PROJECT SUMMARY – Overall This renewal proposal seeks to continue the Georgia Cystic Fibrosis Research and Translation Core Center (the Georgia CF Core Center) at Emory University, Children's Healthcare of Atlanta, Augusta University, and the Georgia Institute of Technology. Funded with partial budget less than two years ago, the Center has rapidly ramped up activities during these pandemic times and already has had great impact on the CF research community in Georgia. Center research funded by this P30 grant focuses on non-pulmonary aspects of CF disease central to the NIDDK mission, including CF-related diabetes (CFRD), CF-related liver and bone disease, and the impact of CF on nutritional status and GI function. Unique to our Center is the study of the relationship between these co-morbidities and lifestyle/behavioral choices such as diet, exercise, and sleep. The Center's research is focused on and enabled by the ~900 patients followed at the participating institutions. The research base has grown to include 73 investigators, across basic and clinical departments at several institutions, with >$27M in direct costs for CF-related research in the current year. These investigators are addressing issues that are becoming ever more important to the health of people with CF, as successes with small-molecule therapeutics enable an “aging” CF population. On the opposite end of the spectrum are studies in toddlers and young children on the genesis of these co-morbidities which have the potential for defining early preventive interventions. We integrate data from multiple platforms spanning from basic science to clinical research informatics to enable longitudinal study of patients with the goal of identifying factors associated with disease progression and advancing our understanding of the CF therapeutic landscape. These clinical and research data are incorporated into the novel Georgia CF Data Warehouse. Aim 1: To provide a robust, well-coordinated environment for CF biomedical research. Aim 2: To facilitate and enable the expansion of the funded research in non-pulmonary complications of CF. Aim 3: To attract new investigators focused on non-pulmonary aspects of CF who will bring new expertise that will advance new perspectives on pathophysiology and treatment, and launch new collaborations. We will accomplish these aims by the coordinated activities of three biomedical research Cores: Diabetes, Endocrinology, & GI/Hepatology Core Nutrition, Lifestyle, & Behaviors Core Clinical Research & Informatics Core These research cores are supported by an Administrative Core which ensures the efficient use of resources and strengthens the intellectual environment for research through a robust Enrichment Program. The successful Pilot & Feasibility Program proposes two new projects; both prior projects already have received extramural support. Continued support of the Core Center will ensure a vigorous research enterprise focused on non-pulmonar...