Biobehavioral Bases & Management of Metabolic Syndrome

生物行为基础

基本信息

批准号：
7248203
负责人：
Ronald B Goldberg
金额：
$ 52.73万
依托单位：
UNIVERSITY OF MIAMI CORAL GABLES
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-06-01 至 2012-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7248203
关键词：
Atherogenic Diet Automobile Driving Behavior Behavior Therapy Behavioral Biochemical Blood Pressure Blood Vessels Body Weight decreased Cardiac Cardiovascular Diseases Cardiovascular system Caring Central obesity Clinic Clinical Clinical Markers Coagulation Process Community Health Community Health Centers Coping Skills Coronary heart disease Development Diabetes Mellitus Disadvantaged Disease Dyslipidemias Education Educational Curriculum Epidemic Ethnic group Exercise Family Practice Fasting Frequencies Functional disorder Glucose Glucose Intolerance Goals Health High Density Lipoprotein Cholesterol Hispanics Hyperlipidemia Individual Inflammation Inflammatory Insulin Insulin Resistance Intervention Latino Life Life Style Lipids Lipoproteins Longitudinal Studies Low income Maintenance Matched Group Measurement Measures Metabolic Metabolic syndrome Minority Groups Modification Morphology Non-Insulin-Dependent Diabetes Mellitus Numbers Obesity Outcome Outcome Measure Oxidative Stress Participant Pathogenesis Patients Phase Phase II Clinical Trials Physical activity Play Population Prevalence Process Professional counselor Protocols documentation Psychosocial Assessment and Care Quality of life Randomized Randomized Clinical Trials Rate Recommendation Risk Risk Factors Role Running Severities Social Environment Societies Standards of Weights and Measures Structure Syndrome Thinking Triglycerides Visit Walking Week Weight Weight Gain Work base biobehavior cardiovascular disorder risk data management diabetes risk dietary restriction eligible participant experience glycemic control heart disease risk improved inner city insulin sensitivity intervention program lifestyle intervention member minority subjects multidisciplinary preclinical study programs psychosocial sedentary socioeconomics stress management waist circumference

项目摘要

About 25% of the population in the US have the metabolic syndrome, a cluster of cardiovascular disease (CVD) risk factors including abdominal obesity, glucose intolerance, elevated blood pressure and dyslipidemia, and this prevalence is even higher in low income groups. The presence of this syndrome increases risk for diabetes by 3-fold and for CVD approximately two-fold. Since obesity, sedentary living and an atherogenic diet are believed to play major roles in the development of the metabolic syndrome, lifestyle modification is considered to be the primary approach to its treatment, although there have been few longterm studies of the efficacy of such programs. This project will compare the effects of a 1-year, structured lifestyle intervention program (Enhanced Care [EC]) in 112 patients (80 completers) with the metabolic syndrome attending an inner city family medicine clinic to that of a matched group receiving standard lifestyle recommendations (Standard Care [SC]) in a randomized clinical trial. By structuring the lifestyle program to modify behavior and improve coping skills, it is predicted that participants will reduce weight by 7% and increase physical activity by at least 150 minutes per week of walking-style exercise. The EC protocol will consist of 4 weekly followed by 4 bi-weekly group sessions making up the Core Curriculum during the first 3 months, followed by 9 monthly Maintenance group sessions, and will be delivered by experienced lifestyle managers with expertise in behavior modification among low-income people as well as in subjects from minority ethnic groups. Assessments of metabolic syndrome components, weight, physical activity, health quality of life, psychosocial status, glucose, insulin and lipid and lipoprotein levels, markers of inflammation, coagulation, oxidative stress and endothelial dysfunction, and subclinical CVD measures, will be undertaken at baseline, 6, and 12 months, since it is anticipated that the EC intervention will improve CVD risk factors and reduce the prevalence and intensity of the metabolic syndrome and the pathophysiological factors driving it. This study is intended to demonstrate that a structured program directed at weight reduction and increasing physical activity can be successfully applied to low income patients with the metabolic syndrome. Reducing the frequency and the severity of the metabolic syndrome through effective weight reduction and increased phsycial activity is expected to lower the rate of diabetes and cardiovascular disease in the long term.

大约 25% 的美国人口患有代谢综合征，这是一组心血管疾病 (CVD) 危险因素包括腹部肥胖、葡萄糖不耐症、血压升高和血脂异常，这种患病率在低收入群体中甚至更高。这种综合症的存在患糖尿病的风险增加 3 倍，患 CVD 的风险增加约 2 倍。由于肥胖、久坐的生活致动脉粥样硬化饮食被认为在代谢综合征、生活方式和生活方式的发展中发挥着重要作用尽管很少有长期的治疗方法，但修饰被认为是其治疗的主要方法研究此类计划的功效。该项目将比较为期 1 年的结构化项目的效果对 112 名患有代谢障碍的患者（80 名完成者）进行生活方式干预计划（强化护理 [EC]）到市中心家庭医学诊所就诊的综合症与接受标准生活方式的匹配组的综合症一项随机临床试验中的建议（标准护理 [SC]）。通过构建生活方式计划改变行为并提高应对技巧，预计参与者体重将减轻7% 每周增加至少 150 分钟的步行锻炼。 EC 协议将包括 4 次每周一次的小组课程，随后是 4 次每两周一次的小组课程，构成前 3 次的核心课程个月，然后是 9 个月的维护小组会议，并将由经验丰富的生活方式提供具有低收入人群行为矫正以及来自以下领域的专业知识的管理者少数民族。代谢综合征的组成部分、体重、体力活动、健康状况的评估生活质量、心理社会状态、葡萄糖、胰岛素、脂质和脂蛋白水平、炎症标志物、将采取凝血、氧化应激和内皮功能障碍以及亚临床 CVD 措施在基线、6 个月和 12 个月，因为预计 EC 干预将改善 CVD 风险因素降低代谢综合征及病理生理因素的患病率和强度驾驶它。本研究旨在证明旨在减轻体重和增加体力活动可以成功地应用于患有代谢综合征的低收入患者。通过有效减轻体重和减少代谢综合征的发生频率和严重程度从长远来看，增加体育活动有望降低糖尿病和心血管疾病的发病率学期。