Yoga and Cardiovascular Disease Risk in Older Women

描述(由申请人提供)：心血管疾病(CVD)仍然是女性死亡的主要原因。随着绝经，心血管疾病的风险急剧上升，在患有2型糖尿病(DM 2)的女性中，心血管疾病的风险进一步增加。这些增加可能是由于胰岛素抵抗的增加和其他相关的动脉粥样硬化改变组成了胰岛素抵抗综合征(IRS)。越来越多的证据表明，在糖尿病和非糖尿病人群中，瑜伽练习可能会提供一种安全且成本效益高的策略，以减少与IRS相关的心血管疾病风险因素。然而，严谨的研究很少。拟议中的K-01奖项将为Kim Innes博士提供必要的培训、技能和经验。Kim Innes博士是一位流行病学家，在女性健康和慢性病方面具有很强的背景，最近在CAM接受了奖学金培训，以开展关于瑜伽对降低女性心血管疾病风险的影响的临床干预研究。她的长期目标是建立一个成功的研究项目 研究瑜伽对心血管疾病及相关慢性胰岛素抵抗疾病的预防和治疗作用。实现这一目标的近期目标是，通过严格的教学培训和 研究，以：1)在先进的量化方法、慢性病生理学和应激生物学方面获得更多的专业知识；2)在心身和精神领域发展坚实的实践和理论背景 行为医学，重点是瑜伽疗法；以及3)加强临床干预技能 研究并获得涉及心身疗法的行为干预研究所需的经验。候选人已经组建了一个特别的赞助委员会，由在这些学科中每一个领域拥有广泛专业知识的调查人员组成，他们将在整个获奖期间指导她的活动和进步。培训计划将包括与主要赞助商和联合赞助商的定期会议，以及参加与英尼斯博士研究领域相关的选定课程、教程、研讨会、研讨会、专业会议和研究实践。Innes博士将执行两项试点研究，这两项研究将包括K奖励的重点和至少两个后续RO1奖励申请的基础，这些申请将在奖励期间提交。这些先导性研究将采用随机对照设计，在两个心血管疾病风险较高的人群中，研究为期8周的温和莱恩加瑜伽计划对胰岛素敏感性和心血管疾病风险相关代谢和心理指标的影响。这两个人群是：目前健康的久坐、超重的绝经后妇女和患有2型糖尿病的绝经后妇女。拟议的研究将为降低绝经后糖尿病和健康女性心血管疾病风险的安全、廉价干预的潜在效用提供重要信息。如果发现是积极的，并在其他更大规模的研究中得到证实，将瑜伽用作心血管疾病及相关合并症的治疗干预和预防措施，可能会节省数十亿美元的医疗保健成本，并可能节省因这些疾病而造成的生产力损失。

DESCRIPTION (provided by applicant): Cardiovascular disease (CVD) remains the leading cause of death in women. CVD risk rises sharply with menopause and is further elevated among women with type 2 diabetes (DM 2). These increases are likely due to the coincident rise in insulin resistance and other, related atherogenic changes comprising the insulin resistance syndrome (IRS). There is growing evidence that the practice of yoga may offer a safe and cost-effective strategy for reducing IRS-related risk factors for CVD in both diabetic and non-diabetic populations. However, rigorous studies are few. The proposed K-01 award will provide the necessary training, skills, and experience for Dr. Kim Innes, an epidemiologist with a strong background in women's health and chronic disease and recent fellowship training in CAM, to conduct clinical intervention research regarding the effects of yoga on CVD risk reduction in women. Her long-term goal is to establish a successful research program investigating yoga for the prevention and management of CVD and related chronic, insulin resistance conditions. Immediate goals toward this end are, through a rigorous program of didactic training and research, to: 1) gain additional expertise in advanced quantitative methods, chronic disease physiology, and stress biology; 2) develop a solid practical and theoretical background in the field of mind-body and behavioral medicine, with a focus on yoga therapy; and 3) strengthen her skills in clinical intervention research and gain needed experience in behavioral intervention studies involving mind-body therapies. The candidate has assembled an exceptional sponsoring committee of investigators with extensive expertise in each of these disciplines, who will guide her activities and progress throughout the award period. The training program will include regular meetings with the lead sponsor and co-sponsors, coupled with participation in selected courses, tutorials, workshops, seminars, professional meetings and research practica relevant to Dr. lnnes's area of research. Dr. Innes will execute two pilot studies that will comprise the focus of the K award and the basis for at least two subsequent RO1 grant applications to be submitted within the award period. Using a randomized controlled design, these pilot studies will investigate the effects of a gentle 8-week lyengar yoga program on insulin sensitivity and related metabolic and psychological indices of CVD risk in two populations at elevated risk for CVD: sedentary, overweight postmenopausal women who are currently healthy and postmenopausal women with DM 2. The proposed studies will yield important information on the potential utility of a safe, inexpensive intervention in reducing CVD risk in both diabetic and healthy women postmenopause. If findings are positive and confirmed in other, larger studies, the use of yoga as a therapeutic intervention and prevention measure for CVD and related comorbidities could potentially save billions of dollars in health care costs and lost productivity due to these disorders.