Osei, Kwame , MD, FACE, FACP
Effects of diet--induced weight loss on HDL functionality in dysglycemic African Americans and Whites
General Research Subject: Type 2 Diabetes
Focus: Diabetic Dyslipidemia, Integrated Physiology\Insulin Resistance, Nutrition-Clinical
Type of Grant: Clinical Translational Research
Project Start Date: January 1, 2011
Project End Date: December 31, 2013
Diabetes Type: Type 2 diabetes
Obesity and diabetes are major public health problems that are associated with increases in cardiovascular disease (CVD). African Americans (AA) with diabetes are generally more obese than white Americans (WA). For comparable, age, gender and BMI, AA are more, insulin resistant but manifest more favorable lipid profile (higher HDL and lower triglycerides) than WA. In addition, AA have 2-4X more cardiovascular disease morbidity and mortality than their WA counterparts. Therefore, the favorable lipid/lipoprotein profile in AA does not appear to be cardioprotective compared to WA. We have recently shown that HDL is less functional in AA compared to WA. Diet-induced weight loss has been demonstrated to improve insulin sensitivity, glucose metabolism, lipid profiles as well as HDL levels in overweight/obese patients with diabetes or impaired glucose tolerance. For the first time, we will compare ethnic differences and benefits of 6 months diet-induced weight loss on non-traditional CVD risk factors such as HDL functionality and its components such as paraoxonase enzyme activity (PON1), and reverse cholesterol transport, oxidized LDL, inflammatory markers and F2 isoprostanes. We hope to demonstrate that diet-induced weight loss can improve HDL functionality in dysglycemic AA.
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?
My research covers the importance of ethnicity and race on the development of type 2 diabetes, metabolic syndrome, cholesterol and cardiovascular disease. My research examines the reasons why African Americans experience more diabetes and the associated cardiovascular diseases. It addresses the paradox between HDL cholesterol, insulin resistance and cardiovascular diseases in African Americans.
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?
Diabetes is a common disease. While preventing eye, kidney disease and nerve damage are very important, it is well known that 75-80% of diabetics die form heart disease and stoke. Most importantly, we are also aware that African Americans suffer more from diabetes and its associated complications than their white counterparts. In fact, African Americans 2-4 x more likely to die from diabetes than whites. Therefore, my research is to understand why African Americans are more prone to diabetes and the cardiovascular complications. Therefore, our goal is to develop strategies to reduce risk factors for diabetes and heart disease, in particular in African Americans using lifestyle modifications and medications
Why is it important for you, personally, to become involved in diabetes research? What role will this award play in your research efforts?
For the past 25years, I have worked with patients with diabetes and their family members who are not diabetic. My passion for diabetes is that with the advances in the technology for medications, insulin and devices to treat the disease, we should be able to prevent the cardiovascular diseases and the associated suffering and death in patients with diabetes. For people who do not have diabetes, we should double our efforts to prevent the disease Therefore; the current study attempts to reduce the risk for diabetes and also examined the mechanism of the benefits in serum glucose, cholesterol (HDL) and body weight in African Americans and whites. My research could provide insights to new opportunities not only to prevent the disease but the associated heart diseases. especially in African Americans.
In what direction do you see the future of diabetes research going?
Diabetes has become epidemic globally. The major trigger for type 2 diabetes is obesity, physical inactivity and rapid changes in our lifestyle. The future of type 2 diabetes research is to develop strategies to prevent diabetes including exercise, and dietary modification. We need intensive research to prevent obesity in our populations. Finally, it is important to determine genetic markers for diabetes. This can help identify individuals at risk for diabetes and explore selection of specific interventions including medications to prevent diabetes in high risk populations.
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