EXERCISE AND ENERGY/SUBSTRATE UTIL IN BLACKS WITH NIDDM

非洲裔美国人(AA)的2型患病率高出2-3倍 糖尿病(DM)、更高的疾病相关发病率和 死亡率和发病年龄早于高加索美国人(CA)。这个 这些差异的病因尚不清楚，但与 胰岛素抵抗和肥胖率增加。因此， 关于代谢和能量方面的种族差异的调查 2型糖尿病在再生障碍性贫血中的发病率将提供关于 再生障碍性贫血人群中肥胖和2型糖尿病的患病率 与CA相比。这项研究的目的包括：1)审查种族 底物利用率、能量消耗、胰岛素的差异 治疗前和治疗前的敏感性、血糖有效性和β细胞功能 在患有2型糖尿病的AA和CA受试者的慢性运动后，2)到 确定慢性运动对静息代谢率的影响 CA和AA的RMR、餐后产热和底物氧化 2型糖尿病受试者，3)比较抵抗和 基质氧化和能量消耗的有氧训练和4) 以确定运动的顺序模式是否与 CA和DAA受试者的不同代谢和能量后果 2型糖尿病。拟议的研究是一项前瞻性的工作。 2型糖尿病AA和CA患者的干预方案。这项研究 人群将包括75名AA和75名患有2型DM的CA受试者。这个 参加学习的时间框架为26周。在学习的第一天， 每个受试者都将接受实验室数据的筛选，评估 D-3H葡萄糖输注及合并糖耐量低减时的葡萄糖周转率 和间接量热法。在第二天的学习中，每个科目都会有一门双科课程。 能量X射线吸收法(DEXA)扫描和磁共振成像 (MRI)扫描以评估身体成分和身体脂肪分布。 在研究的第三天，胰岛素敏感性、葡萄糖有效性和β细胞 功能将使用伯格曼最小模型方法进行评估。 然后，受试者将被随机分配开始为期8周的 有氧或耐力训练，与其他运动交叉进行 额外8周的培训计划。每种新陈代谢和 人体测量研究将进行四次；进入 学习，在完成每个锻炼计划后，8周 在运动干预后。这项研究将为 再生障碍性贫血与2型糖尿病相关的代谢异常 运动干预在AA和CA人群中的重要性。这个 本研究的结果可能是开出一种 再生障碍性贫血合并2型糖尿病患者的有效运动方式 糖尿病。我相信我过去的经历已经为我的职业生涯做好了准备 学术研究作为独立的调查者。建议的K08 格兰特将帮助我实现这些目标，并成为有竞争力的人 用于公共卫生服务和其他国家资金。这个项目是 我参与的先前研究的连续体，同时 研究对葡萄糖代谢知之甚少的领域， 运动对葡萄糖代谢影响的种族差异。

African Americans (AA) have a 2-3 fold higher prevalence of type 2 diabetes mellitus (DM), greater disease-associated morbidity and mortality and earlier age of onset than Caucasian Americans (CA). The etiology for these differences is unclear but has been related to insulin resistance and an increased prevalence of obesity. Thus, investigations into racial differences in metabolic and energy aspects of type 2 DM in AA will provide important data on the increased prevalence of both obesity and type 2 DM in the AA population when compared to CA. The aims of the study include: 1) To examine racial differences in substrate utilization, energy expenditure, insulin sensitivity, glucose effectiveness and beta cell function before and after chronic exercise in AA and CA subjects with type 2 DM, 2) To determine the effects of chronic excercise on the resting metabolic rate (RMR), postprandial thermogenesis and substrate oxidation in CA and AA subjects with type 2 DM, 3) To compare the effects of resistance vs. Aerobic training on substrate oxidation and energy expenditure and 4) to determine whether the sequential pattern of exercise is associated with different metabolic and energy consequences in CA an dAA subjects with type 2 DM. The proposed study is a prospective exercise intervention program in AA and CA subjects with type 2 DM. The study population will consist of 75 AA and 75 CA subjects with type 2 DM. The time frame for study participation will be 26 weeks. On study day 1, each subject will undergo screening laboratory data, assessment of glucose turnover rates with D-3 3H glucose infusion and concomitant IGTT and indirect calorimetry. On study day 2, each subject will have a dual energy x-ray absorptiometry (DEXA) scan and a magnetic resonance imaging (MRI) scan for assessment of body composition and body fat distribution. On study day 3, insulin sensitivity, glucose effectiveness and beta-cell function will be assessed using the Bergman Minimal Model Methodology. The subjects will then be randomly allocated to begin either 8 weeks of aerobic or resistance training with a crossover to the other exercise training program for an additional 8 weeks. Each metabolic and anthropometric study will be prformed four times; upon entry to the study, after completion of each of the exercise programs, and 8 weeks after the exercise intervention. This study will provide insights into the metabolic abnormalities assoicated with type 2 DM in AA and the importance of exercise intervention in the AA and CA population. The findings of the present study could be the basis of prescribing an effective exercise modality in AA patients with type 2 diabetes mellitus. I believe my past experience has prepared me for a career in academic research as an independent investigator. The proposed K08 grant will help me to achieve these goals as wellas become competivitie for Public Health Service and other national funding. This project is a continuum of previous research in which I have been involved while it examines and area of glucose metabolism in which little is known, the racial differences in the effects of exercise on glucose metabolism.