CV RISK FACTOR REDUCTION & EXERCISE TRAINING IN PREMENOPAUSAL WOMEN WITH NIDDM

非糖尿病绝经前女性心血管疾病（CVD）的发病率比男性低得多，但绝经前糖尿病女性似乎失去了这一优势，可能比男性有更大的CVD风险。因此，降低CVD风险的干预措施具有巨大的潜在益处。我们的假设是，在绝经前的NIDDM妇女，运动训练将通过改善血脂和脂蛋白降低心血管疾病的风险。60名NIDDM妇女将参加为期6个月的运动训练计划（30名运动和30名非运动对照），在3个月和6个月时测量运动表现和危险因素，以记录变化的时间过程。将通过测量胰岛素敏感性和血糖控制来评估疾病程度。跑步机测试和体力活动问卷将评估运动表现。待测量的脂质和脂蛋白包括总胆固醇、HDL-C和亚组分、LDL-C、VLDL-C和载脂蛋白A-1和B。一部分女性将参与重点研究，以阐明运动训练如何影响风险因素的潜在机制。为此，将测量脂质组成（LC）和胆固醇酯转移（CET）活性，以确定运动训练是否降低CET（在NIDDM中加速）并改善LC。减少绝经前妇女的心血管危险因素具有重要意义，因为动脉粥样硬化并发症是NIDDM患者死亡的主要原因。

Non-diabetic premenopausal women have a much lower incidence of cardiovascular disease (CVD) than men, but premenopausal women with diabetes appear to lose this advantage and may have a greater CVD risk than men. Interventions to reduce CVD risk are therefore of great potential benefit. Our hypothesis is that in premenopausal women with NIDDM, exercise training will reduce CVD risk by improving lipids and lipoproteins. Sixty women with NIDDM will participate in a six month program of exercise training (30 exercise and 30 nonexercising controls) with measurements of exercise performance and risk factors at three and six months to document the time course of changes. Degree of disease will be assessed by measuring insulin sensitivity and glycemic control Treadmill testing and physical activity questionnaire will evaluate exercise performance. Lipids and lipoproteins to be measured include total cholesterol, HDL-C and subfractions, LDL-C, VLDL-C and apolipoproteins A-1 and B. A subset of women will participate in focused studies to elucidate potential mechanisms for how exercise training may affect risk factors. For this purpose, lipid composition (LC) and cholesteryl ester transfer (CET) activity will be measured to determine whether exercise training reduces CET (accelerated in NIDDM) and improves LC. Reduction of cardiovascular risk factors in premenopausal women has important implications since atherosclerotic complications are the leading causes of death in persons with NIDDM.