WEIGHT LOSS IN OVERWEIGHT PATIENTS WITH CORONARY HEART DISEASE + TYPEII DIABETES

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。美国目前正在经历肥胖症和II型糖尿病的流行。超过一半的总人口被归类为超重。由于超重与许多心脏风险因素有关，如高胆固醇、高血压和糖尿病，超重的人比正常体重的人更容易患上冠心病(CHD)。事实上，最近确诊的CHD患者中有75%-88%超重，其中超过20%的人患有II型糖尿病。针对冠心病患者的心脏康复运动计划在帮助人们单独通过运动减肥方面并不是非常有效。我们建议研究以下两个方面的有效性：1.基于行为的减肥计划，其特征是每天的卡路里摄取目标和实现饮食目标的大量行为和社会支持；2.帮助减肥干预的锻炼计划。该锻炼计划的特点是几乎每天都在心脏康复/GCRC运动测试和训练设施进行锻炼，同时进行居家步行。结果将包括通过CT扫描的体重、脂肪质量和腹部脂肪，血脂、C反应蛋白的测量，凝血、血管扩张能力、葡萄糖耐量的测量，超声心动图心脏功能和腹部脂肪活检。Pratley博士的实验室将分析脂肪组织中瘦素、脂联素、白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)、巨噬细胞趋化蛋白(MCP)、巨噬细胞抑制蛋白(MIP)和纤溶酶原激活物抑制物-1(PAI-1)的基因表达水平；所有这些都与脂肪组织、炎症和血栓形成有关。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The United States is currently experiencing an epidemic of obesity and type II diabetes. Over half of the general population is classified as overweight. In that being overweight is associated with a number of cardiac risk factors such as high cholesterol, high blood pressure and diabetes, overweight people are much more likely to develop coronary heart disease (CHD) than average-weight people. In fact 75-88% of people with recently diagnosed CHD are overweight and over 20% of these individuals have Type II diabetes. Cardiac Rehabilitation exercise programs for people with CHD have not been very effective in helping people lose weight through exercise-alone. We propose to study the effectiveness of: 1. A behaviorally-based weight loss program characterized by a daily calorie-intake goal and substantial behavioral and social support to attain dietary goals, and 2. An exercise program to assist with the weight loss intervention. The exercise program is characterized by almost daily exercise at the Cardiac Rehabilitation/ GCRC Exercise Testing and Training facility along with home-based walking. Outcome measures will include, body weight, fat mass and abdominal fat by CT scanning, measures of blood lipids, C-reactive protein, measures of clotting, vasodilatory capacity, glucose tolerance, echocardiographic cardiac function and an abdominal fat biopsy. Adipose tissue will be analyzed in Dr. Pratley's laboratory for gene expression levels of leptin, adiponectin, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha ), macrophage chemotactic protein (MCP), macrophage inhibitory protein (MIP) and plasminogen activator-inhibitor-1 (PAI-1); all associated with adipose tissue, inflammation and thrombosis.