Metabolic Syndrome X
Conditions
Keywords
cardiometabolic disease
Brief summary
The investigators posit that a multi-national collaborative effort with focused investigations in environments with the highest levels of exposure (developing countries such as China and India), are likely to provide new and much needed data on the risk posed by these variables on an individuals life-time risk for type 2 diabetes and cardiovascular complications. The investigators will test this hypothesis through the establishment of a network that would lead studies on the links between exposure and adverse Chronic cardiometabolic effects and propose doing this in this as part of 3 specific aims.
Detailed description
In aim 1, the investigators propose to establish feasibility of such an effort in Beijing, China, an effort that will involve implementation of novel exposure assessment methodologies simultaneously with the ability to execute key surrogate outcome measures of importance in cardiovascular risk with CM diseases. In Aim 2, the association between functional cardiovascular risk variables \[insulin sensitivity, Blood Pressure, endothelial function\] and acute and sub-acute variations in personal black carbon and ambient particulate matter 2.5 levels among 50 individuals with the chronic cardiometabolic syndrome will be investigated. In Aim 3, the investigators will examine potential biologic pathways of importance in the proposed functional outcomes. Specifically the investigators will determine the association between ambient particulate matter 2.5 levels and alterations in adipocytokines/inflammatory variables and autonomic nervous system balance.
Interventions
None listed
Sponsors
University of Michigan
Peking Union Medical College
National Institute of Environmental Health Sciences (NIEHS)
Sanjay Rajagopalan
Study design
Observational model
ECOLOGIC_OR_COMMUNITY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
35 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Nonsmokers, 35-65 years living in a nonsmoking household. * CM will be defined by IDF criteria (http://www.idf.org) specific for Asians \[waist circumference \>90 cm in males and 80 cm in females) plus any two of the following four factors: TG level: \>150 mg/dL, HDL: \< 40 mg/dL in males and \< 50 mg/dL in females, systolic BP \>130, fasting plasma glucose \> 100 mg/dL or previously diagnosed type 2 diabetes.
Exclusion criteria
* Any active smoking within past 1 year, occupational exposures to pollutants (per discretion of investigators), self-reported daily secondhand smoke exposure \> 1 hour long (workplace or home), * History of any CV disease (e.g. previous myocardial infarction), or overt type 2 diabetes. * Fasting glucose \> 126 mg/dL or a screening BP is \>160/100 mm Hg. * Patients cannot be taking any anti-hypertensive, glucose-lowering, or lipid-lowering medications or drugs that can alter baseline insulin sensitivity, BP, or endothelial function (e.g. anti-oxidants, multi-vitamins, folic acid, fish oil supplementation, L-arginine), * Daily use of NSAIDS is not allowed; however intermittent PRN usage is acceptable. In the course of the year should a subject develop any of
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Death | 48 months | Death, MI (fatal and non-fatal), target vessel revascularization and hospitalization for angina at 6 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Inflammation markers | 30 days | EPC counts and measurement of LyC6hi, CD11b+ cells |
Countries
China, United States
Outcome results
None listed