Biobehavioral Bases & Management of Metabolic Syndrome

生物行为基础

• 批准号: 7248203
• 负责人: Ronald B Goldberg
• 金额: $ 52.73万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-06-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7248203
• 关键词: Atherogenic Diet; Automobile Driving; Behavior; Behavior Therapy; Behavioral; Biochemical; Blood Pressure; Blood Vessels; Body Weight decreased; Cardiac; Cardiovascular Diseases; Cardiovascular system; Caring; Central obesity; Clinic; Clinical; Clinical Markers; Coagulation Process; Community Health; Community Health Centers; Coping Skills; Coronary heart disease; Development; Diabetes Mellitus; Disadvantaged; Disease; Dyslipidemias; Education; Educational Curriculum; Epidemic; Ethnic group; Exercise; Family Practice; Fasting; Frequencies; Functional disorder; Glucose; Glucose Intolerance; Goals; Health; High Density Lipoprotein Cholesterol; Hispanics; Hyperlipidemia; Individual; Inflammation; Inflammatory; Insulin; Insulin Resistance; Intervention; Latino; Life; Life Style; Lipids; Lipoproteins; Longitudinal Studies; Low income; Maintenance; Matched Group; Measurement; Measures; Metabolic; Metabolic syndrome; Minority Groups; Modification; Morphology; Non-Insulin-Dependent Diabetes Mellitus; Numbers; Obesity; Outcome; Outcome Measure; Oxidative Stress; Participant; Pathogenesis; Patients; Phase; Phase II Clinical Trials; Physical activity; Play; Population; Prevalence; Process; Professional counselor; Protocols documentation; Psychosocial Assessment and Care; Quality of life; Randomized; Randomized Clinical Trials; Rate; Recommendation; Risk; Risk Factors; Role; Running; Severities; Social Environment; Societies; Standards of Weights and Measures; Structure; Syndrome; Thinking; Triglycerides; Visit; Walking; Week; Weight; Weight Gain; Work; base; biobehavior; cardiovascular disorder risk; data management; diabetes risk; dietary restriction; eligible participant; experience; glycemic control; heart disease risk; improved; inner city; insulin sensitivity; intervention program; lifestyle intervention; member; minority subjects; multidisciplinary; preclinical study; programs; psychosocial; sedentary; socioeconomics; stress management; waist circumference

About 25% of the population in the US have the metabolic syndrome, a cluster of cardiovascular disease (CVD) risk factors including abdominal obesity, glucose intolerance, elevated blood pressure and dyslipidemia, and this prevalence is even higher in low income groups. The presence of this syndrome increases risk for diabetes by 3-fold and for CVD approximately two-fold. Since obesity, sedentary living and an atherogenic diet are believed to play major roles in the development of the metabolic syndrome, lifestyle modification is considered to be the primary approach to its treatment, although there have been few longterm studies of the efficacy of such programs. This project will compare the effects of a 1-year, structured lifestyle intervention program (Enhanced Care [EC]) in 112 patients (80 completers) with the metabolic syndrome attending an inner city family medicine clinic to that of a matched group receiving standard lifestyle recommendations (Standard Care [SC]) in a randomized clinical trial. By structuring the lifestyle program to modify behavior and improve coping skills, it is predicted that participants will reduce weight by 7% and increase physical activity by at least 150 minutes per week of walking-style exercise. The EC protocol will consist of 4 weekly followed by 4 bi-weekly group sessions making up the Core Curriculum during the first 3 months, followed by 9 monthly Maintenance group sessions, and will be delivered by experienced lifestyle managers with expertise in behavior modification among low-income people as well as in subjects from minority ethnic groups. Assessments of metabolic syndrome components, weight, physical activity, health quality of life, psychosocial status, glucose, insulin and lipid and lipoprotein levels, markers of inflammation, coagulation, oxidative stress and endothelial dysfunction, and subclinical CVD measures, will be undertaken at baseline, 6, and 12 months, since it is anticipated that the EC intervention will improve CVD risk factors and reduce the prevalence and intensity of the metabolic syndrome and the pathophysiological factors driving it. This study is intended to demonstrate that a structured program directed at weight reduction and increasing physical activity can be successfully applied to low income patients with the metabolic syndrome. Reducing the frequency and the severity of the metabolic syndrome through effective weight reduction and increased phsycial activity is expected to lower the rate of diabetes and cardiovascular disease in the long term.

美国约25%的人口患有代谢综合征，这是一系列心血管疾病 (心血管疾病)危险因素包括腹型肥胖、糖耐量低减、高血压和 血脂异常，这种患病率在低收入人群中甚至更高。这种综合征的存在 患糖尿病的风险增加3倍，患心血管疾病的风险增加近2倍。由于肥胖、久坐不动的生活和 导致动脉粥样硬化的饮食被认为在代谢综合征、生活方式的发展中起着重要作用。 改良被认为是治疗它的主要方法，尽管几乎没有长期的治疗方法。 对这类项目的有效性的研究。该项目将比较为期1年、结构化的 生活方式干预计划(加强护理[EC])对112名代谢紊乱患者(80名完成者)的干预 在市中心家庭医学诊所就诊的综合征与接受标准生活方式的匹配组的症状 随机临床试验中的建议(标准护理[SC])。通过构建生活方式计划来 改变行为，提高应对技能，预计参与者体重将减轻7%和 每周至少增加150分钟的步行式锻炼，增加体力活动。欧共体议定书将 包括每周4次，然后是前3周的4次双周小组会议，构成核心课程 几个月，然后每月举行9次维护小组会议，并将由经验丰富的生活方式提供 具有在低收入人群中的行为矫正方面的专长的经理，以及在 少数民族。代谢综合征成分、体重、体力活动、健康的评估 生活质量，心理社会状况，血糖，胰岛素，血脂和脂蛋白水平，炎症标志物， 将采取凝血、氧化应激和内皮功能障碍以及亚临床心血管疾病措施。 在基线、6个月和12个月，因为预计欧盟的干预将改善心血管疾病的风险因素 减少代谢综合征和病理生理因素的患病率和强度 开着它。这项研究旨在证明，旨在减轻体重和 增加体力活动可以成功地应用于患有代谢综合征的低收入患者。 通过有效的减肥和减少代谢综合征的频率和严重程度 从长远来看，增加体育活动有望降低糖尿病和心血管疾病的发病率 学期。