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与常规护理相比,生活方式干预对家族性高胆固醇血症患者心血管疾病风险指标无显著改善:一项随机对照试验的结果

No significant improvement of cardiovascular disease risk indicators by a lifestyle intervention in people with familial hypercholesterolemia compared to usual care: results of a randomised controlled trial.

作者信息

Broekhuizen Karen, van Poppel Mireille N M, Koppes Lando L, Kindt Iris, Brug Johannes, van Mechelen Willem

机构信息

Department of Public and Occupational Health, EMGO+Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

BMC Res Notes. 2012 Jul 4;5:181. doi: 10.1186/1756-0500-5-181.

Abstract

BACKGROUND

People with Familial Hypercholesterolemia (FH) may benefit from lifestyle changes supporting their primary treatment of dyslipidaemia. This project evaluated the efficacy of an individualised tailored lifestyle intervention on lipids (low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), total cholesterol (TC) and triglycerides), systolic blood pressure, glucose, body mass index (BMI) and waist circumference in people with FH.

METHODS

Adults with FH (n = 340), recruited from a Dutch cascade screening program, were randomly assigned to either a control group or an intervention group. The personalised intervention consisted of web-based tailored lifestyle advice and personal counselling. The control group received care as usual. Lipids, systolic blood pressure, glucose, BMI, and waist circumference were measured at baseline and after 12 months. Regression analyses were conducted to examine differences between both groups.

RESULTS

After 12 months, no significant between-group differences of cardiovascular disease (CVD) risk indicators were observed. LDL-C levels had decreased in both the intervention and control group. This difference between intervention and control group was not statistically significant.

CONCLUSIONS

This project suggests that an individually tailored lifestyle intervention did not have an additional effect in improving CVD risk indicators among people with FH. The cumulative effect of many small improvements in all indicators on long term CVD risk remains to be assessed in future studies.

TRIAL REGISTRATION

NTR1899 at ww.trialregister.nl.

摘要

背景

家族性高胆固醇血症(FH)患者可能会从支持血脂异常初级治疗的生活方式改变中获益。本项目评估了个体化定制的生活方式干预对FH患者血脂(低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)和甘油三酯)、收缩压、血糖、体重指数(BMI)和腰围的影响。

方法

从荷兰级联筛查项目中招募的340名FH成年患者被随机分为对照组或干预组。个性化干预包括基于网络的定制生活方式建议和个人咨询。对照组接受常规护理。在基线和12个月后测量血脂、收缩压、血糖、BMI和腰围。进行回归分析以检验两组之间的差异。

结果

12个月后,未观察到心血管疾病(CVD)风险指标在组间存在显著差异。干预组和对照组的LDL-C水平均有所下降。干预组与对照组之间的这种差异无统计学意义。

结论

本项目表明,个体化定制的生活方式干预对改善FH患者的CVD风险指标没有额外作用。所有指标中许多小改善对长期CVD风险的累积影响仍有待未来研究评估。

试验注册

荷兰试验注册中心编号为NTR1899(网址:ww.trialregister.nl) 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b351/3392724/f381abcb338d/1756-0500-5-181-1.jpg

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