META-HEALTH I

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。在过去的十年中，美国人口中所有年龄组的肥胖症都呈爆炸性增长。这种流行病在东南部的非洲裔美国人中尤其成问题。虽然遗传因素发挥了贡献的作用，它是假设，种族差异的肥胖和肥胖相关的心血管疾病（CVD）是有关的生物因素和行为之间的动态相互作用，以独特的环境背景下，在种族社区。肥胖通常与代谢和生理环境的紊乱有关。一组与肥胖相关的异常被定义为代谢综合征。肥胖的心血管并发症似乎与脂肪组织自身产生脂肪因子的能力有关，脂肪因子直接导致胰岛素抵抗、内皮功能障碍、炎症和血管疾病。拟议的计划将使用国家的最先进的方法来定义潜在的种族差异的代谢，生理和生化特征与肥胖以及有益的反应，改变生活方式。该计划采用多学科策略，通过借鉴心理学，生理学，生物化学，护理和临床医学领域，系统地表征肥胖相关CVD的潜在种族差异。在一系列相互关联的主题研究中，我们计划的研究计划范围从：民族社区内的流行病学研究，到民族社区实践中以患者为中心的临床试验干预，到人类病理生物学的新型生物标志物的分析。这个合作的多研究者团队是建立在医学院和埃默里大学莫尔豪斯之间的互补伙伴关系。这种伙伴关系共同致力于解决我们所服务的高风险CVD人群中惊人的种族差异。具体目标是：目标1：在一个基于人群的双种族队列中，将心理社会/文化因素和生物介质的相对影响定义为肥胖和代谢综合征种族差异的决定因素。目标二：定义以患者为目标的行为干预措施的有效性，以提高非裔美国人代谢综合征患者在社区为基础的临床实践的背景下的健康。目标3：评估创新的生活方式干预策略对非裔美国人血管疾病风险的传统和新型生物标志物的影响。目标4：加强从事心血管疾病差异研究/实践的研究员/从业人员的教育/培训，并促进伙伴关系，提高族裔社区内的心血管健康。

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. Over the past decade, there has been an explosive increase in obesity among all age groups within the US population. This epidemic is particularly problematic among AfricanAmericans in the Southeast. Although genetic factors play a contributory role, it is postulated that ethnic disparities in obesity and obesity-related cardiovascular disease (CVD) is related to a dynamic interplay between biological factors and the behavioral response to the unique environmental context within ethnic communities. Obesity is often associated with perturbations in the metabolic and physiologic milieu. A cluster of obesity-related abnormalities has been defined as the ¿Metabolic Syndrome¿. The CVD complications of obesity appears to be related to the capacity for adipose tissue itself to generate ¿adipokines¿ that directly predispose to insulin-resistance, endothelial dysfunction, inflammation and vascular disease. The proposed program will use state-of-the-art approaches to define potential ethnic differences in the profile of metabolic, physiologic and biochemical features associated with obesity as well as the salutary responses to lifestyle modification. The proposed program uses a multi-disciplinary strategy to systematically characterize potential ethnic differences in obesity-related CVD by drawing upon the fields of psychology, physiology, biochemistry, nursing and clinical medicine. In a thematic series of inter-related studies, our Program¿s research plan ranges from: epidemiology studies within the ethnic communities, to patient-centered clinical trial interventions within ethnic community practices, to the analysis of novel biomarkers of human pathobiology. This collaborative multi-investigator team is built upon a complementary partnership between the Morehouse School of Medicine and Emory University. This partnership shares a joint commitment to address the striking ethnic disparities in the high-risk CVD population that we serve. The specific aims are: Aim 1: Define the relative influence of psychosocial/cultural factors and biological mediators as determinants of ethnic disparities in obesity and the metabolic syndrome in a population-based bi-racial cohort. Aim 2: Define the effectiveness of patient-targeted behavioral interventions to enhance the health of African-American patients with the Metabolic Syndrome in the context of community-based clinical practices. Aim 3: To assess the impact of innovative lifestyle intervention strategies on conventional and novel biomarkers of vascular disease risk in African-Americans. Aim 4: To enhance the education/training of fellows/practitioners engaged in CVD disparities research/practice and promote partnerships that enhance cardiovascular health within ethnic communities.