CRP AND ADIPONECTIN AS MARKERS FOR INSULIN RESISTANCE

CRP 和脂联素作为胰岛素抵抗的标志物

• 批准号: 7609636
• 负责人: Yuan-Xiang Meng
• 金额: $ 14.35万
• 依托单位: MOREHOUSE SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-01 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7609636
• 关键词: African American; Ambulatory Care; American; Area; Biological Assay; Biological Markers; C-reactive protein; Cells; Clinical; Clinical Research; Computer Retrieval of Information on Scientific Projects Database; Daily; Diabetes Mellitus; Diagnosis; Disease; Early identification; Epidemiologic Studies; Ethnic group; Funding; Goals; Grant; Hypertension; Image Analysis; Individual; Inflammation; Inflammatory; Institution; Insulin; Insulin Resistance; Intervention; Lead; Measures; Methods; Morbidity - disease rate; Non obese; Obesity; Plasma; Population; Predictive Value; Predictive Value of Tests; Primary Prevention; ROC Curve; Race; Research; Research Personnel; Resources; Sampling; Source; Testing; Therapeutic; United States National Institutes of Health; Vascular Diseases; adiponectin; atherogenesis; base; caucasian American; clinically significant; cysteine rich protein; improved; indexing; intravenous glucose tolerance test; mortality; non-diabetic; validation studies

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 goal of the study is to determine whether biomarkers such as the high sensitivity C-reactive protein (Hs CRP) and adiponectin can be used as clinically useful assays for insulin resistance (IR) in non-diabetic, obese and non-obese African Americans (AA) and Caucasian Americans (CA). IR is a disorder in which the cells do not use insulin properly. Experimental and epidemiological studies have demonstrated the strong associations among IR and a variety of diseases, including vascular diseases (e.g., hypertension, CHD, and CVA), dys-lipidemia, diabetes (DM), systemic inflammation, and atherogenesis. Although IR can be measured by a variety of methods, there are no clear cut-offs for the diagnosis of IR and most of methods are difficult to apply in daily clinical practice, in particular, for outpatient care settings. In this project, we hypothesize that CRP is positively correlated to adiposity and IR (a pro-inflammatory state) whereas adiponectin is inversely correlated to adiposity and IR in non-diabetic AA and CA. The predictive value of clinically useful biomarker indices, such as CRP and adiponectin, is different in the two ethnic populations. The specific aims of the study are: 1) Establish the relationship between CRP and adiponectin plasma levels with simple assays of IR (eg HOMA) in a randomly ascertained, population-based sample of non-diabetic, obese and non-obese subjects composed of both AA and CA in the metro-Atlanta area. 2) Test the hypothesis that the relationship between CRP and adiponectin plasma levels with IR differs in AA versus CA. 3) Utilize a ROC analysis to determine cut-points for CRP or adiponectin levels that distinguish subjects with clinically significant and non-significant IR in each race/ethnic group. 4) Perform a pilot validation study to test the predictive value of CRP and adiponectin for IR by using the frequently-sampled intravenous glucose tolerance test (FSIGT)) in a subset of our population-based sample in the controlled setting of the Clinical Research Center. This study may lead to the early identification of individuals with IR using simplified practical approach. It will help us to develop new strategies for primary prevention of CHD, CVA, and DM. The interventions aimed at improving IR may provide additional therapeutic benefits to reduce the morbidity and mortality of CVA and DM.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 该研究的目的是确定高灵敏度 C 反应蛋白 (Hs CRP) 和脂联素等生物标志物是否可以用作非糖尿病、肥胖和非肥胖非裔美国人 (AA) 和白种人美国人 (CA) 中胰岛素抵抗 (IR) 的临床有用检测方法。 IR 是一种细胞不能正确使用胰岛素的疾病。实验和流行病学研究表明，IR 与多种疾病之间存在密切关联，包括血管疾病（例如高血压、CHD 和 CVA）、血脂异常、糖尿病 (DM)、全身炎症和动脉粥样硬化。虽然 IR 可以通过多种方法测量，但 IR 的诊断没有明确的界限，并且大多数方法难以应用于日常临床实践，特别是门诊护理环境。在本项目中，我们假设在非糖尿病 AA 和 CA 中，CRP 与肥胖和 IR（促炎症状态）呈正相关，而脂联素与肥胖和 IR 呈负相关。临床上有用的生物标志物指数（例如 CRP 和脂联素）的预测价值在两个种族人群中是不同的。该研究的具体目标是： 1) 在亚特兰大大都会地区随机确定的非糖尿病、肥胖和非肥胖受试者样本（由 AA 和 CA 组成）中，通过简单的 IR 测定（例如 HOMA），建立 CRP 和脂联素血浆水平之间的关系。 2) 检验以下假设：AA 与 CA 中 CRP 和脂联素血浆水平与 IR 之间的关系有所不同。 3) 利用 ROC 分析确定 CRP 或脂联素水平的切点，以区分每个种族/民族中具有临床显着性和非显着性 IR 的受试者。 4) 在临床研究中心的受控环境中，在基于人群的样本子集中使用频繁采样的静脉葡萄糖耐量试验 (FSIGT) 进行试点验证研究，以测试 CRP 和脂联素对 IR 的预测价值。这项研究可能会导致使用简化的实用方法早期识别 IR 个体。它将帮助我们制定 CHD、CVA 和 DM 一级预防的新策略。旨在改善 IR 的干预措施可能会提供额外的治疗益处，以降低 CVA 和 DM 的发病率和死亡率。