Bihan H, Takbou K, Cohen R, Michault A, Boitou F, Reach G, Le Clésiau H
Department of Endocrinology, Diabetology and Metabolic Diseases, Avicenne Hospital, 93009 Bobigny cedex, France.
Diabetes Metab. 2009 Jun;35(3):185-91. doi: 10.1016/j.diabet.2008.11.002. Epub 2009 Mar 18.
As the constantly progressing metabolic syndrome is accompanied by an increased risk of type 2 diabetes and cardiovascular complications, it is essential to take appropriate, non-pharmacological, cost-effective measures immediately after the diagnosis has been made. The purpose of our prospective, non-controlled, 6-month study was to determine the impact of lifestyle interventions involving patients' behaviour in collaboration with their general practitioners (GPs).
We recruited 95 patients (46 men and 49 women, aged 45 to 60 years) who presented with the metabolic syndrome. Each patient received a copy of the national French recommendations (PNNS) leaflet, containing guidelines aimed to balance dietary intake and increase daily physical activity. Socioeconomic status was estimated using the EPICES score. Following a less than 1 hour face-to-face interventional session with each patient to present the lifestyle-modification goals, we contacted each patient's GP by phone to advise on measures to reinforce these lifestyle modifications.
The percentage of patients presenting with the metabolic syndrome decreased by 52.4% after 6 months. Hypertension, triglycerides and waist circumference decreased by 30.5, 29.3 and 22.0%, respectively, in the study patients. Rates of compliance to PNNS goals at the last follow-up versus baseline were: for drinks, 63.0% versus 22.2%; for sweet products, 91.4% versus 49.4%; for fat, 91.4% versus 80.3%; and for increased exercise, 26.9% versus 6.4%.
Short-term, single lifestyle modifications targeting the metabolic syndrome in collaboration with GPs was effective in decreasing most of the parameters of the syndrome. However, no factors predictive of success were identified.
随着不断进展的代谢综合征会增加2型糖尿病和心血管并发症的风险,在做出诊断后立即采取适当的、非药物的、具有成本效益的措施至关重要。我们这项为期6个月的前瞻性、非对照研究的目的是确定与患者的全科医生(GP)合作进行的涉及患者行为的生活方式干预的影响。
我们招募了95例患有代谢综合征的患者(46名男性和49名女性,年龄在45至60岁之间)。每位患者都收到了一份法国国家建议(PNNS)手册,其中包含旨在平衡饮食摄入和增加日常身体活动的指南。使用EPICES评分评估社会经济状况。在与每位患者进行不到1小时的面对面干预会议以介绍生活方式改变目标后,我们通过电话联系了每位患者的全科医生,就加强这些生活方式改变的措施提供建议。
6个月后,患有代谢综合征的患者百分比下降了52.4%。研究患者的高血压、甘油三酯和腰围分别下降了30.5%、29.3%和22.0%。最后一次随访时与基线相比达到PNNS目标的依从率分别为:饮料方面,63.0%对22.2%;甜食方面,91.4%对49.4%;脂肪方面,91.4%对80.3%;增加运动方面,26.9%对6.4%。
与全科医生合作针对代谢综合征进行的短期单一生活方式改变有效地降低了该综合征的大多数参数。然而,未发现成功的预测因素。