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.

在美国，大约25%的人患有代谢综合征，这是一组心血管疾病 (CVD)危险因素包括腹部肥胖、葡萄糖耐受不良、血压升高和 血脂异常，这种患病率在低收入群体中甚至更高。这种综合症的出现 糖尿病风险增加3倍，CVD风险增加约2倍。由于肥胖，久坐不动的生活和 致动脉粥样硬化的饮食被认为在代谢综合征、生活方式、 修改被认为是其治疗的主要方法，尽管很少有长期的 研究这些方案的有效性。本项目将比较一个为期一年的，结构化的 在112例代谢性疾病患者（80例完成者）中实施生活方式干预计划（增强型护理[EC]）， 与接受标准生活方式的匹配组相比， 推荐（标准治疗[SC]）。通过构建生活方式计划， 改变行为并提高应对技能，预计参与者将减轻7%的体重， 每周至少增加150分钟的步行运动。EC方案将 包括4个每周一次，然后是4个双周一次的小组会议，构成了前3个月的核心课程。 个月，然后是9个月的维护小组会议，并将提供经验丰富的生活方式 管理人员在低收入人群中的行为矫正方面具有专业知识， 少数民族群体。评估代谢综合征组分、体重、体力活动、健康 生活质量、心理社会状态、葡萄糖、胰岛素和脂质及脂蛋白水平、炎症标志物， 将进行凝血、氧化应激和内皮功能障碍以及亚临床CVD测量 在基线、6个月和12个月时，因为预期EC干预将改善CVD风险因素 降低代谢综合征的患病率和严重程度， 这项研究的目的是证明，一个结构化的计划，针对减轻体重， 增加身体活动可以成功地应用于患有代谢综合征的低收入患者。 通过有效的减肥降低代谢综合征的频率和严重程度， 长期以来，增加身体活动有望降低糖尿病和心血管疾病的发病率。 term.