YOGA FOR THE MANAGEMENT OF HIV-METABOLIC SYNDROMES

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 高效抗逆转录病毒疗法(HAART)的引入极大地提高了艾滋病毒携带者的生活质量，显著降低了其发病率和死亡率。但是，HIV感染和HAART与一系列代谢和拟人化综合征(HIV-代谢综合征；HIV+MS)有关，这些综合征危及艾滋病毒携带者的长期心血管疾病(CVD)风险。这些并发症的原因是多方面的。几乎没有安全有效的传统治疗方法(药物、改变的抗艾滋病毒药物)被确定。古老的瑜伽生活方式已经重新流行起来，作为一种补充的、非传统的治疗代谢、拟人化和心血管疾病的方法。瑜伽通过练习姿势、肌肉收缩、控制呼吸和冥想，在饮食习惯、运动和休息、呼吸方式以及身心关系之间提供综合控制和和谐平衡。生理过程之间的整体平衡提供了疾病的缓解。我们建议客观地检查瑜伽生活方式干预对26名感染艾滋病毒的女性和26名男性的安全性和有效性，这些患者接受了HAART治疗，并经历了增加心血管疾病风险的代谢综合征。我们假设瑜伽生活方式干预将是安全的，并增强(补充)标准护理治疗对HIV+MS的好处。参与者将被随机分配到继续标准护理治疗，或在标准护理治疗的基础上增加有监督的瑜伽生活方式干预。瑜伽生活方式干预将由Living by Design Inc.雇用的训练有素和经验丰富的瑜伽教练授课和监督。Living by Design Inc.是一家总部位于圣路易斯的医疗保健计划，为艾滋病毒(和其他慢性病)患者提供补充和替代康复疗法。在治疗前和治疗4个月结束时，将对口服葡萄糖耐量、胰岛素敏感性、血脂/脂蛋白水平、纤溶和炎症的血清标志物、脂肪组织分布、心血管功能和心血管风险进行量化。瑜伽生活方式实践尚未在慢性感染的替代管理策略中进行客观测试，这种慢性感染会对心血管疾病和其他健康风险产生终身影响。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The introduction of highly active antiretroviral therapy (HAART) has dramatically improved quality of life, and substantially reduced morbidity and mortality rates for people living with HIV. But, HIV-infection and HAART have been associated with a cluster of metabolic and anthropomorphic syndromes (HIV-metabolic syndrome; HIV+MS) that jeopardize long-term cardiovascular disease (CVD) risk profiles for people living with HIV. The cause of these complications is multifactorial. Few safe and effective traditional treatments (drugs, changing anti-HIV medications) have been identified. The ancient practice of a Yoga lifestyle has been re-popularized as a complementary, non-traditional treatment for metabolic, anthropomorphic, and cardiovascular disorder. Yoga provides integrated control and harmonious balance among eating habits, exercise, and rest, breathing style, and the mind-body relationship through the practice of postures, muscle contraction, controlled breathing, and meditation. Holistic balance among physiologic processes provides relief from disease. We propose to objectively examine the safety and efficacy of a yoga lifestyle intervention in 26 women and 26 men infected with HIV, treated with HAART and experiencing metabolic syndromes that increase CVD risk. We hypothesize that a yoga lifestyle intervention will be safe and enhance (complement) the benefits of standard-of-care therapy for HIV+MS. Participants will be randomly assigned to continue standard-of-care therapy, or add a supervised yoga lifestyle intervention to standard-of-care therapy. Yoga lifestyle intervention will be taught and supervised by trained and experienced yoga instructors employed by Living By Design Inc., a St. Louis-based healthcare program that provides complementary and alternative rehabilitative therapies to people living with HIV (and other chronic disorders). Standardized and objective measurements of oral glucose tolerance, insulin sensitivity, serum lipid/lipoprotein levels, serum markers of fibrinolysis and inflammation, adipose tissue distribution, cardiovascular function adn CVD risk will be quantified before and at the end of 4-months of therapy. Yoga lifestyle practices have not been objectively tested in alternative management strategy for a chronic infection with lifelong implications for CVD and other health risks.