Intensive lifestyle changes are necessary to improve insulin sensitivity - A randomized controlled trial
Intensive lifestyle changes are necessary to improve insulin sensitivity - A randomized controlled trial
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DOI：
10.2337/diacare.25.3.445
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发表时间：
2002-03-01
期刊：
影响因子：
16.2
通讯作者：
Jones, IE
中科院分区：
文献类型：
--
作者：
McAuley, KA;Wilson, N;Jones, IE
生活方式必须改变到何种程度才能改善胰岛素敏感性尚未确定。本研究比较了目前的饮食和运动建议对胰岛素敏感性的影响，并对血糖正常的胰岛素抵抗个体进行了更密集的干预。（通过正葡萄糖胰岛素钳夹测定）将男性和女性随机分为对照组或两个饮食和锻炼联合方案之一，一组（中等水平）基于当前的建议，另一组基于更密集的饮食和锻炼计划。胰岛素敏感性采用正葡萄糖胰岛素钳夹法测量，身体成分采用双能X线吸收法测量，人体测量和有氧健身在4个月的干预期前后进行评估。四天的饮食摄入量进行了记录，并持续葡萄糖，胰岛素，和lipids.Results-only密集组显示出显着改善胰岛素敏感性（增加23%，P=0.006比9%，在适度组，P=0.23）。这与有氧健身的显著改善有关（强化组增加11%，P=0.02，适度组增加1%，P=0.94）和更大的纤维摄入量，但报告的总或饱和膳食脂肪没有差异。一个更密集的项目。改善有氧健身似乎是两个干预组之间的主要差异，尽管体重减轻和饮食组成也可能在决定胰岛素敏感性方面发挥重要作用。
Objective-The extent to which lifestyle must be altered to improve insulin sensitivity has not been established. This study compares the effect on insulin sensitivity of current dietary and exercise recommendations with a more intensive intervention in normoglycemic insulin-resistant individuals.Research design and methods-Seventy-nine normoglycemic insulin-resistant (determined by the euglycemic insulin clamp) men and women were randomized to either a control group or one of two combined dietary and exercise programs, One group (modest level) was based on current recommendations and the other on a more intensive dietary and exercise program. Insulin sensitivity as measured using a euglycemic insulin clamp, body composition was measured using dual-energy X-ray absorptiometry, and anthropometry and aerobic fitness were assessed before and after a 4-month intervention period. Four-day dietary intakes were recorded, and lasting glucose, insulin, and lipids were measured.Results-only the intensive group showed a significant improvement in insulin sensitivity (23% increase, P=0.006 vs 9% in the modest group, P=0.23). This was associated with a significant improvement in aerobic fitness (11% increase in the intensive group, P=0.02 vs. 1% in the modest group, P=0.94) and a greater fiber intake, but no difference in reported total or saturated dietary fat.Conclusions-Current clinical dietary and exercise recommendations, even when vigorously implemented, did not significantly improve insulin sensitivity however, a more intensive program did. Improved aerobic fitness appeared to be the major difference between the two intervention groups, although weight loss and diet composition may have also played an important role in determining insulin sensitivity.