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.

美国约有25％的人口患有代谢综合征，这是一群心血管疾病 （CVD）风险因素，包括腹部肥胖，葡萄糖不耐症，血压升高和 低收入群体的血脂异常，这种患病率甚至更高。这种综合征的存在 将糖尿病的风险增加3倍，而CVD的风险约为2倍。自肥胖，久坐的生活和 据信，动脉粥样硬化饮食在代谢综合征，生活方式的发展中起着重要作用 尽管长期很少，但修改被认为是治疗的主要方法 研究此类程序的功效。该项目将比较1年结构化的影响 112名患者（80个完成者）的生活方式干预计划（增强护理[EC]）与代谢 综合症参加内城家庭医学诊所，与匹配的群体接受标准生活方式 在一项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 修改行为​​并提高应对能力，可以预测参与者将减轻7％的体重 将体育活动提高至少150分钟的步行式运动。 EC协议将 由每周4个，然后由4个每两周的小组会议组成，组成了前3个核心课程 几个月，然后进行9个每月维护小组会议，并将通过经验丰富的生活方式进行 具有低收入人士以及受试者的行为修改方面专业知识的经理 少数族裔群体。代谢综合征成分，体重，体育锻炼，健康评估 生活质量，社会心理状况，葡萄糖，胰岛素和脂质和脂蛋白水平，炎症标志物， 将进行凝结，氧化应激和内皮功能障碍以及亚临床CVD措施 在基线，6个和12个月时，预计EC干预将改善CVD风险因素 并降低代谢综合征的患病率和强度和病理生理因素 开车。这项研究旨在证明一个结构化的计划是针对体重减轻和 增加体育锻炼可以成功应用于代谢综合征的低收入患者。 通过减轻有效的体重和 预计伴侣活性会降低长期以来糖尿病和心血管疾病的速度 学期。