Kujala Urho M, Jokelainen Jari, Oksa Heikki, Saaristo Timo, Rautio Nina, Moilanen Leena, Korpi-Hyövälti Eeva, Saltevo Juha, Vanhala Mauno, Niskanen Leo, Peltonen Markku, Tuomilehto Jaakko, Uusitupa Matti, Keinänen-Kiukaannemi Sirkka
Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
BMJ Open. 2011 Dec 19;1(2):e000292. doi: 10.1136/bmjopen-2011-000292. Print 2011.
Objectives To investigate the association between increase in physical activity and changes in cardiometabolic risk factors during a lifestyle intervention programme in routine clinical settings. Design Prospective follow-up. Setting 400 primary healthcare centres and occupational healthcare outpatient clinics in Finland. Participants Individuals at high risk for type 2 diabetes identified in the implementation project of the national diabetes prevention programme (FIN-D2D) and participating in baseline and 1-year follow-up visits. Final study group comprised the 1871 non-diabetic participants who responded at follow-up visit to a question on stability versus increase of physical activity. Interventions Lifestyle intervention. Primary outcome measures Cardiometabolic risk factors (body composition, blood pressure and those measured from fasting venous blood samples) measured at baseline and follow-up visits. Results Of the participants, 310 (16.6% of all responders) reported at follow-up having clearly increased their physical activity during the past year, while 1380 (73.8%) had been unable to increase their physical activity. Those who increased their activity decreased their weight by 3.6 kg (95% CI 2.9 to 4.3, age and sex adjusted, p<0.001) and waist circumference by 3.6 cm (95% CI 2.9 to 4.3, p<0.001) more than those who did not increase their activity. Similarly, those who increased their physical activity had greater reductions in total cholesterol (group difference in reduction 0.17 mmol/l, 95% CI 0.06 to 0.28, p=0.002), low-density lipoprotein cholesterol (0.16 mmol/l, 95% CI 0.06 to 0.26, p=0.001), low-density lipoprotein/high-density lipoprotein ratio (0.17, 95% CI 0.08 to 0.25, p<0.001) as well as fasting glucose (0.09 mmol/l, 95% CI 0.03 to 0.15, p=0.004) and 2 h glucose levels (0.36 mmol/l, 95% CI 0.17 to 0.55, p=0.023) than those who did not increase their physical activity. Conclusion Increasing physical activity seems to be an important feature of cardiometabolic risk reduction among individuals at high risk for type 2 diabetes participating in preventive interventions in routine clinical settings.
在常规临床环境下的生活方式干预项目中，研究身体活动增加与心血管代谢危险因素变化之间的关联。
前瞻性随访。
芬兰400家初级医疗保健中心和职业医疗门诊诊所。
在国家糖尿病预防计划（FIN-D2D）实施项目中确定的2型糖尿病高危个体，并参加基线和1年随访。最终研究组包括1871名非糖尿病参与者，他们在随访时回答了关于身体活动是保持稳定还是增加的问题。
生活方式干预。
在基线和随访时测量的心血管代谢危险因素（身体成分、血压以及空腹静脉血样本检测指标）。
在参与者中，310人（占所有应答者的16.6%）在随访时报告在过去一年中身体活动明显增加，而1380人（73.8%）未能增加身体活动。与未增加身体活动的人相比，增加身体活动的人体重减轻了3.6千克（95%CI 2.9至4.3，年龄和性别校正后，p<0.001），腰围减少了3.6厘米（95%CI 2.9至4.3，p<0.001）。同样，与未增加身体活动的人相比，增加身体活动的人总胆固醇降低幅度更大（降低幅度的组间差异为0.17毫摩尔/升，95%CI 0.06至0.28，p=0.002），低密度脂蛋白胆固醇（0.16毫摩尔/升，95%CI 0.06至0.26，p=0.001），低密度脂蛋白/高密度脂蛋白比值（0.17，95%CI 0.08至0.25，p<0.001），以及空腹血糖（0.09毫摩尔/升，95%CI 0.03至0.15，p=0.004）和2小时血糖水平（0.36毫摩尔/升，95%CI 0.17至0.55，p=0.023）。
在常规临床环境下参与预防性干预的2型糖尿病高危个体中，增加身体活动似乎是降低心血管代谢风险的一个重要因素。
