生活方式干预对2型糖尿病亲属的长期（1年和2年）影响。

Long-term (1- and 2-year) effects of lifestyle intervention in type 2 diabetes relatives.

作者信息

Brekke Hilde K, Jansson Per-Anders, Lenner Ragnhild A

机构信息

Department of Clinical Nutrition, Sahlgrenska Academy at Göteborg University, Box 459, 405 30 Göteborg, Sweden.

出版信息

Diabetes Res Clin Pract. 2005 Dec;70(3):225-34. doi: 10.1016/j.diabres.2005.03.027.

DOI:10.1016/j.diabres.2005.03.027

PMID:15885845

Abstract

AIMS

To study the long-term (1- and 2-year) effect of a lifestyle intervention on non-diabetic first-degree relatives of type 2 diabetic patients, i.e., the 1-year effect of diet versus diet and exercise in relation to a control group and the 2-year sustainability of these treatment effects.

METHOD

Seventy-seven healthy first-degree relatives (men and women) between the ages of 25 and 55 were allocated to one of three groups: diet group (D), diet and exercise group (DE) and control group (C). For ethical reasons, after 1 year the control group began the intervention and were followed for another 2 years. Diet and physical activity counselling was based on current nutrition recommendations, including increased intake of fatty fish and low glycaemic index foods. The fatty acid composition of the erythrocyte membrane was studied as an objective measure of dietary change. Assessments included fasting insulin, 2-h insulin, oral glucose tolerance test (OGTT), anthropometry and blood lipid measurements. Groups D and DE received intensive follow-up through unannounced telephone interviews during the first 4 months.

RESULTS

Dietary changes were significant at 1 year, and to a large degree sustained at 2 years. Adherence to advice regarding fat quality was confirmed through changes in the fatty acid composition of the erythrocyte membrane. The least active subjects in DE increased their physical activity (PA). At 1 year, group D showed a reduction in the ratio of LDL to HDL cholesterol (p=0.028) while group DE decreased their body weight by 2.7% (p<0.029) and increased HDL (p<0.037) versus controls. At 2 years, cholesterol levels (total, LDL and the ratio LDL/HDL) were reduced within group D and when compared to DE (p=0.022, 0.009, 0.035, respectively). Fasting insulin was reduced within group DE and when compared to group D (p=0.025).

CONCLUSIONS

Positive changes in lifestyle, blood lipids and fasting insulin can be achieved and maintained in a non-diabetic population at risk of type 2 diabetes after 2 years.

摘要

目的

研究生活方式干预对2型糖尿病患者非糖尿病一级亲属的长期（1年和2年）影响，即饮食与饮食加运动相对于对照组的1年效果以及这些治疗效果的2年持续性。

方法

77名年龄在25至55岁之间的健康一级亲属（男性和女性）被分配到三个组之一：饮食组（D）、饮食加运动组（DE）和对照组（C）。出于伦理原因，1年后对照组开始干预并再随访2年。饮食和身体活动咨询基于当前的营养建议，包括增加富含脂肪的鱼类和低血糖指数食物的摄入量。研究红细胞膜的脂肪酸组成作为饮食变化的客观指标。评估包括空腹胰岛素、2小时胰岛素、口服葡萄糖耐量试验（OGTT）、人体测量和血脂测量。在最初4个月期间，D组和DE组通过不定期电话访谈接受强化随访。

结果

1年时饮食变化显著，且在很大程度上可持续至2年。通过红细胞膜脂肪酸组成的变化证实了对脂肪质量建议的依从性。DE组中最不活跃的受试者增加了他们的身体活动（PA）。1年时，D组的低密度脂蛋白与高密度脂蛋白胆固醇比值降低（p = 0.028），而DE组与对照组相比体重下降了2.7%（p < 0.029）且高密度脂蛋白增加（p < 0.037）。2年时，D组内以及与DE组相比胆固醇水平（总胆固醇、低密度脂蛋白以及低密度脂蛋白/高密度脂蛋白比值）降低（分别为p = 0.022、0.009、0.035）。DE组内以及与D组相比空腹胰岛素降低（p = 0.025）。