DIABETES, DEPRESSION, & CORONARY HEART DISEASE

糖尿病、抑郁症、

基本信息

批准号：
7719097
负责人：
JULIE A WAGNER
金额：
$ 0.74万
依托单位：
UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-04-01 至 2009-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7719097
关键词：
Adrenergic beta-Antagonists Age Alcohol consumption Angiotensin-Converting Enzyme Inhibitors Antihypertensive Agents Blood Pressure C-reactive protein Circadian Rhythms Computer Retrieval of Information on Scientific Projects Database Coronary heart disease Cross-Sectional Studies Data Diabetes Mellitus Dyslipidemias Endothelium Factor VIII-Related Antigen Funding Grant Heart Diseases Hemostatic Agents High Density Lipoprotein Cholesterol Hip region structure Hydrocortisone Individual Inflammatory Institution Lipids Mediating Mental Depression Microalbuminuria Non-Insulin-Dependent Diabetes Mellitus Participant Physical activity Postmenopause Production Proteins Publishing Recording of previous events Research Research Design Research Personnel Resources Risk Risk Factors Salivary Sampling Smoking History Source Testing Triglycerides United States National Institutes of Health VWF gene Woman bone brachial artery design heart disease risk hypothalamic-pituitary-adrenal axis indexing von Willebrand Factor

项目摘要

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. Diabetes and depression both independently put women at increased risk for coronary heart disease (CHD). Thus, a better understanding of how these risk factors interact is crucial to our understanding of heart disease in women. One hypothesized mechanism for the depression-diabetes-CHD relationship is the Hypothalamic-Pituitary-Adrenal (HPA) axis and cortisol production. Currently, no data have been published that look at these variables in concert. Thus, it is unclear if they each convey an individual risk that becomes additive when combined, or if they interact to convey multiplicative risk. The study being proposed is a cross sectional study of depression, diabetes, and CHD risk in women. The research design is a 2X2 factorial design. The sample will consist of 80 age-matched postmenopausal women. The independent variables are 1) presence of a history of depression (yes or no), and 2) T2DM status (yes or no). The dependent variables are salivary cortisol levels, lipids (total cholesterol, HDL subfractions, and triglycerides), waist-to-hip ratio, brachial artery flow mediated dilation, hemostatic indicator (vWF), inflammatory marker (c-reactive protein), microalbuminuria, and blood pressure. Variables that will be controlled for include BMI (Bone Mass Index), lipid lowering agents, beta blockers, ACE inhibitors, antihypertensive agents, and history of smoking, physical activity, and alcohol use. Three hypotheses will be tested: 1) There will be a main effect for diabetes, such that participants with diabetes will show higher WHR, blood pressure, vWf, C-Reactive Protein (CRP), dyslipidemia, microalbuminuria, and more impaired endothelium dependent brachial reactivity (EDBR) than those without diabetes; 2) There will be a main effect for history of depression, such that participants a positive history will show higher WHR, blood pressure, vWf, CRP, microalbuminuria, more impaired EDBR, and a flatter cortisol pulsatile circadian rhythm than those with a negative history; 3) there will be an interaction between history of depression and diabetes, such that participants with both diabetes and positive history of depression will show higher WHR, blood pressure, vWf, CRP, and more impaired EDBR, than those with only history of depression or diabetes.

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。糖尿病和抑郁症都会独立增加女性患冠心病 (CHD) 的风险。因此，更好地了解这些危险因素如何相互作用对于我们了解女性心脏病至关重要。抑郁症-糖尿病-冠心病关系的一种假设机制是下丘脑-垂体-肾上腺（HPA）轴和皮质醇的产生。目前，尚未发布综合考虑这些变量的数据。因此，尚不清楚它们是否各自传达了一种单独的风险，当组合时该风险会变得相加，或者它们是否相互作用以传达乘性风险。拟议的研究是一项针对女性抑郁症、糖尿病和冠心病风险的横断面研究。研究设计是 2X2 因子设计。样本将由 80 名年龄匹配的绝经后女性组成。自变量是 1) 是否有抑郁病史（是或否），以及 2) T2DM 状况（是或否）。因变量是唾液皮质醇水平、血脂（总胆固醇、HDL 亚组分和甘油三酯）、腰臀比、肱动脉血流介导的扩张、止血指标 (vWF)、炎症标记物（C 反应蛋白）、微量白蛋白尿、和血压。需要控制的变量包括BMI（骨量指数）、降脂药、β受体阻滞剂、ACE抑制剂、抗高血压药以及吸烟史、体力活动和饮酒史。将测试三个假设：1）将对糖尿病产生主要影响，例如糖尿病参与者将表现出更高的腰臀比、血压、vWf、C反应蛋白（CRP）、血脂异常、微量白蛋白尿和更多受损的内皮依赖性肱动脉反应性（EDBR）高于未患糖尿病的人； 2) 对抑郁症病史有主要影响，与阴性病史的参与者相比，阳性病史的参与者会表现出更高的腰臀比、血压、vWf、CRP、微量白蛋白尿、更受损的 EDBR 以及更平坦的皮质醇脉动昼夜节律; 3) 抑郁症病史和糖尿病之间存在相互作用，因此，与仅有抑郁症病史的参与者相比，同时患有糖尿病和抑郁症病史的参与者会表现出更高的 WHR、血压、vWf、CRP 和更受损的 EDBR糖尿病。