Population Science, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
Obesity (Silver Spring). 2010 Mar;18(3):548-54. doi: 10.1038/oby.2009.304. Epub 2009 Oct 1.
It is difficult to identify the successful component(s) related to changes in metabolic syndrome (MetS) from lifestyle interventions: the weight loss, the behavior change, or the combination. The purpose of this study is to determine the effects of a weight-stable randomized controlled trial of low-fat diet and exercise, alone and in combination, on MetS. Men (n = 179) and postmenopausal women (n = 149) with elevated low-density lipoprotein cholesterol (LDL-C) and low high-density lipoprotein cholesterol (HDL-C) were randomized into a 1-year, weight-stable trial with four treatment groups: control (C), diet (D), exercise (E), or diet plus exercise (D+E). MetS was defined using a continuous score. Changes in MetS score (DeltaMetS) were compared between groups using analysis of covariance, stratified by gender and using two models, with and without baseline and change in percent body fat (DeltaBF) as a covariate. In men, DeltaMetS was higher for D vs. C (P = 0.04), D+E vs. C (P = 0.0002), and D+E vs. E (P = 0.02). For women, DeltaMetS was greater for D vs. C (P = 0.045), E vs. C (P = 0.02), and D+E vs. C (P = 0.004). After adjusting for DeltaBF, all differences between groups were attenuated and no longer significant. DeltaMetS were associated with DeltaBF for both men (P < 0.0001) and women (P = 0.004). After adjustment for DeltaBF, low-fat diet alone and in combination with exercise had no effect on MetS. The key component for MetS from low-fat diet and/or increased physical activity appears to be body fat loss.
从生活方式干预中很难确定与代谢综合征（MetS）变化相关的成功因素（因素）：体重减轻、行为改变还是两者的结合。本研究的目的是确定低脂肪饮食和运动单独和联合的、为期 1 年的、体重稳定的随机对照试验对 MetS 的影响。患有升高的低密度脂蛋白胆固醇（LDL-C）和低高密度脂蛋白胆固醇（HDL-C）的男性（n = 179）和绝经后女性（n = 149）被随机分为 1 年、体重稳定的试验，分为四个治疗组：对照组（C）、饮食组（D）、运动组（E）或饮食加运动组（D+E）。使用连续评分定义 MetS。使用协方差分析比较组间 MetS 评分变化（DeltaMetS），按性别分层，并使用两种模型，一种有，一种没有作为协变量的基础值和体脂百分比变化（DeltaBF）。在男性中，D 组与 C 组相比，DeltaMetS 更高（P = 0.04），D+E 组与 C 组相比，DeltaMetS 更高（P = 0.0002），D+E 组与 E 组相比，DeltaMetS 更高（P = 0.02）。对于女性，D 组与 C 组相比，DeltaMetS 更高（P = 0.045），E 组与 C 组相比，DeltaMetS 更高（P = 0.02），D+E 组与 C 组相比，DeltaMetS 更高（P = 0.004）。调整 DeltaBF 后，所有组间差异均减弱且不再显著。男性（P < 0.0001）和女性（P = 0.004）的 DeltaMetS 均与 DeltaBF 相关。调整 DeltaBF 后，单独进行低脂肪饮食和联合进行增加体力活动对 MetS 没有影响。低脂肪饮食和/或增加体力活动对 MetS 的关键因素似乎是体脂减少。
