Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial.
Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial.
复制标题
DOI：
10.1001/archinternmed.2010.334
复制
发表时间：
2010-09-27
影响因子：
--
通讯作者：
Yanovski, Susan Z.
中科院分区：
文献类型：
--
作者：
Wing, Rena R.;Bahnson, Judy L.;Bray, George A.;Clark, Jeanne M.;Coday, Mace;Egan, Caitlin;Espeland, Mark A.;Foreyt, John P.;Gregg, Edward W.;Goldman, Valerie;Haffner, Steven M.;Hazuda, Helen;Hill, James O.;Horton, Edward S.;Hubbard, Van S.;Jakicic, John;Jeffery, Robert W.;Johnson, Karen C.;Kahn, Steven;Killean, Tina;Kitabchi, Abbas E.;Lewis, Cora E.;Manus, Cathy;Maschak-Carey, Barbara J.;Michaels, Sara;Montez, Maria;Montgomery, Brenda;Nathan, David M.;Patricio, Jennifer;Peters, Anne;Pi-Sunyer, Xavier;Pownall, Henry;Reboussin, David;Rejeski, Jack;Rubin, Richard;Safford, Monika;Skarphol, Tricia;Van Dorsten, Brent;Wadden, Thomas A.;Wagenknecht, Lynne;Wesche-Thobaben, Jacqueline;West, Delia S.;Williamson, Donald;Yanovski, Susan Z.
生活方式干预可短期改善2型糖尿病患者的糖尿病和心血管疾病（CVD）风险因素，但尚无长期数据。我们研究了生活方式干预对4年来体重、健康和心血管（CVD）风险因素变化的影响。Look AHEAD是一项多中心随机临床试验，比较了强化生活方式干预（ILI）和糖尿病支持和教育（DSE，对照组）对5145名年龄在45至76岁之间的超重或肥胖（BMI > 25 kg/m2）的2型糖尿病患者主要CVD事件发生率的影响。参与者有持续的干预和年度评估。平均四年的随访，ILI组的参与者比DSE组的参与者有更大的体重减轻百分比（−6.15% vs − 0.88%，p<.0001）和更大的健身改善（12.74% vs. 1.96%，p < .0001），HbA1c（A1 c，−0.36% vs. 0.09%，p<.0001），收缩压（收缩压，−5.33 vs −2.97 mmHg，p<.0001），舒张压（舒张压，-2.92 vs.-2.48 mmHg，p<0.012）、高密度脂蛋白胆固醇（高密度脂蛋白胆固醇，3.67 vs. 1.97 mg/dl，p<0.0001）和甘油三酯（-25.56 vs.-19.75 mg/dl，p<0.0006）。DSE组LDL-C的降低幅度大于ILI组（−11.27 vs −12.84 mg/dl，p= 0.009），但经药物使用调整后，两组LDL-C的变化无差异。虽然最大的好处往往是在1年，ILI参与者仍然有更大的改善比DSE在体重，健身，HbA 1c，SBP和HDL-C在4年。强化的生活方式干预可以产生并维持2型糖尿病患者的显着体重减轻和健身改善。在四年的随访中，ILI患者的血糖控制、血压、HDL-C和甘油三酯的总体水平更好，因此在相当长的时间内CVD风险较低。这是否转化为CVD事件的减少将最终由Look AHEAD研究解决。
Lifestyle interventions produce short-term improvements in glycemia and cardiovascular disease (CVD) risk factors in individuals with type 2 diabetes, but no long-term data are available. We examined the effects of a lifestyle intervention on changes in weight, fitness and cardiovascular (CVD) risk factors over 4 years. Look AHEAD is a multi-center randomized clinical trial comparing the effects of intensive lifestyle intervention (ILI) and diabetes support and education (DSE, control group) on the incidence of major CVD events in 5145 individuals with type diabetes, aged 45 to 76 years, who were overweight or obese (BMI > 25 kg/m2). Participants have ongoing intervention and annual assessments. Averaged across four years of follow-up, participants in ILI had greater percent weight losses than those in DSE (−6.15% vs −0.88%, p<.0001) and greater improvements in fitness (12.74% vs. 1.96%, p < .0001), HbA1c (A1c, −0.36% vs. 0.09%, p<.0001), systolic blood pressure (SBP, −5.33 vs. −2.97 mmHg, p<.0001), diastolic blood pressure (DBP, −2.92 vs. −2.48 mmHg, p<.012), HDL-cholesterol (HDL-C, 3.67 vs. 1.97 mg/dl, p<.0001), and triglycerides (−25.56 vs. −19.75 mg/dl, p<.0006). Reductions in LDL-C were greater in DSE than ILI (−11.27 vs. −12.84 mg/dl, p=.009), but adjusted for medication use, changes in LDL-C did not differ between the two groups. Although the greatest benefits were often seen at 1 year, ILI participants still had greater improvements than DSE in weight, fitness, HbA1c, SBP, and HDL-C at 4 years. Intensive lifestyle intervention can produce and maintain significant weight losses and improvements in fitness in individuals with type 2 diabetes. Across four years of follow-up, those in ILI had better overall levels of glycemic control, blood pressure, HDL-C and triglycerides, and thus spent considerable time with lower CVD risk. Whether this translates to reduction in CVD events will ultimately be addressed by the Look AHEAD study.
登录
查看更多内容
影响因子：
16.2
作者：
Pan, XR;Li, GW;Howard, BV
通讯作者：
Howard, BV
影响因子：
--
作者：
Horvath, Karl;Jeitler, Klaus;Siebenhofer, Andrea
通讯作者：
Siebenhofer, Andrea
影响因子：
16.2
作者：
Looker, HC;Knowler, WC;Hanson, RL
通讯作者：
Hanson, RL
影响因子：
--
作者：
Katzmarzyk, PT;Church, TS;Blair, SN
通讯作者：
Blair, SN
影响因子：
158.5
作者：
FRICK, MH;ELO, O;NIKKILA, EA
通讯作者：
NIKKILA, EA