Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance - The Da Qing IGT and diabetes study
Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance - The Da Qing IGT and diabetes study
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DOI：
10.2337/diacare.20.4.537
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发表时间：
1997-04-01
期刊：
影响因子：
16.2
通讯作者：
Howard, BV
中科院分区：
文献类型：
--
作者：
Pan, XR;Li, GW;Howard, BV
葡萄糖耐量受损（IGT）个体发生NIDDM的风险很高。本研究的目的是确定IGT患者的饮食和运动干预是否可以延缓NIDDM的发展，即，降低NIDDM的发病率，从而降低糖尿病并发症如心血管、肾脏和视网膜疾病的总发病率，以及归因于这些并发症的超额死亡率。研究设计和方法--在1986年，对来自中国大庆市33个卫生保健诊所的110，660名男性和女性进行IGT和NIDDM筛查。在这些人中，577人被归类为IGT（使用世界卫生组织标准）。受试者被随机分配到临床试验中，或者是对照组，或者是三个积极治疗组之一：仅饮食，仅运动，或饮食加运动。在6年的时间里，每隔2年进行一次随访评估检查，以确定是否发生NIDDM。考克斯比例风险分析用于确定NIDDM的发病率是否因治疗分配而异。（95% CI，59.8-75.2），对照组为43.8%饮食组、运动组和饮食加运动组分别为41.1%（95%CI，33.4-49.4）和46.0%（95%CI，37.3-54.7）（P < 0.05）。当按诊所分析时，每个积极干预组与对照诊所差异显著（P < 0.05）。当受试者被分层为瘦或超重（BMI <或大于或等于25 kg/m2）时，活性治疗组中糖尿病发生率的相对降低相似。在调整基线BMI和空腹血糖差异的比例风险分析中，饮食、运动和饮食加运动干预与31%的（P < 0.03），46%（P < 0.0005），42%（P < 0.005）降低患糖尿病的风险，结论-饮食和/或运动干预导致IGT患者在B年期间糖尿病发病率显著下降。
QBJECTIVE - Individuals with impaired glucose tolerance (IGT) have a high risk of developing NIDDM. The purpose of this study was to determine whether diet and exercise interventions in those with IGT may delay the development of NIDDM, i.e., reduce the incidence of NIDDM, and thereby reduce the overall incidence of diabetic complications, such as cardiovascular, renal, and retinal disease, and the excess mortality attributable to these complications.RESEARCH DESIGN AND METHODS - In 1986, 110,660 men and women from 33 health care clinics in the city of Da Qing, China, were screened for IGT and NIDDM. Of these individuals, 577 were classified (using World Health Organization criteria) as having IGT. Subjects were randomized by clinic into a clinical trial, either to a control group or to one of three active treatment groups: diet only, exercise only, or diet plus exercise. Follow-up evaluation examinations were conducted at 2-year intervals over a 6-year period to identify subjects who developed NIDDM. Cox's proportional hazard analysis was used to determine if the incidence of NIDDM varied by treatment assignment.RESULTS - The cumulative incidence of diabetes at 6 years was 67.7% (95% CI, 59.8-75.2) in the control group compared with 43.8% (95% CI, 35.5-52.3) in the diet group, 41.1% (95% CI, 33.4-49.4) in the exercise group, and 46.0% (95% CI, 37.3-54.7) in the diet-plus-exercise group (P < 0.05). When analyzed by clinic, each of the active intervention groups differed significantly from the control clinics (P < 0.05). The relative decrease in rate of development of diabetes in the active treatment groups was similar when subjects were stratified as lean or overweight (BMI < or greater than or equal to 25 kg/m(2)). In a proportional hazards analysis adjusted for differences in baseline BMI and fasting glucose, the diet, exercise, and diet-plus-exercise interventions were associated with 31% (P < 0.03), 46% (P < 0.0005), and 42% (P < 0.005) reductions in risk of developing diabetes, respectively.CONCLUSIONS - Diet and/or exercise interventions led to a significant decrease in the incidence of diabetes over a B-year period among those with IGT.