Heart Disease Risk Factors In African Americans

非裔美国人的心脏病危险因素

• 批准号: 7734143
• 负责人: Anne E Sumner
• 金额: $ 25.96万
• 依托单位: NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7734143
• 关键词: Accounting; Affect; Africa; African American; Age; Agreement; Attention; Biological; Body Size; Body fat; Body mass index; Cardiovascular Diseases; Central obesity; Characteristics; Cholesterol; Complex; Data; Data Set; Development; Diabetes Mellitus; Diagnosis; Disease; Education; Environment; Ethnic Origin; Failure; Fasting; Fatty acid glycerol esters; Glucose; Glucose Intolerance; Goals; Guidelines; Health; Height; High Density Lipoprotein Cholesterol; Hormones; Hour; Hyperglycemia; Hypertension; Hypertriglyceridemia; Individual; Insulin; Insulin Resistance; Intravenous; Investigation; Lipids; Measures; Metabolic syndrome; Methods; Mexican Americans; Modeling; Modification; National Health and Nutrition Examination Survey; Nonesterified Fatty Acids; Obesity; Parents; Participant; Physicians; Physiology; Prevalence; Protocols documentation; Range; Research; Risk; Risk Factors; Sampling; Surveys; Testing; Triglycerides; United States; Variant; Weight; Woman; Work; base; cardiovascular risk factor; cohort; density; design; diabetes risk; ethnic difference; heart disease risk; indexing; insight; mathematical model; men; model development; non-diabetic; nutrition; particle; programs; waist circumference

One hundred eighty-two nondiabetic African-Americans (74 Men, 108 Women) have participated. The age range of the participants is 20 to 50 years. This sample of African Americans can be considered representative because the prevalence of obesity (43%), glucose intolerance (22%) and hypertension (21%) is similar to NHANES data. NHANES stands for National Health and Nutrition Examination and is a nationwide survey with thousands of participants. The participants range from very lean to very obese. The mean body mass index of participants is 30.6 kg/m2 (range 18.5 54.7). Body mass index is a mathematical method used to correct weight for height. Due to the broad range of body mass index in the participants it is possible to make conclusions about the relationship of body size to insulin resistance. We have found in African American men that a waist circumference of 102 cm in men predicts both insulin resistance and obesity. Therefore we are completely in agreement with the National Cholesterol Education Program values for whites. However, in African American women we found that a waist circumference of 98 cm predicted both insulin resistance and obesity. Based on investigations in white women the National Cholesterol Education Program recommends that a waist circumference threshold of 88 cm be used. Therefore our work demonstrates the need for ethnic specific modifications of guidelines in women. Elevated TG and low HDL are considered lipid hallmarks of insulin resistance. However while elevated TG is a marker of insulin resistance in whites, we have shown that TG is not a marker of insulin resistance in African Americans. The investigation of the relationship of TG to insulin resistance has become such an important component of this research, that the cohort of African Americans participating in this protocol are now known as TARA for Triglyceride and Cardiovascular Risk in African Americans. Results from TARA were so impressive that the hypothesis that TG was not a marker of insulin resistance in African Americans was tested in NHANES data from 1999-2001. In this nationwide data set of whites, African Americans and Mexican Americans, the fact that TG was not a marker of insulin resistance was confirmed. However, TG was a marker of insulin resistance in whites and Mexican Americans. Again this demonstrates the need for ethnic specific guidelines. This work with NHANES was in press. To develop an index of free fatty acid sensitivity to insulin, we are working with mathematicians. The modeling is underway. The modeling of the influence of insulin on glucose levels was done in the nineteen eighties by Richard N. Bergman and colleagues. Because of the multiplicity of hormones that affect free fatty acid levels as well as the much wider range of biological variation in free fatty acids than glucose, achieving a model of the effect of insulin on free fatty acids is an even greater challenge. To achieve a model 150 participants in TARA have had frequently sampled intravenous glucose tests with glucose, insulin and free fatty acids levels determined at 36 timepoints in a 3 to 6 hour period. The complex multicompartment modeling is underway.

182名非糖尿病非洲裔美国人（74名男性，108名女性）参加了研究。参与者的年龄范围为20至50岁。该非裔美国人样本可被视为具有代表性，因为肥胖（43%）、葡萄糖耐受不良（22%）和高血压（21%）的患病率与NHANES数据相似。NHANES代表国家健康和营养检查，是一项有数千名参与者的全国性调查。参与者的范围从非常瘦到非常胖。参与者的平均体重指数为30.6公斤/平方米（范围18.5 - 54.7）。身体质量指数是一种数学方法，用于根据身高校正体重。由于参与者的体重指数范围很广，因此可以得出关于体型与胰岛素抵抗关系的结论。我们在非裔美国男性中发现，男性腰围102厘米预示着胰岛素抵抗和肥胖。因此，我们完全同意国家胆固醇教育计划对白人的价值观。然而，在非裔美国妇女中，我们发现腰围98厘米预示着胰岛素抵抗和肥胖。根据对白色女性的调查，国家胆固醇教育计划建议使用腰围阈值88 cm。因此，我们的工作表明，有必要对妇女的指导方针进行种族特定的修改。 TG升高和HDL降低被认为是胰岛素抵抗的脂质标志。然而，虽然TG升高是白人胰岛素抵抗的标志物，但我们已经证明TG不是非裔美国人胰岛素抵抗的标志物。TG与胰岛素抵抗关系的研究已成为本研究的重要组成部分，参与本方案的非裔美国人队列现在被称为非裔美国人甘油三酯和心血管风险的塔拉。塔拉研究的结果是如此令人印象深刻，以至于在1999-2001年的NHANES数据中对TG不是非裔美国人胰岛素抵抗标志物的假设进行了检验。在这个全国性的白人、非洲裔美国人和墨西哥裔美国人的数据集中，TG不是胰岛素抵抗的标志物的事实得到了证实。然而，TG是白人和墨西哥裔美国人胰岛素抵抗的标志物。这再次表明需要有针对具体族裔的指导方针。这项与国家卫生和保健服务机构合作的工作正在加紧进行。 为了开发游离脂肪酸对胰岛素敏感性的指数，我们正在与数学家合作。建模正在进行中。胰岛素对葡萄糖水平影响的模型是在20世纪80年代由Richard N。伯格曼及其同事。由于影响游离脂肪酸水平的激素的多样性以及游离脂肪酸比葡萄糖更广泛的生物变异范围，因此获得胰岛素对游离脂肪酸的影响的模型是一个更大的挑战。为了建立模型，塔拉的150名参与者经常进行静脉葡萄糖试验，在3至6小时内的36个时间点测定葡萄糖、胰岛素和游离脂肪酸水平。复杂的多室建模正在进行中。

项目成果

High-risk African Americans with multiple risk factors for cardiovascular disease: challenges in prevention, diagnosis, and treatment.

具有多种心血管疾病危险因素的高危非裔美国人：预防、诊断和治疗方面的挑战。

• 发表时间: 2006
• 期刊: Ethnicity & disease
• 影响因子: 3.2
• 作者: Williams,RichardAllen;Gavin3rd,JamesR;Phillips,RobertA;Sumner,AnneE;Duncan,AlanK;Hollar,Danielle;Hennekens,CharlesH
• 通讯作者: Hennekens,CharlesH

Preventing Diabetes and Atherosclerosis in Sub-Saharan Africa: Should the Metabolic Syndrome Have a Role?

• DOI: 10.1007/s12170-009-0026-7
• 发表时间: 2009-05-01
• 期刊: CURRENT CARDIOVASCULAR RISK REPORTS
• 影响因子: 1.9
• 作者: Imoisili, Omoye E.;Sumner, Anne E.
• 通讯作者: Sumner, Anne E.

STATA: a statistical analysis system for examining biomedical data.

• DOI: 10.1007/978-1-4419-9019-8_23
• 发表时间: 2003
• 期刊: Advances in experimental medicine and biology
• 作者: R. Boston;A. Sumner

Obese premenopausal African-American women with normal and impaired glucose tolerance have a similar degree of insulin resistance but differ in beta-cell function.

糖耐量正常和受损的肥胖绝经前非裔美国女性具有相似程度的胰岛素抵抗，但 β 细胞功能不同。

• DOI: 10.2337/diacare.24.11.1978
• 发表时间: 2001
• 期刊: Diabetes care
• 影响因子: 16.2
• 作者: Sumner,AE;Farmer,NM;Cochran,CS;Sebring,NG;Vanevski,K;Reynolds,JC;Premkumar,A;Boston,RC
• 通讯作者: Boston,RC

The multiphasic profile of free fatty acids during the intravenous glucose tolerance test is unresponsive to exogenous insulin.

静脉内葡萄糖耐量试验期间游离脂肪酸的多相特征对外源性胰岛素没有反应。

• DOI: 10.1016/j.metabol.2004.03.020
• 发表时间: 2004
• 期刊: Metabolism: clinical and experimental
• 作者: Sumner,AE;Bergman,RN;Vega,GL;Genovese,DJ;Cochran,CS;Pacak,K;Watanabe,RM;Boston,RC
• 通讯作者: Boston,RC