P20GM152305-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10770674. Licensed CC0.

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