Aerobic Plus Resistance Training and Insulin Sensitivity in African American Men

描述（由申请人提供）：到目前为止，还没有一项大规模的、随机的、对照的研究来检验运动训练对非裔美国男性糖尿病风险因素（主要是胰岛素抵抗）的益处。全国标准化估计显示，所有20岁及以上的非裔美国人中有15%至20%患有糖尿病（包括确诊和未确诊的）。规律的体育活动是糖尿病发展的一个可改变的危险因素。尽管有研究表明，运动训练可以降低白种人成人的糖尿病发病率，但不能假设白种人成人的益处也适用于其他种族的男性。这些类型的研究通常在大学环境中进行，与社区项目相比，这对非裔美国人参与者来说可能是一个障碍。因此，我们建议在非裔美国男性队列中进行随机社区试验，评估定期运动对糖尿病危险因素的影响。这项建议的标题是有氧加阻力训练增加非洲裔美国男性胰岛素敏感性（ARTIIS）。研究小组将由年龄在35岁到70岁之间、久坐不动、健康的非裔美国男性组成。在这个年龄段，我们招募的是患糖尿病风险最高的男性，因此，他们很可能从锻炼项目中受益。运动训练组的男性将进行150分钟的有氧运动，以及2天的力量训练。目标运动强度为最大摄氧量的50-70%（有氧）和1RM的50-80%（力量）。这一运动剂量与目前的国家体育活动建议一致，因此，ARTIIS将有助于确定目前的建议是否对非洲裔美国男性的健康有益。我们认识到非裔美国男性是一个难以接触的群体。为了确保成功参与，我们将利用社区健身设施来提供项目。因此，运动训练组的男性将能够在他们的社区中锻炼。主要结局指标是糖尿病的危险因素，包括胰岛素对葡萄糖负荷的反应、空腹胰岛素和c肽。次要结局是心血管健康、肌肉力量、体重和组成以及心理结局。

DESCRIPTION (provided by applicant): To date, there has not been a large-scale, randomized, controlled study examining the benefits of exercise training the diabetes risk factor, mainly insulin resistance, in African American males. National standardized estimates show that between 15% and 20% of all African Americans aged twenty and older have diabetes (including both diagnosed and undiagnosed). Regular physical activity is a modifiable risk factor for the development of diabetes. Although it has been shown that exercise training results in a reduction of diabetes in Caucasian adults, it cannot be assumed that the benefits derived in Caucasian adults apply to men of other ethnic groups. These types of studies are typically conducted at the university setting, which can be a barrier for African American participants compared to a community-based program. Therefore, we proposed to a randomized community-based trial assessing the effect of regular exercise on risk factors for diabetes in an exclusively African American male cohort. This proposal is entitled Aerobic Plus Resistance Training to Increase Insulin Sensitivity in African American Men (ARTIIS). The study group will consist of sedentary, healthy African American men aged 35 to 70 years. At this age group, we are recruiting men who are at the highest risk of developing diabetes and therefore, the group who is likely to benefit from an exercise program. Males in the exercise training group will engage in 150 minutes of aerobic activity, as well as 2 days of strength training. The target exercise intensity is 50-70% of VO2 max (aerobic) and 50-80% of 1RM (strength). This exercise dose is consistent with the current national physical activity recommendations, and therefore, ARTIIS will assist in determining if the current recommendations result in health benefits for African American males. We recognize that African American males are a difficult-to-reach population. In order to ensure successful participation we will utilize community-based fitness facilities to deliver the program. Thus males in the exercise training group will be able to exercise in their community. Primary outcome measures are risk factors for diabetes including insulin response to a glucose load, fasting insulin, and c-peptide. Secondary outcomes are cardiovascular fitness, muscular strength, body weight and composition, and psychological outcomes. PUBLIC HEALTH RELEVANCE: This study is designed to assess the effect of exercise training on insulin resistance in African American males. African American males have higher rates of diabetes and lower levels of fitness when compared to Caucasian males. A project such as this is necessary because there is evidence to show that exercise training can reduce the risk of developing diabetes, though no studies have been conducted in African American males. In addition, ARTIIS will test the effect adhering to the 2008 Physical Activity Guidelines for Americans (150 minutes of moderate intensity aerobic activity and 2 days of 20 minutes of muscular strength activity), on insulin resistance in African American men. This study will provide important information that can either strengthen or refine current physical activity recommendations. Furthermore, this intervention will be delivered through a community-based facility in order to increase the likelihood that the intervention will be sustainable.