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: 7606707
• 负责人: KAREN-KIM E INNES
• 金额: $ 1.43万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2008-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7606707
• 关键词: Address; Adherence; Adult; Biological Availability; Blood Coagulation Disorders; Blood specimen; Cardiovascular system; Caring; Cause of Death; Chronic; Chronic Disease; Class; Classification; Complex; Computer Retrieval of Information on Scientific Projects Database; Control Groups; Daily; 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; Rate; Research; Research Personnel; Resources; Risk; Sleep disturbances; Somatomedins; Source; Structure; Syndrome; Training; United States; United States National Institutes of Health; Validity and Reliability; Visceral; Week; Yoga; age related; aged; cardiovascular risk factor; cost; design; diabetes education; diabetic; disability; eligible participant; indexing; instrument; insulin sensitivity; programs; psychologic; 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. Research in western populations with DM 2 is limited, however 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.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 2 型糖尿病 (DM 2) 是一种严重、慢性、与年龄相关的疾病，与胰岛素抵抗综合征 (IRS) 密切相关，是美国死亡和残疾的主要原因，并且在美国和全国范围内迅速达到流行病的程度。全球。 越来越多的证据表明，瑜伽可能为 2 型糖尿病的治疗和心血管后遗症的预防带来特殊希望，并可能提供一种安全且经济有效的方法来解决这种复杂、破坏性且迅速增加的慢性疾病背后的多种相互关联的因素。 。然而，针对西方 2 型糖尿病人群的研究有限，并且缺乏关于瑜伽对成人糖尿病患者生理、人体测量和心理特征的影响的严格、系统的研究。 拟议的试点研究将采用随机对照设计来调查为期 8 周的结构化艾扬格瑜伽计划对 2 型糖尿病成人患者的胰岛素敏感性以及 CVD 风险的其他相关代谢和心理指标的影响。 参与者将是 46 名年龄在 50-75 岁之间、确诊为 DM 2 并参加 UVA 糖尿病教育和管理计划 (DEMP) 的患者。 符合资格的参与者将被随机分为瑜伽组或对照组，并按性别和种族/民族分层。 我们的主要目的是评估艾扬格瑜伽对 QUICKI 估计的胰岛素敏感性变化的影响，QUICKI 是一种结合了出色的可靠性和有效性以及最小受试者负担的测量方法。 我们的次要目标是：1）评估瑜伽对胰岛素抵抗其他标志物（空腹血糖、胰岛素、糖化血红蛋白、果糖胺、餐后血糖）和相关心血管疾病风险指数的影响，包括交感神经激活、血脂异常、内皮功能、炎症、凝血病、内脏肥胖、胰岛素样生长因子生物利用度、心理疾病和睡眠障碍； 2) 评估和优化总体方案设计，包括少数族裔和非少数族裔参与者的招募和保留率、方案遵守情况以及仪器负担。 干预措施将包括为期 8 周的结构化艾扬格瑜伽训练，除了每天在家进行定向瑜伽练习外，还包括每周两节 90 分钟的课程。所有参与者将继续接受常规护理，并参加 DEMP 计划。 完成研究后，对照组还将获得 6 节瑜伽课程的优惠券。 在8周治疗期之前和之后，将收集空腹血样，并测量胰岛素敏感性的特定标志物以及与胰岛素抵抗和DM 2 相关的其他生理、人体测量和心理指标。 这项研究的结果将：1）提供关键的初步和可行性数据，以支持更大规模的多种族随机临床试验，调查瑜伽练习对患有 2 型糖尿病的老年人的胰岛素抵抗以及相关代谢和心理指标的影响； 2) 提供有关瑜伽在管理 DM 2 中的潜在效用的重要初步信息。