Kalter-Leibovici Ofra, Younis-Zeidan Nuha, Atamna Ahmed, Lubin Flora, Alpert Gershon, Chetrit Angela, Novikov Ilia, Daoud Nihaya, Freedman Laurence S
Units of Cardiovascular Epidemiology, Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Ramat-Gan 52621, Israel.
Arch Intern Med. 2010 Jun 14;170(11):970-6. doi: 10.1001/archinternmed.2010.103.
Few randomized controlled trials on lifestyle interventions have been reported in non-Western populations; none have been reported in Arab populations.
From 2 Muslim Arab communities in Israel, obese, nondiabetic women aged 35 to 54 years with 1 or more components of the metabolic syndrome were randomized to either an intensive (n = 100) or a moderate (control) (n = 101) 12-month lifestyle intervention. Women in the intensive intervention had 11 individual and 11 group counseling sessions per year with a dietitian and 22 physical activity group sessions per year. Women in the moderate intervention had 3 individual and 2 group dietary counseling sessions per year and no guided physical activity. Cultural issues were addressed in the design and conduct of both interventions. The primary outcome measure was change in the metabolic syndrome and its components.
At 12 months, the intensive intervention group had median declines of 3.0 mg/dL (to convert to millimoles per liter, multiply by 0.0555) in fasting plasma glucose and 4.5 mg/dL (to convert to millimoles per liter, multiply by 0.0113) in triglyceride levels compared with median increases of 1 mg/dL in fasting plasma glucose and 5.8 mg/dL in triglyceride levels in the moderate intervention group (P = .01 and P = .02, respectively). The median waist circumference decreased by 5.4 cm in the intensive intervention group and by 3.1 cm in the moderate intervention group (P = .10). The prevalence of the metabolic syndrome decreased by 4.0% in the intensive intervention group and increased by 5.2% in the moderate intervention group (P = .12).
The 12-month culturally sensitive intensive lifestyle intervention was effective in improving some of the metabolic syndrome components in obese Arab women. Trial Registration clinicaltrials.gov Identifier: NCT00273572.
关于生活方式干预的随机对照试验在非西方人群中报道较少；在阿拉伯人群中尚无相关报道。
从以色列的2个穆斯林阿拉伯社区中，将年龄在35至54岁、患有肥胖症且无糖尿病、具有1种或更多代谢综合征组分的女性随机分为强化组（n = 100）或中度（对照）组（n = 101），进行为期12个月的生活方式干预。强化干预组的女性每年接受营养师11次个体咨询和11次小组咨询，以及每年22次体育活动小组课程。中度干预组的女性每年接受3次个体饮食咨询和2次小组饮食咨询，且无指导性体育活动。在两种干预措施的设计和实施过程中均考虑了文化问题。主要结局指标是代谢综合征及其组分的变化。
在12个月时，强化干预组空腹血糖中位数下降了3.0mg/dL（换算为毫摩尔每升时，乘以0.0555），甘油三酯水平下降了4.5mg/dL（换算为毫摩尔每升时，乘以0.0113）；相比之下，中度干预组空腹血糖中位数升高了1mg/dL，甘油三酯水平升高了5.8mg/dL（P值分别为0.01和0.02）。强化干预组腰围中位数减少了5.4cm，中度干预组减少了3.1cm（P = 0.10）。强化干预组代谢综合征患病率下降了4.0%，中度干预组增加了5.2%（P = 0.12）。
为期12个月且对文化敏感的强化生活方式干预对改善肥胖阿拉伯女性的某些代谢综合征组分有效。试验注册 clinicaltrials.gov标识符：NCT00273572。
