YOGA EFFECTS ON INSULIN SENSITIVITY AND RELATED INDICES OF CARDIOVASCULAR RISK

瑜伽对胰岛素敏感性和心血管风险相关指标的影响

• 批准号: 7951474
• 负责人: KAREN-KIM E INNES
• 金额: $ 0.78万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-03-01 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7951474
• 关键词: Address; Adherence; Adult; Biological Availability; Blood Coagulation Disorders; Blood specimen; Cardiovascular system; Cause of Death; Chronic; Chronic Disease; Classification; Clinical Research; Complex; Computer Retrieval of Information on Scientific Projects Database; Control Groups; Data; Diagnosis; Disease; Dyslipidemias; Elderly; Enrollment; Epidemic; Ethnic Origin; Fasting; Fructosamine; Funding; Gender; Glucose; Glycosylated Hemoglobin; Grant; Home environment; Inflammation; Institution; Insulin; Insulin Resistance; Intervention; Link; Measures; Metabolic; Minority; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Participant; Patients; Physiological; Pilot Projects; Population; Prevention; Protocols documentation; Race; Randomized; Randomized Clinical Trials; Research; Research Personnel; Resources; Risk; Sleep disturbances; Somatomedins; Source; Structure; Syndrome; Training; United States; United States National Institutes of Health; Validity and Reliability; Visceral; Yoga; age related; aged; cardiovascular risk factor; cost; design; diabetes education; diabetic; disability; eligible participant; fasting glucose; indexing; instrument; insulin sensitivity; programs; psychologic; treatment as usual; treatment duration

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. Type 2 diabetes mellitus (DM 2), a serious, chronic, age-related disorder strongly linked to the insulin resistance syndrome (IRS), is a leading cause of death and disability in the United States and is fast reaching epidemic proportions both nationally and globally. There is growing evidence that yoga may offer particular promise for the management of DM 2 and prevention of cardiovascular sequellae, and may provide a safe and cost-effective means of addressing the multiple, interrelated factors underlying this complex, devastating, and rapidly increasing chronic disorder. However, research in western populations with DM 2 is limited, and rigorous, systematic studies regarding the effects of yoga on physiological, anthropometric, and psychological profiles in diabetic adults are lacking. The proposed pilot study will use a randomized controlled design to investigate the effects of an 8 week structured Iyengar yoga program on insulin sensitivity and other related metabolic and psychological indices of CVD risk in adults with Type 2 diabetes. Participants will be 46 patients aged 50-75 who have an established diagnosis of DM 2 and are enrolled in the UVA Diabetes Education and Management Program (DEMP). Eligible participants will be randomized into yoga or control groups, stratified on gender and race/ethnicity. Our primary aim is to evaluate the effects of Iyengar yoga on change in insulin sensitivity as estimated by the QUICKI, a measure that combines excellent reliability and validity with minimal subject burden. Our secondary aims are: 1) to assess the effects of yoga on other markers of insulin resistance (fasting glucose, insulin, glycated hemoglobin, fructosamine, post-prandial glucose), and related CVD risk indices, including measures of sympathetic activation, dyslipidemia, endothelial function, inflammation, coagulopathy, visceral adiposity, insulin-like growth factor bioavailability, psychological morbidity, and sleep disturbance; and 2) to evaluate and optimize the overall protocol design, including recruitment, and retention rates, protocol adherence, and instrument burden in both minority and non-minority participants. The intervention will comprise 8 weeks of structured Iyengar yoga training, including two 90-minute classes/week in addition to daily directed yoga practice at home. All participants will continue to receive usual care and to participate in the DEMP program. Controls will also receive coupons for 6 yoga classes upon completion of the study. Before and after the 8 week treatment period, fasting blood samples will be collected, and specific markers of insulin sensitivity and other physiological, anthropometric, and psychological indices associated with insulin resistance and DM 2 will be measured. Findings of this study will 1) provide critical preliminary and feasibility data to support larger, multi-ethnic randomized clinical trials investigating the influence of yoga practice on insulin resistance and related metabolic and psychologic indices in older adults with type 2 diabetes; and 2) yield important preliminary information on the potential utility of yoga in managing DM 2.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 2型糖尿病（DM 2）是一种与胰岛素抵抗综合征（IRS）密切相关的严重，慢性，年龄相关的疾病，是美国的死亡和残疾的主要原因，并且在全国和全球范围内迅速达到流行比例。 越来越多的证据表明，瑜伽可能为DM 2的管理和预防心血管后遗症提供了特别的希望，并且可以提供一种安全且具有成本效益的方法，以解决这种复杂，破坏性且快速增加慢性疾病的多重相互关联的因素。然而，缺乏关于瑜伽对糖尿病成年人生理，人体测量学和心理特征的影响的DM 2的研究有限，并且严格的系统研究。 拟议的试点研究将使用随机控制的设计来研究一个为期8周的IYENGAR瑜伽计划对2型糖尿病的成年人中CVD风险的胰岛素敏感性以及其他相关代谢性和心理指数的影响。 参与者将是46名50-75岁的患者，他们的诊断为DM 2，并参加了UVA糖尿病教育和管理计划（DEMP）。 符合条件的参与者将被随机分为瑜伽或对照组，并根据性别和种族/种族分层。 我们的主要目的是评估Iyengar瑜伽对QuickI估计的胰岛素敏感性变化的影响，该措施将出色的可靠性和有效性与最小的受试者负担结合在一起。 Our secondary aims are: 1) to assess the effects of yoga on other markers of insulin resistance (fasting glucose, insulin, glycated hemoglobin, fructosamine, post-prandial glucose), and related CVD risk indices, including measures of sympathetic activation, dyslipidemia, endothelial function, inflammation, coagulopathy, visceral adiposity, insulin-like生长因子生物利用度，心理发病率和睡眠障碍； 2）评估和优化总体协议设计，包括少数和非少数族裔参与者的招聘率，保留率，协议依从性以及仪器负担。 该干预措施将包括8周的结构化Iyengar瑜伽培训，包括每周在家中进行的两个90分钟/周的课程。所有参与者将继续接受常规护理并参加DEMP计划。 研究完成后，控件还将获得6个瑜伽课的优惠券。 在8周治疗期之前和之后，将收集空腹血液样本，并测量胰岛素敏感性和其他生理，人体测量值以及与胰岛素抵抗和DM 2相关的心理指标的特定标记。 这项研究的结果将1）提供关键的初步和可行性数据，以支持更大的多种族随机临床试验，研究了瑜伽实践对2型糖尿病老年人的瑜伽疗法对胰岛素抵抗以及相关代谢和心理指数的影响； 2）产生有关瑜伽在管理DM 2中潜在效用的重要初步信息。