Community Exercise and Metabolic Syndrome in Black Families

黑人家庭的社区锻炼和代谢综合症

• 批准号: 7650085
• 负责人: Diane M. Becker
• 金额: $ 79.19万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-02 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7650085
• 关键词: Address; Adherence; Adult; Aerobic; Aerobic Exercise; Affect; Affective; African American; Age-Years; Biological; Biological Markers; Blood Pressure; Blood Vessels; Body Composition; Body fat; Brothers; C-reactive protein; Characteristics; Cholesterol; Clinical; Cognitive Science; Communities; Community Health; Community Trial; Coronary Arteriosclerosis; Coronary heart disease; Counseling; Diet; Dietitian; Dilatation - action; Dual-Energy X-Ray Absorptiometry; Education; Effectiveness; Elements; Emotional; Exercise; Family; Fasting; Focus Groups; Friends; Fright; Goals; Guidelines; Health; High Density Lipoprotein Cholesterol; Impaired fasting glycaemia; Individual; Inflammatory; Insulin; Insulin Resistance; Intervention; Interview; LDL Cholesterol Lipoproteins; Life Style; Lipids; Measures; Mediating; Metabolic; Metabolic syndrome; Modeling; Outcome; Participant; Patients; Pattern; Performance; Persuasive Communication; Pharmacotherapy; Physical Fitness; Physical activity; Plasma; Population; Prevalence; Primary Prevention; Proxy; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Recording of previous events; Relative (related person); Research; Resistance; Risk; Risk Factors; Sampling; Self Efficacy; Self-control as a personality trait; Siblings; Sister; Site; Syndrome; Testing; Training; Translations; Treatment Protocols; Triglycerides; Vascular Diseases; Work; abdominal fat; base; brachial artery; cardiovascular risk factor; clinically significant; community intervention; control trial; design; disorder risk; efficacy research; fitness; follow-up; high risk; human old age (65+); improved; lifestyle factors; meetings; muscle form; non-diabetic; physiologic model; premature; programs; role model; sedentary; self help; social; social cognitive theory; strength training

DESCRIPTION (provided by applicant): Black Americans who have a sibling < 60 years of age with premature coronary artery disease (CAD) have an increased risk of developing CAD themselves, and a marked excess prevalence of all cardiovascular risk factors, particularly the metabolic syndrome, which is a potent CAD precursor in this high-risk population. Sedentary lifestyle is associated with the metabolic syndrome and its vascular disease substrate. Moderate- intensity exercise is known to abolish metabolic syndrome risk factors in well-controlled research settings. However, habitual moderate intensity exercise is difficult to achieve among high-risk Black Americans. We propose a community-based coach-mediated intervention to achieve regular resistance and aerobic activity of sufficient intensity to ameliorate risk factors and reduce the prevalence of the metabolic syndrome. We will test a strategy to engage participants exercise based on: 1) an effectiveness hypothesis, that one year of a guided exercise program provided in the community and implemented by a trained coach from the community will result in a significant improvement in physical fitness and exercise adherence, and 2). an efficacy hypothesis that the community intervention will result in a significant reduction in individual CAD risk factors, particularly metabolic risk factors, and will be accompanied by improvement in "vascular health" in Black American non-CAD nondiabetic individuals with the metabolic syndrome. We will use a randomized trial of the community-based exercise intervention (C-FIT) compared to a self-help exercise (SELF) control intervention using culturally sensitive materials and referral to community exercise sites. The sample will be comprised of 200 already identified < 65 year old unaffected brothers and sisters of premature CAD patients accrued within the past 10 years. The outcomes at 6 months, 1- and 2-years include changes in habitual physical activity and aerobic and strength fitness, body composition, insulin resistance syndrome, high sensitivity C-reactive protein, blood pressure and lipids levels. Endpoints also include a proxy for improved vascular health and conversion from having the metabolic syndrome to normal. The analysis will use regression adjustment for the baseline level of the dependent variables using mixed-model analysis of covariance (MM-ANCOVA). The integration of biological and social cognitive science frameworks allows translation of exercise efficacy research findings to the "real world" to achieve exercise of sufficient intensity to moderate metabolic risk factors that are prevalent in high risk Black American families. This study is designed to determine the impact of a community-based personal trainer model over a year of moderate intensity aerobic fitness and strength training on the metabolic syndrome and its components in high risk people from African Americans with premature coronary disease. Outcomes will include changes in factors that affect cardiovascular risk. Long term-outcomes will be examined at 1 and 2 years.

描述（由申请人提供）：患有早产冠状动脉疾病（CAD）的黑人美国人患有冠状动脉疾病（CAD）的风险增加，并且明显的过度患病率是所有心血管危险因素，尤其是代谢综合征，尤其是这种高危人群中有效的CAD前体。久坐的生活方式与代谢综合征及其血管疾病底物有关。在良好控制的研究环境中，已知中等强度的运动是消除代谢综合征风险因素。但是，在高风险的黑人美国人中很难实现习惯性中等强度运动。我们提出了一个基于社区的教练介导的干预措施，以实现足够强度的定期抵抗和有氧活动，以减轻危险因素并降低代谢综合征的患病率。我们将测试一项基于以下基础的参与者练习的策略：1）有效性假设，即社区提供的一年指导性运动计划并由社区训练有素的教练实施，将显着改善身体健康和锻炼的依从性，以及2）。一个有效性假设，即社区干预将显着减少单个CAD危险因素，尤其是代谢危险因素，并将伴随着黑人美国非CAD非CAD非糖尿病患者的“血管健康”的改善。与使用文化敏感的材料并将其转介到社区运动地点相比，我们将使用基于社区的运动干预（C-FIT）的随机试验（C-FIT）。该样本将包括200名已经确定的<65岁的未受影响的过早CAD患者的兄弟姐妹。 6个月，1和2年的结果包括习惯性体育锻炼，有氧运动和力量适应性，身体组成，胰岛素抵抗综合征，高灵敏度C反应蛋白，血压和脂质水平。终点还包括改善血管健康和从代谢综合征到正常的转化率的代理。该分析将使用混合模型协方差分析（MM-Ancova）对因变量的基线水平进行回归调整。生物学和社会认知科学框架的整合允许将运动功效研究结果转化为“现实世界”，以实现足够的强度，以适应高风险黑人美国家庭中普遍存在的代谢危险因素。这项研究旨在确定一年中中等强度的有氧健身和力量训练对代谢综合征及其成分的高风险人群中，来自非洲裔美国人患有早产冠状动脉疾病的高风险人群的影响。结果将包括影响心血管风险的因素的变化。长期外观将在1年和2年期间检查。