Effects of a long-term lifestyle intervention program with Mediterranean diet and exercise for the management of patients with metabolic syndrome in a primary care setting
Effects of a long-term lifestyle intervention program with Mediterranean diet and exercise for the management of patients with metabolic syndrome in a primary care setting
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DOI：
10.1016/j.ejim.2015.04.007
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发表时间：
2015-06-01
影响因子：
8
通讯作者：
Bernal-Lopez, M. R.
中科院分区：
文献类型：
--
作者：
Gomez-Huelgas, R.;Jansen-Chaparro, S.;Bernal-Lopez, M. R.
背景：在初级保健环境中对代谢综合征患者进行长期管理的生活方式干预(LSI)计划的影响尚不清楚。方法：这项为期3年的前瞻性对照试验随机选择患有代谢综合征的成年受试者在西班牙马拉加的一家社区卫生中心接受强化LSI或常规护理。LSI受试者接受了地中海饮食的指导，并接受了初级保健专业人员的定期有氧运动计划。主要结果包括代谢综合征不同组成部分(腹围、血压、高密度脂蛋白胆固醇、空腹血糖和甘油三酯)与基线相比的变化。结果：在2492名筛查对象中，601名代谢综合征患者(24.1%)被随机分为LSI组(n=298)和常规护理组(n=303)；其中，77%和58%的人完成了研究。在研究结束时，LSI在腹围(-0.001.4+/-6 cm对+2.1+/-6.7 cm，p<；0.001)、收缩压(-5.5+/-15毫米汞对-0.6+/-19毫米汞，p=0.004)、舒张压(-4.6+/-10毫米汞对-0.2+/-13毫米汞，p<；高密度脂蛋白胆固醇(+4+/-12 mg/dL比+2+/-12 mg/dL，p=0.001)；而空腹血糖和甘油三酯浓度差异无统计学意义(-4+/-35 mg/dl比-1+/-32 mg/dl，p=0.43和-0.4+/-83 mg/dl比+6+/-113 mg/dl，p=0.28)。结论：由专业护理人员提供的强化LSI咨询可显著改善代谢综合征患者的腹围、血压和高密度脂蛋白-胆固醇，但对血糖和甘油三酯水平的影响有限。(C)2015年欧洲内科医学联合会。爱思唯尔出版，版权所有。
Background: The impact of a lifestyle intervention (LSI) program for the long-term management of subjects with metabolic syndrome in a primary care setting is not known.Methods: This 3-year prospective controlled trial randomized adult subjects with metabolic syndrome to receive intensive LSI or to usual care in a community health centre in Malaga, Spain. LSI subjects received instruction on Mediterranean diet and a regular aerobic exercise program by their primary care professionals. Primary outcome included changes from baseline on different components of metabolic syndrome (abdominal circumference, blood pressure, HDL-cholesterol, fasting plasma glucose and triglycerides).Results: Among the 2,492 subjects screened, 601 subjects with metabolic syndrome (24.1%) were randomized to LSI (n = 298) or to usual care (n = 303); of them, a 77% and a 58%, respectively, completed the study. At the end of the study period, LSI resulted in significant differences vs. usual care in abdominal circumference (-0.4 +/- 6 cm vs. +2.1 +/- 6.7 cm, p < 0.001), systolic blood pressure (-5.5 +/- 15 mmHg vs. -0.6 +/- 19 mmHg, p = 0.004), diastolic blood pressure (-4.6 +/- 10 mmHg vs. -0.2 +/- 13 mmHg, p < 0.001) and HDL-cholesterol (+4 +/- 12 mg/dL vs. +2 +/- 12 mg/dL, p = 0.05); however, there were no differences in fasting plasma glucose and triglyceride concentration (-4 +/- 35 mg/dl vs. -1 +/- 32 mg/dl, p = 0.43 and -0.4 +/- 83 mg/dl vs. +6 +/- 113 mg/dl, p = 0.28).Conclusion: Intensive LSI counseling provided by primary care professionals resulted in significant improvements in abdominal circumference, blood pressure and HDL-cholesterol but had limited effects on glucose and triglyceride levels in patients with metabolic syndrome. (C) 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.