Bo Simona, Ciccone Giovannino, Guidi Sabrina, Gambino Roberto, Durazzo Marilena, Gentile Luigi, Cassader Maurizio, Cavallo-Perin Paolo, Pagano Gianfranco
Department of Internal Medicine, University of Turin, Corso Dogliotti 14, 10126 Turin, Italy.
Eur J Endocrinol. 2008 Dec;159(6):685-91. doi: 10.1530/EJE-08-0334. Epub 2008 Sep 4.
OBJECTIVE/DESIGN: The influence of diet and exercise on metabolic syndrome is controversial since fit individuals might also eat healthier foods. We evaluated the association of diet/exercise variation with reductions in metabolic variables and C-reactive protein (CRP) values in the experimental and control arms of a 1-year randomized lifestyle intervention trial performed in patients with multiple metabolic abnormalities.
A prospective study of 169 cases and 166 controls after a lifestyle intervention was performed.
In the intervention group, 15/169 (8.9%), 63/169 (37.3%), and 70/169 (41.4%) reached only dietary, only exercise, and dietary/exercise targets respectively. Reductions in weight, body mass index (BMI), and waist were significant only in patients who increased exercise. Most controls did not reach any target (131/166, 78.9%), while only few patients reached only dietary (13/166, 7.8%), only exercise (5/166, 3.0%), and dietary/exercise targets (17/166, 10.2%). Weight, BMI, and waist reduction was more pronounced in those reaching the exercise target. In the whole cohort, increased exercise was inversely associated with weight, BMI, waist, and CRP, increased saturated fat was directly associated with weight, BMI, waist, and diastolic pressure variations, while increased fiber intake was inversely associated with glucose values in a multiple regression model. After adjusting for waist changes, the associations between exercise and CRP (beta=-0.023; 95% CI -0.028 -0.017; P<0.001) and the associations between fiber and glucose (beta=-0.022; -0.031 -0.013; P<0.001) remained significant.
Independent of weight reduction, exercise level and fiber intake are inversely associated with CRP and fasting glucose values respectively. Change in lifestyle may lower inflammation and prevent metabolic deterioration.
目的/设计：饮食和运动对代谢综合征的影响存在争议，因为健康的个体可能也会食用更健康的食物。我们在一项针对患有多种代谢异常的患者进行的为期1年的随机生活方式干预试验的实验组和对照组中，评估了饮食/运动变化与代谢变量及C反应蛋白（CRP）值降低之间的关联。
对169例病例和166例对照进行了生活方式干预后的前瞻性研究。
在干预组中，分别有15/169（8.9%）、63/169（37.3%）和70/169（41.4%）仅达到饮食、仅达到运动以及饮食/运动目标。体重、体重指数（BMI）和腰围的降低仅在增加运动的患者中显著。大多数对照组未达到任何目标（131/166，78.9%），而只有少数患者仅达到饮食目标（13/166，7.8%）、仅达到运动目标（5/166，3.0%）以及饮食/运动目标（17/166，10.2%）。在达到运动目标的人群中，体重、BMI和腰围的降低更为明显。在整个队列中，在多元回归模型中，增加运动与体重、BMI、腰围和CRP呈负相关，增加饱和脂肪与体重、BMI、腰围和舒张压变化呈正相关，而增加纤维摄入量与血糖值呈负相关。在调整腰围变化后，运动与CRP之间的关联（β=-0.023；95%CI -0.028 -0.017；P<0.001）以及纤维与血糖之间的关联（β=-0.022；-0.031 -0.013；P<0.001）仍然显著。
独立于体重减轻，运动水平和纤维摄入量分别与CRP和空腹血糖值呈负相关。生活方式的改变可能会降低炎症并预防代谢恶化。
