EXERCISE AND ENERGY/SUBSTRATE UTIL IN BLACKS WITH NIDDM

非裔美国人（AA）2型的患病率高2-3倍 糖尿病（DM），更高的疾病相关发病率， 死亡率和发病年龄早于高加索美国人（CA）。 的 这些差异的病因尚不清楚，但与 胰岛素抵抗和肥胖症患病率的增加。 因此，在本发明中， 对代谢和能量方面种族差异的调查 2型糖尿病的AA将提供重要的数据增加 AA人群中肥胖和2型DM的患病率， 与CA相比。 本研究的目的包括：（1）研究种族 底物利用、能量消耗、胰岛素 敏感性、葡萄糖有效性和β细胞功能， 在患有2型DM的AA和CA受试者中进行慢性运动后，2） 确定慢性运动对静息代谢率的影响 (RMR)CA和AA的餐后产热和底物氧化 2型糖尿病受试者，3）比较抵抗与 有氧训练对基质氧化和能量消耗的影响; 以确定锻炼的顺序模式是否与 在CA和dAA受试者中具有不同的代谢和能量后果 2型DM 拟议的研究是一项前瞻性工作 2型糖尿病AA和CA患者干预方案。 研究 人群将由75名患有2型DM的AA和75名CA受试者组成。 的 参与研究的时间范围为26周。 在研究第1天， 每例受试者将接受筛选实验室数据、 D-3 3 H葡萄糖输注和伴随IGTT的葡萄糖周转率 间接量热法。 在研究第2天，每例受试者将接受一次双重 能量X射线吸收法（DEXA）扫描和磁共振成像 (MRI)扫描以评估身体组成和身体脂肪分布。 在研究第3天，胰岛素敏感性、葡萄糖有效性和β细胞 将使用Bergman最小模型方法评估功能。 然后将受试者随机分配至开始8周的 有氧或阻力训练与其他运动交叉 培训计划为期8周。 每种代谢和 人体测量研究将进行四次;进入 研究，完成每个锻炼计划后，8周 运动干预后。 这项研究将提供见解， AA患者与2型DM相关的代谢异常， 运动干预在AA和CA人群中的重要性。 的 本研究的结果可能是处方的基础， 2型糖尿病再障患者有效运动方式 糖尿病。 我相信我过去的经验使我能从事 学术研究作为一个独立的调查员。 建议的K 08 格兰特将帮助我实现这些目标，并提高竞争力 公共卫生服务和其他国家资金。 这个项目是 我参与的一系列研究， 检查和葡萄糖代谢领域，其中知之甚少， 运动对葡萄糖代谢影响的种族差异。

African Americans (AA) have a 2-3 fold higher prevalence of type 2 diabetes mellitus (DM), greater disease-associated morbidity and mortality and earlier age of onset than Caucasian Americans (CA). The etiology for these differences is unclear but has been related to insulin resistance and an increased prevalence of obesity. Thus, investigations into racial differences in metabolic and energy aspects of type 2 DM in AA will provide important data on the increased prevalence of both obesity and type 2 DM in the AA population when compared to CA. The aims of the study include: 1) To examine racial differences in substrate utilization, energy expenditure, insulin sensitivity, glucose effectiveness and beta cell function before and after chronic exercise in AA and CA subjects with type 2 DM, 2) To determine the effects of chronic excercise on the resting metabolic rate (RMR), postprandial thermogenesis and substrate oxidation in CA and AA subjects with type 2 DM, 3) To compare the effects of resistance vs. Aerobic training on substrate oxidation and energy expenditure and 4) to determine whether the sequential pattern of exercise is associated with different metabolic and energy consequences in CA an dAA subjects with type 2 DM. The proposed study is a prospective exercise intervention program in AA and CA subjects with type 2 DM. The study population will consist of 75 AA and 75 CA subjects with type 2 DM. The time frame for study participation will be 26 weeks. On study day 1, each subject will undergo screening laboratory data, assessment of glucose turnover rates with D-3 3H glucose infusion and concomitant IGTT and indirect calorimetry. On study day 2, each subject will have a dual energy x-ray absorptiometry (DEXA) scan and a magnetic resonance imaging (MRI) scan for assessment of body composition and body fat distribution. On study day 3, insulin sensitivity, glucose effectiveness and beta-cell function will be assessed using the Bergman Minimal Model Methodology. The subjects will then be randomly allocated to begin either 8 weeks of aerobic or resistance training with a crossover to the other exercise training program for an additional 8 weeks. Each metabolic and anthropometric study will be prformed four times; upon entry to the study, after completion of each of the exercise programs, and 8 weeks after the exercise intervention. This study will provide insights into the metabolic abnormalities assoicated with type 2 DM in AA and the importance of exercise intervention in the AA and CA population. The findings of the present study could be the basis of prescribing an effective exercise modality in AA patients with type 2 diabetes mellitus. I believe my past experience has prepared me for a career in academic research as an independent investigator. The proposed K08 grant will help me to achieve these goals as wellas become competivitie for Public Health Service and other national funding. This project is a continuum of previous research in which I have been involved while it examines and area of glucose metabolism in which little is known, the racial differences in the effects of exercise on glucose metabolism.