Roumen C, Corpeleijn E, Feskens E J M, Mensink M, Saris W H M, Blaak E E
Department of Human Biology, Nutrition and Toxicology Research Institute Maastricht, NUTRIM, Maastricht University, Maastricht, The Netherlands.
Diabet Med. 2008 May;25(5):597-605. doi: 10.1111/j.1464-5491.2008.02417.x.
To determine the effect of a 3-year diet and exercise lifestyle intervention, based on general public health recommendations, on glucose tolerance, insulin resistance and metabolic cardiovascular risk factors in Dutch subjects with impaired glucose tolerance (IGT).
The study was a randomized controlled lifestyle intervention over 3 years. A total of 147 IGT subjects (75 male, 72 female) were randomized to the intervention (INT) group or control (CON) group; 106 subjects (52 INT, 54 CON) completed 3 years of intervention. Annually, glucose, insulin and free fatty acid (FFA) concentrations were determined fasting and after an oral glucose tolerance test. Measurements of body weight, serum lipids, blood pressure and maximal aerobic capacity were also performed.
Analysis of those who completed the 3-year trial, showed that the lifestyle intervention improved body weight (INT -1.08 +/- 4.30 kg; CON +0.16 +/- 4.91 kg, P = 0.01), homeostatis model assessment index for insulin resistance and 2-h FFA. Two-hour glucose concentrations improved in the INT group, the difference being most pronounced after 1 year, with a return to baseline values after 3 years, from 8.59 +/- 1.55 to 8.55 +/- 0.34 mm; in contrast, 2-h glucose deteriorated in the CON group-from 8.46 +/- 1.84 to 9.35 +/- 2.50 mm (P = 0.02). In the INT group, diabetes incidence was reduced by 58% (P = 0.025).
Our lifestyle intervention showed a sustained beneficial effect on 2-h glucose concentrations, insulin resistance and 2-h FFA, even after 3 years. Our lifestyle intervention is effective, but for implementation more information is needed about factors influencing adherence.
基于一般公共卫生建议，确定为期3年的饮食和运动生活方式干预对荷兰糖耐量受损（IGT）受试者的糖耐量、胰岛素抵抗和代谢性心血管危险因素的影响。
该研究为一项为期3年的随机对照生活方式干预。总共147名IGT受试者（75名男性，72名女性）被随机分为干预（INT）组或对照组（CON）；106名受试者（52名INT组，54名CON组）完成了3年的干预。每年测定空腹及口服葡萄糖耐量试验后的血糖、胰岛素和游离脂肪酸（FFA）浓度。还进行了体重、血脂、血压和最大有氧能力的测量。
对完成3年试验的受试者的分析表明，生活方式干预改善了体重（INT组-1.08±4.30kg；CON组+0.16±4.91kg，P=0.01）、胰岛素抵抗的稳态模型评估指数和2小时FFA。INT组的2小时血糖浓度有所改善，差异在1年后最为明显，3年后恢复到基线值，从8.59±1.55降至8.55±0.34mmol/L；相比之下，CON组的2小时血糖恶化，从8.46±1.84升至9.35±2.50mmol/L（P=0.02）。在INT组，糖尿病发病率降低了58%（P=0.025）。
我们的生活方式干预即使在3年后对2小时血糖浓度、胰岛素抵抗和2小时FFA仍显示出持续的有益影响。我们的生活方式干预是有效的，但在实施方面，需要更多关于影响依从性因素的信息。
