DESCRIPTION (provided by applicant): Wanda K. Nicholson, MD, MPH is seeking this K23 award to study the role of inflammatory markers as predictors of gestational diabetes mellitus (GDM) and incident Type 2 diabetes mellitus (Type 2 DM), to complete advanced training in the conduct of longitudinal studies, and to transition to an independent career in clinical research. Dr. Nicholson is an Assistant Professor in the Department of Gynecology and Obstetrics at Johns Hopkins and has fellowship training in clinical research and an early track record of peer reviewed clinical research. Parity has been previously linked to Type 2 DM; however, the underlying mechanism for this association is unclear. Recently, markers of inflammation (e.g. C-reactive protein) have emerged as independent predictors of Type 2 DM. No studies have examined whether the association of parity with Type 2 DM is mediated by the presence of inflammation. Moreover, it is unclear whether inflammatory markers are also predictors of GDM. She proposes to determine the effect of parity and inflammatory markers on prevalent and incident cases of Type 2 DM through cross-sectional and case-cohort analyses of the NHANES III and ARIC data, respectively. In addition, a prospective case-cohort study will assess inflammatory markers as risk predictors of GDM. This proposal will provide an in-depth examination of the role of parity and inflammatory markers in the pathogenesis of GDM and Type 2 DM. During this award, Dr. Nicholson will gain new skills and knowledge in the research methods for prospective study design, multivariate assessment of risk factors and longitudinal data analysis. The combination of observational research, primary data collection and advanced educational training will provide the basis for further prospective studies integrating the relation of parity and inflammation to GDM and Type 2 DM. This award will give Dr. Nicholson the dedicated time and experience she needs to develop into an independent clinical investigator