C-Reactive Protein and Exercise in Postmenopausal Women

描述(由申请人提供)： C反应蛋白(CRP)是男性和女性心血管疾病(CVD)的独立预测因子。C反应蛋白是全身炎症反应的标志，治疗过程中降低C反应蛋白水平可降低心血管风险。由于横断面研究和干预研究发现，激素替代疗法(HRT)显著增加了CRP水平，因此，CRP作为绝经后妇女心血管疾病危险因素可能具有特别的相关性。我们有初步的横断面数据表明，HRT-CRP关系可能会被更高水平的心肺适能所消除，而不受体重指数的影响。心肺健康是有规律的身体活动习惯的反映，它可能会影响CRP，这一观点提出了一种令人兴奋的潜在机制，可以降低绝经后妇女的CRP。据我们所知，目前还没有关于单独运动训练对绝经后妇女C反应蛋白影响的随机临床试验的报道，也没有研究不同剂量的运动对C反应蛋白变化的影响。这项拟议的研究包括两项研究，这两项研究都将利用我们中心正在进行的NIH资助的项目。第一项是来自NIA资助的有氧运动中心纵向研究(AG06945)的横断面流行病学研究。我们的计划是从现有的医疗记录中提取更多的数据，以扩大初步工作，探索心肺功能、HRT使用和CRP水平之间的关系。第二项拟议的研究是NHLBI资助的女性运动剂量反应研究(DREW)(HL66262)的前瞻性辅助研究。在DREW项目中，450名超重、久坐、绝经后的女性将被随机分配到不锻炼对照组或三个锻炼组中的一个，分别为每周体育锻炼(锻炼)50%、100%和150%的公共卫生共识建议。研究周期为6个月，所有的锻炼过程都受到监督。我们建议从冰冻血浆样本中检测CRP，以检验体力活动(和健身)变化与CRP之间的剂量-反应关系。此外，我们还建议在一部分受试者中测量内脏肥胖症，以评估身体成分和脂肪分布的变化以及体力活动(和体能)的变化与CRP变化的相对重要性。这些研究为快速探索C反应蛋白、体力活动和激素替代疗法之间的关系提供了一个创新的、独特的、及时的和经济有效的机会。

DESCRIPTION (provided by applicant): C-reactive protein (CRP) is an independent predictor of cardiovascular disease (CVD) in men and women. CRP is a marker of systemic inflammation and therapeutic lowering of CRP was found to result in reduced CVD risk. CRP may have particular relevance as a CVD risk factor in post-menopausal women as cross-sectional and intervention studies find that hormone replacement therapy (HRT) substantially increases CRP. We have preliminary cross-sectional data suggesting that the HRT-CRP relation may be abolished by higher levels of cardiorespiratory fitness, independently of body mass index. The idea that cardiorespiratory fitness, a reflection of regular physical activity habits, may affect CRP presents an exciting potential mechanism to reduce CRP in postmenopausal women. To our knowledge there are no published reports from randomized clinical trials on the effect of exercise training alone on CRP in postmenopausal women, nor are there any studies examining the effects of different doses of exercise on changes in CRP. The proposed research consists of 2 studies and both will capitalize on ongoing NIH-funded projects at our center. The 1st is a cross-sectional epidemiological study from the NIA-funded Aerobics Center Longitudinal Study (AG06945). Our plan is to abstract additional data from the existing medical records to expand preliminary work exploring the relation between cardiorespiratory fitness, HRT use, and CRP levels. The 2nd proposed study is a prospective ancillary study to the NHLBI-funded, Dose-Response to Exercise in Women (DREW) study (HL66262). In DREW, 450 overweight, sedentary, postmenopausal women will be randomly assigned either to a no-exercise control group or to 1 of 3 exercise groups at 50, 100, and 150%, respectively, of the consensus public health recommendations for weekly physical activity (exercise). The study period is 6 months and all exercise sessions are supervised. We propose to measure CRP from frozen plasma samples to examine the dose-response relation between changes in physical activity (and fitness) and CRP. Additionally, we propose to measure visceral adiposity in a sub-set of the DREW participants to evaluate the relative importance of changes in body composition and fat distribution and changes in physical activity (and fitness) in relation to changes in CRP. These studies represent an innovative, unique, timely, and cost-effective opportunity to quickly explore the relation between CRP, physical activity, and HRT.