The effect of the PREMIER interventions on insulin sensitivity
The effect of the PREMIER interventions on insulin sensitivity
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DOI：
10.2337/diacare.27.2.340
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发表时间：
2004-02-01
期刊：
影响因子：
16.2
通讯作者：
Svetkey, LP
中科院分区：
文献类型：
--
作者：
Ard, JD;Grambow, SC;Svetkey, LP
目的：这项PREMIER的辅助研究旨在确定综合行为干预对高血压患者胰岛素敏感性的影响，无论是否采用饮食方法来停止高血压（DASH）饮食模式。研究设计和方法-参与者被分配到三种血压非药物干预措施中的一种（A组，仅建议；B组，已建立；C组，已建立加DASH）。既定的干预措施包括体重减轻、减少钠摄入量、增加体育活动和适度饮酒；在c组的既定干预措施中加入DASH饮食模式。DASH饮食模式富含水果、蔬菜和低脂乳制品，同时总脂肪、饱和脂肪和胆固醇含量较低。它含有丰富的营养物质，如镁、钙和蛋白质，这些与改善胰岛素敏感性有关。在基线和6个月时，使用频繁采样的静脉葡萄糖耐量试验和最小模型分析来测量胰岛素敏感性。结果：两个干预组将总热量、脂肪热量百分比和钠摄入量降低到相似的水平，能量消耗和体重减轻的量相似。只有C组的协变量差异包括蛋白质、钾、钙和镁的摄入量增加。与对照组相比，只有C组胰岛素敏感性有明显改善，从1.96提高到2.95 （P=0.047）。B组空腹胰岛素和血糖水平明显下降，但胰岛素敏感性变化与对照组相比无统计学意义。结论：这些结果表明，将DASH饮食模式作为血压控制综合干预的一部分，可以提高胰岛素的作用，超过不包括DASH的综合干预的效果。
Objective-This ancillary study of PREMIER sought to determine the effects on insulin sensitivity of a comprehensive behavioral intervention for hypertension with and without the Dietary Approaches to Stop Hypertension (DASH) dietary pattern.Research Design and Methods-Participants were assigned to one of three nonpharmacologic interventions for blood pressure (group A, advice only; group B, established; and group C, established plus DASH). The established intervention included weight loss, reduced sodium intake, increased physical activity, and moderate alcohol intake; the DASH dietary pattern was added to the established intervention for those in group C. The DASH dietary pattern is high in fruits, vegetables, and low-fat dairy products while being lower in total fat, saturated fat, and cholesterol. It is abundant in nutrients such as magnesium, calcium, and protein, which have been associated with improved insulin sensitivity. Insulin sensitivity was measured at baseline and at 6 months using the frequently sampled intravenous glucose tolerance test with minimal model analysis.Results-Both intervention groups decreased total calories, percentage of calories from fat, and sodium intake to similar levels, with similar amounts of energy expenditure and weight loss. Covariate differences seen only in group C included increased intake of protein, potassium, calcium, and magnesium. Compared with control subjects, insulin sensitivity improved significantly only in group C, from 1.96 to 2.95 (P=0.047). Group B did have a significant decrease in fasting insulin and glucose, but the changes in insulin sensitivity did not reach statistical significance when compared with control subjects.Conclusions-These results suggest that including the DASH dietary pattern as part of a comprehensive intervention for blood pressure control enhances insulin action beyond the effects of a comprehensive intervention that does not include DASH.