Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
J Ren Nutr. 2011 Nov;21(6):462-71. doi: 10.1053/j.jrn.2010.12.002. Epub 2011 Mar 31.
To investigate the effect of dietitian involvement in a multidisciplinary lifestyle intervention comparing risk factor modification for cardiovascular disease with standard posttransplant care in renal transplant recipients (RTR) with abnormal glucose tolerance (AGT).
Randomized controlled trial.
Hospital outpatient department.
Adult RTR with AGT.
RTR with AGT were randomized to a lifestyle intervention that consisted of either regular consultations with the dietitian and multidisciplinary team or standard care.
Dietary intake, physical activity (PA) levels, cardiorespiratory fitness (CF), and anthropometry.
Total fat and percent saturated fat intake rates were significantly lower in the intervention group as compared with the control group at 2-year follow-up, 54 g (16 to 105 g) versus 65 g (34 to 118 g), P = .01 and 10% (5% to 17%) versus 13% (4% to 20%), P = .05., respectively. There was a trend for an overweight (but not obese) individual to lose more weight in the intervention group (4% loss vs. a gain of 0.25% at the 2-year follow-up). Overall, RTR were significantly less fit than age- and gender-matched controls, mean peak oxygen uptake was 19.42 ± 7.09 mL/kg per minute versus 28.35 ± 8.80 mL/kg per minute, P = .000. Simple exercise advice was not associated with any improvement in total PA or CF in either group at the 2-year follow-up.
Dietary advice can contribute to healthier eating habits and a trend for weight loss in RTR with AGT. These improvements in conjunction with multidisciplinary care and pharmacological treatment can lead to improvements in cardiovascular risk factors such as lipid profile. Simple advice to increase PA was not effective in improving CF and other measures are needed.
研究营养师参与多学科生活方式干预对伴有异常葡萄糖耐量（AGT）的肾移植受者（RTR）心血管疾病风险因素改善的效果，与标准移植后护理相比。
随机对照试验。
医院门诊。
伴有 AGT 的成年 RTR。
伴有 AGT 的 RTR 被随机分为生活方式干预组，该干预组包括营养师和多学科团队的定期会诊或标准护理。
饮食摄入、体力活动（PA）水平、心肺功能（CF）和人体测量。
与对照组相比，干预组在 2 年随访时的总脂肪和饱和脂肪百分比摄入量显著降低，分别为 54 g（16 至 105 g）对 65 g（34 至 118 g），P =.01 和 10%（5%至 17%）对 13%（4%至 20%），P =.05。干预组超重（但非肥胖）个体体重减轻趋势更为明显（2 年随访时体重减轻 4%，而对照组体重增加 0.25%）。总体而言，RTR 的体能明显不如年龄和性别匹配的对照组，平均峰值摄氧量为 19.42 ± 7.09 mL/kg/min 对 28.35 ± 8.80 mL/kg/min，P =.000。在 2 年随访时，无论在哪个组，简单的运动建议都与总 PA 或 CF 的任何改善均无关。
饮食建议可有助于 RTR 伴有 AGT 人群形成更健康的饮食习惯和减轻体重的趋势。这些改善与多学科护理和药物治疗相结合可导致血脂等心血管危险因素的改善。简单增加 PA 的建议并不能有效改善 CF，需要采取其他措施。
