META-HEALTH I

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。 在过去的十年里，美国人口中所有年龄段的肥胖率都出现了爆炸性的增长。这种流行病在东南部的非裔美国人中尤其成问题。虽然遗传因素起了一定的作用，但肥胖和肥胖相关心血管疾病(CVD)的种族差异被认为与生物因素和对种族社区内独特环境背景的行为反应之间的动态相互作用有关。 肥胖通常与新陈代谢和生理环境的紊乱有关。一系列与肥胖相关的异常被定义为代谢综合征。肥胖的心血管并发症似乎与脂肪组织本身产生脂肪因子的能力有关，这些脂肪因子直接导致胰岛素抵抗、内皮功能障碍、炎症和血管疾病。拟议的计划将使用最先进的方法来确定与肥胖相关的代谢、生理和生化特征的潜在种族差异，以及对生活方式改变的有益反应。 拟议的计划使用多学科战略，通过借鉴心理学、生理学、生化、护理和临床医学领域，系统地描述与肥胖相关的心血管疾病的潜在种族差异。在一系列相互关联的专题研究中，我们的项目研究计划范围从种族社区内的流行病学研究，到种族社区实践中以患者为中心的临床试验干预，到人类病理生物学的新生物标记物的分析。这个由多名研究人员组成的协作团队建立在莫尔豪斯医学院和埃默里大学之间的互补伙伴关系之上。这一伙伴关系共同致力于解决我们所服务的高危心血管疾病人群中显著的种族差异问题。具体目标是： 目的1：在以人群为基础的双种族队列中，确定心理社会/文化因素和生物中介因素作为肥胖和代谢综合征种族差异的决定因素的相对影响。 目的2：在以社区为基础的临床实践背景下，明确针对患者的行为干预的有效性，以提高患有代谢综合征的非裔美国患者的健康。 目的3：评估创新的生活方式干预策略对非洲裔美国人血管疾病风险的传统和新型生物标记物的影响。 目标4：加强对从事心血管疾病差异研究/实践的研究员/从业人员的教育/培训，促进促进族裔社区心血管健康的伙伴关系。

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. Over the past decade, there has been an explosive increase in obesity among all age groups within the US population. This epidemic is particularly problematic among African Americans in the Southeast. Although genetic factors play a contributory role, it is postulated that ethnic disparities in obesity and obesity-related cardiovascular disease (CVD) is related to a dynamic interplay between biological factors and the behavioral response to the unique environmental context within ethnic communities. Obesity is often associated with perturbations in the metabolic and physiologic milieu. A cluster of obesity-related abnormalities has been defined as the Metabolic Syndrome. The CVD complications of obesity appears to be related to the capacity for adipose tissue itself to generate adipokines that directly predispose to insulin-resistance, endothelial dysfunction, inflammation and vascular disease. The proposed program will use state-of-the-art approaches to define potential ethnic differences in the profile of metabolic, physiologic and biochemical features associated with obesity as well as the salutary responses to lifestyle modification. The proposed program uses a multi-disciplinary strategy to systematically characterize potential ethnic differences in obesity-related CVD by drawing upon the fields of psychology, physiology, biochemistry, nursing and clinical medicine. In a thematic series of inter-related studies, our Programs research plan ranges from: epidemiology studies within the ethnic communities, to patient-centered clinical trial interventions within ethnic community practices, to the analysis of novel biomarkers of human pathobiology. This collaborative multi-investigator team is built upon a complementary partnership between the Morehouse School of Medicine and Emory University. This partnership shares a joint commitment to address the striking ethnic disparities in the high-risk CVD population that we serve. The specific aims are: Aim 1: Define the relative influence of psychosocial/cultural factors and biological mediators as determinants of ethnic disparities in obesity and the metabolic syndrome in a population-based bi-racial cohort. Aim 2: Define the effectiveness of patient-targeted behavioral interventions to enhance the health of African American patients with the Metabolic Syndrome in the context of community-based clinical practices. Aim 3: To assess the impact of innovative lifestyle intervention strategies on conventional and novel biomarkers of vascular disease risk in African-Americans. Aim 4: To enhance the education/training of fellows/practitioners engaged in CVD disparities research/practice and promote partnerships that enhance cardiovascular health within ethnic communities.