Biobehavioral Bases of CHD Risk and Management

描述（由申请人提供）： 该计划项目竞争性更新申请包括一个综合的多学科计划，包括3个密切相关的项目，检查与2型糖尿病，代谢综合征或高脂血症相关的冠心病（CHD）风险的临床前和/或临床标志物，以及它们参与动脉粥样硬化CHD过程的进展或改善。在每个项目中，我们将通过使用行为干预措施，如饮食限制，运动，压力管理和/或社会环境的操纵来检查风险因素的修改。结果变量将包括血糖控制/胰岛素抵抗和/或血脂异常、氧化应激、炎症和疾病的明显表现的测量。第一个项目将确定与标准护理（SC）相比，糖尿病生活方式改变社区方法（CALM-D）计划（包括饮食，体力活动和应对技能培训）是否可以降低抑郁，体重和HbA 1c，并改善在大型综合社区卫生中心就诊的低收入，少数民族，抑郁，超重，2型糖尿病患者的药物依从性。第二个项目将确定与SC相比，社区健康和降低代谢综合征风险（CHARMS）计划还包括饮食，体力活动和应对技能培训，可以减轻体重，增加体力活动并降低代谢综合征的频率和严重程度。第三个项目将通过研究社会环境对高脂血症、氧化和炎症疾病过程的影响，评估行为在Watanabe遗传性高脂血症兔动脉粥样硬化进展中的作用。这些项目将与生化分析核心、心血管测量核心以及数据管理和统计分析核心相互作用，并在很大程度上依赖这些核心。

DESCRIPTION (provided by applicant): This program project competitive renewal application consists of an integrated, multidisciplinary program including 3 closely related projects examining the preclinical and/or clinical markers of coronary heart disease (CHD) risk associated with type 2 diabetes, metabolic syndrome or hyperlipidemia and their involvement in the progression or amelioration of atherosclerotic CHD processes. In each project we will examine the modification of risk factors through the use of behavioral interventions such as dietary restriction, exercise, stress management and/or manipulations of social environment. Outcome variables will include measures of glycemic control/insulin resistance and/or dyslipidemia, oxidative stress, inflammation and overt manifestations of disease. The first Project will determine if compared to Standard Care (SC), a Community Approach to Lifestyle Modification for Diabetes (CALM-D) program including diet, physical activity and coping skills training, can decrease depression, weight and HbA1c and improve medication adherence in low income, minority, depressed, overweight, type 2 diabetic patients seen in a large comprehensive community health center. The second Project will determine if compared to SC, a Community Health and Risk-reduction in Metabolic Syndrome (CHARMS) program also including diet, physical activity and coping skills training, can decrease weight, increase physical activity and reduce the frequency and severity of metabolic syndrome. The third project will assess the role of behavior in the progression of atherosclerosis in the Watanabe Heritable Hyperlipidemic Rabbit by examining the influence of social environment on hyperlipidemic, oxidative, and inflammatory disease processes. The projects will interact with and rely heavily on, the Biochemical Analyses Core, the Cardiovascular Measurement Core and the Data Management and Statistical Analyses Core.