Effectiveness of a lifestyle intervention on metabolic syndrome. A randomized controlled trial
Effectiveness of a lifestyle intervention on metabolic syndrome. A randomized controlled trial
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DOI：
10.1007/s11606-007-0399-6
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发表时间：
2007-12-01
影响因子：
5.7
通讯作者：
Pagano, Gianfranco
中科院分区：
文献类型：
--
作者：
Bo, Simona;Ciccone, Giovannino;Pagano, Gianfranco
研究背景：强化生活方式干预可显著降低高风险人群糖尿病的进展。目的：目前尚不清楚适度干预是否能有效降低一般人群的代谢异常。设计：双臂随机对照1年试验。患者：335例患者来自代谢异常人群队列，其中375例年龄45- 60岁。意大利西北部64年。测量我们比较了由受过训练的专业人员进行的基于一般性诊断的生活方式干预计划与由家庭医生提供的标准非结构化信息在降低多种代谢和炎症异常患病率方面的有效性。干预组（n=169）和对照组（n =166）的临床/人体测量/实验室和生活方式特征没有显著差异。与对照组相比，前者显着降低了总/饱和脂肪的摄入量，增加了多不饱和脂肪/纤维的摄入量和运动水平。12个月后，干预组的体重、腰围、高敏C反应蛋白和大多数代谢综合征组分下降，而对照组则增加。生活方式干预显著降低了代谢综合征（比值比[OR]=0.28; 95%CI 0.18-0.44），绝对风险降低31%（21-41），相当于3.2（2-5）例患者需要接受治疗才能在12个月后预防1例病例。干预后中心性肥胖（OR=0.33; 0.20-0.56）、高脂血症（OR=0.48; 0.31-0.75）和糖尿病（OR=0.23; 0.06-0.85）的患病率显著降低。家庭医生的常规护理在改善高危人群进行性代谢恶化方面无效。
BACKGROUND Intensive lifestyle intervention significantly reduces the progression to diabetes in high-risk individuals.OBJECTIVE It is not known whether a program of moderate intervention might effectively reduce metabolic abnormalities in the general population.DESIGN Two-arm randomized controlled 1-year trial.PATIENTS Three hundred and thirty-five patients participated from a dysmetabolic population-based cohort of 375 adults aged 45-64 years in northwestern Italy.MEASUREMENTS We compared the effectiveness of a general recommendation-based program of lifestyle intervention carried out by trained professionals versus standard unstructured information given by family physicians at reducing the prevalence of multiple metabolic and inflammatory abnormalities.RESULTS At baseline, clinical/anthropometric/laboratory and lifestyle characteristics of the intervention (n=169) and control (n=166) groups were not significantly different. The former significantly reduced total/saturated fat intake and increased polyunsaturated fat/fiber intake and exercise level compared to the controls. Weight, waist circumference, high-sensitivity C-reactive protein, and most of the metabolic syndrome components decreased in the intervention group and increased in the controls after 12 months. Lifestyle intervention significantly reduced metabolic syndrome (odds ratio [OR]=0.28; 95% CI 0.18-0.44), with a 31% (21-41) absolute risk reduction, corresponding to 3.2 (2-5) patients needing to be treated to prevent 1 case after 12 months. The intervention significantly reduced the prevalence of central obesity (OR=0.33; 0.20-0.56), and hypertriglyceridemia (OR=0.48; 0.31-0.75) and the incidence of diabetes (OR=0.23; 0.06-0.85).CONCLUSION A lifestyle intervention based on general recommendations was effective in reducing multiple metabolic/inflammatory abnormalities. The usual care by family physicians was ineffective at modifying progressive metabolic deterioration in high-risk individuals.