Cardiovascular Diseases Clinical Trial
Official title:
Health, Risk Factors, Exercise Training, and Genetics
To document the role of the genotype in the cardiovascular and metabolic responses to aerobic exercise-training and the contribution of inherited factors in the changes brought about by regular exercise for several cardiovascular disease and diabetes risk factors. A consortium of laboratories from five institutions in the United States and Canada are carrying out this study.
BACKGROUND:
This research should increase our understanding of human variation, the genetics of
adaptation to exercise-training and of the concomitant changes in cardiovascular disease and
diabetes risk factors.
DESIGN NARRATIVE:
A total of 742 sedentary subjects were recruited, initially tested, exercise-trained in the
laboratory with the same program for 20 weeks, and re-tested. The subjects came from
families of Caucasian descent with both parents and three biological adult offspring and
families of African-American ancestry. Oxygen uptake, expiratory volume and respiratory
exchange ratio, blood pressure, heart rate, blood lactate, glucose, glycerol and free-fatty
acids, stroke volume and cardiac output were measured during exercise before and after
training and maximal oxygen uptake was determined. Plasma lipids, lipoproteins and
apoproteins, glucose tolerance and insulin response to an intravenous glucose load, plasma
sex steroids and glucocorticoids, resting systolic and diastolic blood pressures, and body
fat and regional fat distribution were also assessed. Dietary habits, level of habitual
physical activity and other lifestyle components were assessed by questionnaires. Genetic
analyses included the determination of the heritability level for each phenotype and its
response to regular exercise, testing for the presence of paternal or maternal effects,
sex-limited effects, major gene effects and segregation patterns. Multivariate genetic
analyses and complex segregation analyses were used to develop hypotheses concerning the
genetic basis of the response to exercise-training.
The study was renewed in September 1997 to perform analyses of the data collected under
Phase I. A series of nongenetic studies were undertaken on the dataset. Physiological,
behavioral, and social determinants of maximal and submaximal indicators of
cardiorespiratory endurance in the sedentary state and in the response to training were
investigated taking into account the contributions of age, gender, and race. Similar
analyses were conducted on the cardiovascular disease and non-insulin dependent diabetes
mellitus (NIDDM) risk factors monitored in the study. Genetic analyses determined the
heritability levels and tested for paternal or maternal effects, major gene effects, and
segregation patterns which were used to develop hypotheses concerning genetic bases of the
response to endurance exercise. A panel of candidate genes were typed and used for
association and linkage studies. Differential display analysis of skeletal muscle
transcripts were used to identify new candidate genes for the response to endurance
exercise. Finally, a genome wide search was undertaken to isolate candidate genomic regions
and positional candidate genes for the response of cardiorespiratory endurance and
cardiovascular and NIDDM risk factor phenotypes.
The study was renewed in 2001 for four years to continue analyses of the data.
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Intervention Model: Single Group Assignment, Primary Purpose: Basic Science
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