CRP AND ADIPONECTIN AS MARKERS FOR INSULIN RESISTANCE

CRP 和脂联素作为胰岛素抵抗的标志物

• 批准号: 7720624
• 负责人: Yuan-Xiang Meng
• 金额: $ 15.61万
• 依托单位: MOREHOUSE SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7720624
• 关键词: African American; Ambulatory Care; American; Area; Biological Assay; Biological Markers; C-reactive protein; Cells; Clinical; Clinical Research; Computer Retrieval of Information on Scientific Projects Database; Daily; Diabetes Mellitus; Diagnosis; Disease; Dyslipidemias; Early identification; Epidemiologic Studies; Ethnic group; Funding; Goals; Grant; Hypertension; Image Analysis; Individual; Inflammation; Inflammatory; Institution; Insulin; Insulin Resistance; Intervention; Lead; Measures; Methods; Morbidity - disease rate; Non obese; Obesity; Plasma; Population; Predictive Value; Predictive Value of Tests; Primary Prevention; ROC Curve; Race; Research; Research Personnel; Resources; Sampling; Source; Testing; Therapeutic; United States National Institutes of Health; Vascular Diseases; adiponectin; atherogenesis; base; caucasian American; clinically significant; cysteine rich protein; improved; indexing; intravenous glucose tolerance test; mortality; non-diabetic; validation studies

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 goal of the study is to determine whether biomarkers such as the high sensitivity C-reactive protein (Hs CRP) and adiponectin can be used as clinically useful assays for insulin resistance (IR) in non-diabetic, obese and non-obese African Americans (AA) and Caucasian Americans (CA). IR is a disorder in which the cells do not use insulin properly. Experimental and epidemiological studies have demonstrated the strong associations among IR and a variety of diseases, including vascular diseases (e.g., hypertension, CHD, and CVA), dyslipidemia, diabetes (DM), systemic inflammation, and atherogenesis. Although IR can be measured by a variety of methods, there are no clear cut-offs for the diagnosis of IR and most of methods are difficult to apply in daily clinical practice, in particular, for outpatient care settings. In this project, we hypothesize that CRP is positively correlated to adiposity and IR (a "pro-inflammatory" state) whereas adiponectin is inversely correlated to adiposity and IR in non-diabetic AA and CA. The predictive value of clinically useful biomarker indices, such as CRP and adiponectin, is different in the two ethnic populations. The specific aims of the study are: 1) Establish the relationship between CRP and adiponectin plasma levels with simple assays of IR (eg HOMA) in a randomly ascertained, population-based sample of non-diabetic, obese and non-obese subjects composed of both AA and CA in the metro-Atlanta area. 2) Test the hypothesis that the relationship between CRP and adiponectin plasma levels with IR differs in AA versus CA. 3) Utilize a ROC analysis to determine cut-points for CRP or adiponectin levels that distinguish subjects with clinically significant and non-significant IR in each race/ethnic group. 4) Perform a pilot validation study to test the predictive value of CRP and adiponectin for IR by using the frequently-sampled intravenous glucose tolerance test (FSIGT)) in a subset of our population-based sample in the controlled setting of the Clinical Research Center. This study may lead to the early identification of individuals with IR using a simplified practical approach. It will help us to develop new strategies for primary prevention of CHD, CVA, and DM. The interventions aimed at improving IR may provide additional therapeutic benefits to reduce the morbidity and mortality of CVA and DM.

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。 该研究的目的是确定生物标志物（例如高灵敏度C反应蛋白（HS CRP）和脂联蛋白是否可以用作非糖尿病，肥胖和非肥胖的非洲裔美国人（AA）和CAUCASIAN美国人（CA）中胰岛素抵抗（IR）的临床有用测定。 IR是一种细胞无法正确使用胰岛素的疾病。实验和流行病学研究表明，IR和多种疾病之间的牢固关联，包括血管疾病（例如高血压，CHD和CVA），血脂异常，糖尿病（DM），全身炎症和动脉粥样硬化。尽管IR可以通过多种方法来衡量，但尚无明确的IR诊断，并且大多数方法很难在日常临床实践中，尤其是用于门诊护理环境中。在这个项目中，我们假设CRP与肥胖和IR（一种“促炎”状态）呈正相关，而脂联素与非糖尿病AA和CA中的肥胖和IR成反比。在两个种族人群中，临床上有用的生物标志物指数（例如CRP和脂联素）的预测价值不同。该研究的具体目的是：1）在一个随机确定的，基于人群的非糖尿病，肥胖和非肥胖受试者的样本中，建立了CRP和脂联素等离子体水平之间的关系，以IR（例如HOMA）的简单测定。 2）检验以下假设：在AA与CA中，CRP与脂联素血浆水平之间的关系不同。 3）利用ROC分析来确定CRP或脂联素水平的切点，这些降低是在每个种族/种族组中区分具有临床意义和不显着性IR的受试者。 4）执行一项试验验证研究，通过在临床研究中心的受控环境中，使用经常采样的静脉葡萄糖耐受性测试（FSIGT）来测试IR的CRP和脂联素对IR的预测价值。这项研究可能导致使用简化的实际方法对患有IR的个体进行早期识别。它将帮助我们制定新的冠心病，CVA和DM的新策略。旨在改善IR的干预措施可能会提供额外的治疗益处，以降低CVA和DM的发病率和死亡率。