This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The central focus of this study is on the importance of resistance to insulin-mediated glucose disposal and compensatory hyperinsulinemia in modulation of insulin resistance (IR) and its role in weight loss and cardiovascular risk.The purpose of this study is to determine the relationship between insulin resistance/hyperinsulinemia and ability to lose weight in obese individuals. In addition, the impact of hyperinsulinemia on risk for coronary heart disease will be addressed. Both non-diabetics and diabetics will be studied.This protocol includes several active arms of a study designed to evaluate the impact of macronutrient composition on: 1) ability to lose weight 2) reduction in cardiovascular risk, among overweight or obese individuals with IR.Total subjects expected for entire studyScreening: 300-400Enrollment:Arm 1: obese nondiabetic: 60Arm 2: obese diabetic diet only: 36Arm 3: obese diabetic monotherapy: 45Arm 4: overweight nondiabetic: 20Arm 5: obese Southeast Asian women: 20Adipose tissue biopsy substudy: 30
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