Worksite Wellness Interventions on Vascular Function, Insulin Sensitivity , HDL

针对血管功能、胰岛素敏感性、HDL 的工作现场健康干预

基本信息

批准号：
8344796
负责人：
Richard Cannon
金额：
$ 109.69万
依托单位：
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/8344796
关键词：
Age Antioxidants Apolipoproteins B Arginine Asians Biological Assay Biological Markers Blood Blood Vessels Body Composition Body Weight decreased Body mass index Businesses C-reactive protein Cardiovascular system Cells Cessation of life Cholesterol Chronic Citrulline Counseling Coupled Data Reporting Diet Dual-Energy X-Ray Absorptiometry Employee Endothelial Cells Enrollment Environment Epidemic Exercise Exercise Tolerance Fasting Fatty acid glycerol esters Food Glucose Health Benefit Health Care Costs High Density Lipoprotein Cholesterol High Density Lipoproteins Hispanics Home environment Hormonal Hyperinsulinism Incentives Incubated Insulin Insulin Resistance Intake Intervention LDL Cholesterol Lipoproteins Label Lower Extremity Measurement Measures Mediating Menopause Minority Modeling Muscle National Heart, Lung, and Blood Institute Nutritional Obesity Overweight Oxygen Consumption Paraoxonase 1 Participant Performance Plasma Population Population Study Productivity Property Protocols documentation Randomized Reactive Oxygen Species Relative (related person)Research Personnel Resistance Resources Risk Risk Reduction Sampling Serum Societies Structure Testing United States National Institutes of Health Wellness Program Woman Work Workplace adipokines arterial stiffness brachial artery cardiovascular disorder risk cardiovascular risk factor cohort diabetic fitness human NOS3 protein improved indexing inflammatory marker insulin sensitivity mortality muscle form non-diabetic programs racial difference sedentary shear stress weight loss intervention

项目摘要

While more likely to be obese than white women, black women have greater muscle mass than whites. In addition, black women have more resistance to insulin-mediated glucose utilization in muscle. Whether the combination of both high lean mass (LM), insulin resistance and chronic hyperinsulinemia leads to a race difference in exercise performance is unknown. One hundred forty non-diabetic sedentary overweight women 64% black; age 4511 years (meanSD), body mass index (BMI) range 25.3 to 57.7 kg/m2 underwent body composition measurements by dual-energy X-ray absorptiometry. Insulin sensitivity index (SI) was calculated from the minimal model, and chronic insulin exposure by fasting insulin level. Exercise performance was measured by peak oxygen consumption (VO2 peak) during graded treadmill exercise.Both total body LM (49.76.6 vs 44.86.2 kg, P<0.001) and lower extremity LM (18.32.9 vs 15.92.5 kg, P<0.001) were greater in blacks than whites, even after adjustment for BMI or total fat mass. SI was lower in blacks than whites (3.11.8 vs 4.72.7 L.U-1min-1, P< 0.001): Lower SI was negatively (r= -0.505, r= -0.342) and higher fasting insulin was positively (r= 0.428, r= 0.428) associated with increased total body and lower extremity LM in blacks (all P<0.01), but did not achieve statistical significance in whites. Blacks had reduced VO2 peak (21.34.6 vs 26.34.8 ml/kg/min, P< 0.001) than whites: both total body (beta= -0.15, P=0.004) and lower extremity LM (beta= -0.47, P=0.002) were independently predictive of reduced VO2 peak in black women, even when age, relative fat mass load and SI were entered into the multiple regression model. By contrast, neither LM was independently predictive of VO2 peak in white women. Thus, overweight black women had more LM, associated with greater chronic insulin exposure, but lower exercise performance than white women. The contributions of hyperinsulinemia to LM and poor exercise tolerance in black women need to be explored. Diet-induced weight loss in overweight women may be associated with decreases not only in total cholesterol and low-density lipoprotein cholesterol (LDL-C), but also in high-density lipoprotein cholesterol (HDL-C) levels. Whether a decrease in HDL-C level is associated with altered HDL function is unknown.One hundred overweight women (60 black, 35 white, 3 Asian, 2 Hispanic; 12 diabetic; age 46 11 years; BMI 33.5 6.1 kg/m2) were enrolled in a six month worksite wellness program, which included a reduced fat and total energy diet and low-intensity exercise to achieve weight loss. Serum cholesterol efflux capacity was measured by incubating 1% apolipoprotein B-depleted serum with 3H-cholesterol-labeled BHK cells expressing ABCA1, ABCG1 or SR-B1 transporters. Antioxidant properties of HDL were estimated by paraoxonase-1 (PON1) activity and the oxygen radical absorbance capacity (ORAC). Endothelial nitric oxide synthase (eNOS) activation was measured by incubating HDL from 49 subjects with cultured endothelial cells and by measuring conversion of L-arginine to L-citrulline. All baseline and six month samples were assayed in pairs. Data are reported as mean value SD. Participants achieved an average weight loss of 2.2 3.9 kg (P<0.001), associated with reductions in all plasma cholesterol values: total cholesterol: -11 24 mg/dL, P<0.001; LDL-C: -6 21 mg/dL, P=0.004; HDL-C: -3 9 mg/dL, P=0.016. Cholesterol efflux capacity by the ABCA1 transporter decreased by 10% (P=0.006); efflux capacities by the ABCG1 and SR-B1 transporters were not significantly altered (both <2%, P>0.736). ORAC decreased by 15% (P=0.018); neither PON1 activity (+1%, P=0.314) nor eNOS activation (-5%, p=0.174) was significantly altered by reduction in HDL-C.Weight loss in overweight women is associated with significant decrease in cholesterol levels, including HDL-C, but small changes in HDL-mediated cholesterol efflux capacity, oxidative protection and eNOS activation.

虽然黑人女性比白人女性更容易肥胖，但黑人女性的肌肉质量却比白人更大。此外，黑人女性对肌肉中胰岛素介导的葡萄糖利用具有更强的抵抗力。高瘦体重（LM）、胰岛素抵抗和慢性高胰岛素血症的结合是否会导致运动表现的种族差异尚不清楚。一百四十名非糖尿病久坐超重女性中 64% 是黑人；年龄 4511 岁（平均值 SD），体重指数（BMI）范围为 25.3 至 57.7 kg/m2，通过双能 X 射线吸收法进行身体成分测量。胰岛素敏感性指数（SI）是根据最小模型计算的，慢性胰岛素暴露是根据空腹胰岛素水平计算的。运动表现通过分级跑步机运动期间的峰值耗氧量（VO2峰值）来衡量。全身LM（49.76.6 vs 44.86.2 kg，P<0.001）和下肢LM（18.32.9 vs 15.92.5 kg，P） <0.001）在黑人中比白人更高，即使在调整了 BMI 或总脂肪量后也是如此。黑人的 SI 低于白人（3.11.8 vs 4.72.7 L.U-1min-1，P< 0.001）：较低的 SI 为负值（r= -0.505，r= -0.342），较高的空腹胰岛素为正值（r= 0.428，r= 0.428）与黑人全身和下肢 LM 增加相关（所有P<0.01），但在白人中没有达到统计学显着性。黑人的摄氧量峰值（21.34.6 vs 26.34.8 ml/kg/min，P < 0.001）比白人低：全身（β = -0.15，P = 0.004）和下肢 LM（β = -0.47，P =0.002）可以独立预测黑人女性摄氧量峰值的降低，即使将年龄、相对脂肪量负荷和 SI 纳入其中多元回归模型。相比之下，这两种 LM 都不能独立预测白人女性的摄氧量峰值。因此，超重的黑人女性有更多的 LM，与更多的慢性胰岛素暴露相关，但运动表现比白人女性低。需要探讨高胰岛素血症对 LM 和黑人女性运动耐量差的影响。超重女性饮食引起的体重减轻可能不仅与总胆固醇和低密度脂蛋白胆固醇（LDL-C）的降低有关，而且还与高密度脂蛋白胆固醇（HDL-C）水平的降低有关。 HDL-C 水平降低是否与 HDL 功能改变相关尚不清楚。对 100 名超重女性（60 名黑人、35 名白人、3 名亚洲人、2 名西班牙裔；12 名糖尿病患者；年龄 46±11 岁；BMI 33.5±6.1 kg/m2）进行了研究参加了为期六个月的工作场所健康计划，其中包括减少脂肪和总能量的饮食以及低强度运动以实现减肥。通过将 1% 载脂蛋白 B 耗尽的血清与表达 ABCA1、ABCG1 或 SR-B1 转运蛋白的 3 H-胆固醇标记的 BHK 细胞一起孵育来测量血清胆固醇流出能力。 HDL 的抗氧化特性通过对氧磷酶 1 (PON1) 活性和氧自由基吸收能力 (ORAC) 来评估。通过将 49 名受试者的 HDL 与培养的内皮细胞一起孵育，并测量 L-精氨酸到 L-瓜氨酸的转化，测量内皮一氧化氮合酶 (eNOS) 激活。所有基线和六个月样本均成对进行分析。数据以平均值 SD 报告。参与者的平均体重减轻了 2.2 ± 3.9 kg (P<0.001)，与所有血浆胆固醇值的降低相关：总胆固醇：-11 ± 24 mg/dL，P<0.001； LDL-C：-6 21 mg/dL，P=0.004； HDL-C：-3 9 毫克/分升，P=0.016。 ABCA1转运蛋白的胆固醇流出能力下降10%（P=0.006）； ABCG1 和 SR-B1 转运蛋白的外排能力没有显着改变（均<2%，P>0.736）。 ORAC下降15%（P=0.018）； HDL-C 的降低不会显着改变 PON1 活性（+1%，P=0.314）和 eNOS 激活（-5%，p=0.174）。超重女性的体重减轻与胆固醇水平（包括 HDL）的显着降低相关-C，但 HDL 介导的胆固醇流出能力、氧化保护和 eNOS 激活的变化很小。