Heart Disease Risk Factors In African Americans

非裔美国人的心脏病危险因素

• 批准号: 7593612
• 负责人: Anne E Sumner
• 金额: $ 24.02万
• 依托单位: NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
• 依托单位国家: 美国
• 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/7593612
• 关键词: Accounting; Affect; African American; Age; Agreement; Attention; Biological; Body Size; Body fat; Body mass index; Cardiovascular Diseases; Central obesity; Characteristics; Cholesterol; Complex; Data; Data Set; Development; Diabetes Mellitus; Diagnosis; Disease; Education; Ethnic Origin; Failure; Fasting; Fatty acid glycerol esters; Glucose; Glucose Intolerance; Goals; Guidelines; Health; Health Personnel; Height; High Density Lipoprotein Cholesterol; Hormones; Hour; Hyperglycemia; Hypertension; Hypertriglyceridemia; Individual; Insulin; Insulin Resistance; Intravenous; Investigation; Lipids; Measures; Metabolic syndrome; Methods; Mexican Americans; Modeling; Modification; National Health and Nutrition Examination Survey; Nonesterified Fatty Acids; Obesity; Participant; Prevalence; Protocols documentation; Range; Research; Risk; Risk Factors; Sampling; Surveys; Testing; Triglycerides; Variant; Weight; Woman; Work; base; cardiovascular risk factor; cohort; density; design; ethnic difference; heart disease risk; indexing; mathematical model; men; model development; non-diabetic; nutrition; particle; programs; waist circumference

One hundred eighty-two nondiabetic African-Americans (74 Men, 108 Women) have participated. The age range of the participants is 20 to 50 years. This sample of African Americans can be considered representative because the prevalence of obesity (43%), glucose intolerance (22%) and hypertension (21%) is similar to NHANES data. NHANES stands for National Health and Nutrition Examination and is a nationwide survey with thousands of participants. The participants range from very lean to very obese. The mean body mass index of participants is 30.6 kg/m2 (range 18.5 54.7). Body mass index is a mathematical method used to correct weight for height. Due to the broad range of body mass index in the participants it is possible to make conclusions about the relationship of body size to insulin resistance. We have found in African American men that a waist circumference of 102 cm in men predicts both insulin resistance and obesity. Therefore we are completely in agreement with the National Cholesterol Education Program values for whites. However, in African American women we found that a waist circumference of 98 cm predicted both insulin resistance and obesity. Based on investigations in white women the National Cholesterol Education Program recommends that a waist circumference threshold of 88 cm be used. Therefore our work demonstrates the need for ethnic specific modifications of guidelines in women. Elevated TG and low HDL are considered lipid hallmarks of insulin resistance. However while elevated TG is a marker of insulin resistance in whites, we have shown that TG is not a marker of insulin resistance in African Americans. The investigation of the relationship of TG to insulin resistance has become such an important component of this research, that the cohort of African Americans participating in this protocol are now known as TARA for Triglyceride and Cardiovascular Risk in African Americans. Results from TARA were so impressive that the hypothesis that TG was not a marker of insulin resistance in African Americans was tested in NHANES data from 1999-2001. In this nationwide data set of whites, African Americans and Mexican Americans, the fact that TG was not a marker of insulin resistance was confirmed. However, TG was a marker of insulin resistance in whites and Mexican Americans. Again this demonstrates the need for ethnic specific guidelines. This work with NHANES was in press. To develop an index of free fatty acid sensitivity to insulin, we are working with mathematicians. The modeling is underway. The modeling of the influence of insulin on glucose levels was done in the nineteen eighties by Richard N. Bergman and colleagues. Because of the multiplicity of hormones that affect free fatty acid levels as well as the much wider range of biological variation in free fatty acids than glucose, achieving a model of the effect of insulin on free fatty acids is an even greater challenge. To achieve a model 150 participants in TARA have had frequently sampled intravenous glucose tests with glucose, insulin and free fatty acids levels determined at 36 timepoints in a 3 to 6 hour period. The complex multicompartment modeling is underway.

一百八十二十名非糖尿病非裔美国人（74名男性，108名女性）参加了比赛。参与者的年龄范围为20至50岁。这种非裔美国人样本可以被认为是代表性的，因为肥胖症的患病率（43％），葡萄糖不耐症（22％）和高血压（21％）与NHANES数据相似。 NHANES代表国家健康和营养考试，是一项与成千上万参与者的全国性调查。参与者的范围从非常苗条到非常肥胖。参与者的平均体重指数为30.6 kg/m2（范围18.5 54.7）。体重指数是一种用于纠正高度重量的数学方法。由于参与者的体重指数广泛，因此可以得出关于体大小与胰岛素抵抗的关系的结论。我们在非洲裔美国人中发现，男性102厘米的腰围预测胰岛素抵抗和肥胖。因此，我们完全同意白人国家胆固醇教育计划的价值观。但是，在非洲裔美国妇女中，我们发现98厘米的腰围预测了胰岛素抵抗和肥胖。根据对白人妇女的调查，国家胆固醇教育计划建议使用88厘米的腰围阈值。因此，我们的工作表明了对妇女指南的特定于种族特定修改的必要性。 升高的TG和低HDL被认为是胰岛素抵抗的脂质标志。但是，尽管TG升高是白人胰岛素抵抗的标志，但我们已经表明，TG不是非裔美国人胰岛素抵抗的标志。对TG与胰岛素抵抗关系的关系的调查已成为这项研究的重要组成部分，以至于参与该方案的非裔美国人队列现在被称为非洲裔美国人的甘油三酸酯和心血管风险的Tara。塔拉（Tara）的结果令人印象深刻，以至于从1999 - 2001年的NHANES数据中测试了TG不是非裔美国人胰岛素抵抗标志的假设。在这个全国范围内的白人，非裔美国人和墨西哥裔美国人的数据集中，TG并不是胰岛素抵抗的标志，这一事实得到了证实。但是，TG是白人和墨西哥裔美国人胰岛素抵抗的标志。同样，这表明了对民族特定准则的必要性。 NHANES的这项工作在印刷中。 为了发展自由脂肪酸对胰岛素敏感性的指数，我们正在与数学家合作。建模正在进行中。理查德·N·伯格曼（Richard N.由于影响游离脂肪酸水平的多种激素以及游离脂肪酸的生物学变化范围比葡萄糖的范围更大，因此实现了胰岛素对游离脂肪酸的影响模型，这是一个更大的挑战。为了实现型号，塔拉的150名参与者经常用葡萄糖，胰岛素和游离脂肪酸水平在3至6小时内确定在36个时点确定的静脉注射葡萄糖测试。复杂的多截面建模正在进行中。