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12 周生活方式干预对中年韩国男性临界高血压患者健康结局和血清脂肪因子的影响。

Effects of a 12-week lifestyle intervention on health outcome and serum adipokines in middle-aged Korean men with borderline high blood pressure.

机构信息

Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Youngin, Korea.

出版信息

J Am Coll Nutr. 2012 Oct;31(5):352-60. doi: 10.1080/07315724.2012.10720440.

Abstract

BACKGROUND

High blood pressure, in relation to blood levels of adipokines such as adiponectin and leptin, is highly associated with an unhealthy lifestyle including sedentary behaviors, poor dietary habits such as excess sodium intake, and heavy drinking. Strategies to reduce blood pressure may benefit the levels of adipokines.

OBJECTIVE

Thus, we aimed to investigate the effects of lifestyle intervention on blood pressure and serum adipokines in middle-aged Korean men with borderline high blood pressure (systolic blood pressure [SBP] ≥ 130 mm Hg or diastolic blood pressure [DBP] ≥ 85 mm Hg).

METHODS

Fifty-two men (aged 42.5 ± 8.5 years) with normal weight (body mass index [BMI] < 25 kg/m(2)) and high BP (NH group) and 40 men (age 42.0 ± 8.4 years) who were obese (BMI ≥ 25 kg/m(2)) with high BP (OH group) underwent 5 sessions of one-on-one intensive counseling including instruction on a nutritionally balanced diet, a low-sodium diet, how to understand calorie requirements, and strategies to implement regular exercise for blood pressure regulation over 12 weeks. In order to increase the awareness of sodium education, a salt sensory test using an unseasoned soup was performed. Anthropometrics, blood pressure measurements, 24-hour recalls were performed, and blood levels of lipids, fasting plasma glucose, C-reactive protein (CRP), leptin, and adiponectin were analyzed at week 0 and at week 12. Sodium consumption was roughly estimated using the Dish-based Frequency Questionnaire-15.

RESULTS

Weight, BMI, body fat (kg and %), waist circumference, hip circumference, and blood pressure were significantly decreased after 12 weeks (p < 0.05) in all subjects. Similarly, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and CRP were decreased (p < 0.05), but LDL-C/HDL-C was significantly decreased (p < 0.01) only in the obese subjects. At baseline, blood levels of leptin were significantly higher in the obese subjects than in the normal weight subjects. In the obese subjects, a significantly negative correlation was found between leptin levels at baseline and percentage change in DBP (r = -0.338, p < 0.05). After 12 weeks, blood levels of adipokines did not show significant changes.

CONCLUSIONS

These results suggest that a short-term (12 weeks) lifestyle intervention had positive effects on blood pressure control and weight reduction in the subjects, but not on their blood levels of adipokines. It is interesting that blood level of baseline leptin was negatively associated with the changes in blood pressure after this short-term intervention.

摘要

背景

高血压与脂联素和瘦素等脂肪因子的血液水平密切相关,与包括久坐行为在内的不健康生活方式高度相关,这些不健康生活方式还包括不良的饮食习惯,如摄入过多的钠和大量饮酒。降低血压的策略可能有益于脂肪因子水平。

目的

因此,我们旨在研究生活方式干预对中年韩国男性(收缩压[SBP]≥130mmHg 或舒张压[DBP]≥85mmHg)的血压和血清脂肪因子的影响。

方法

52 名男性(年龄 42.5±8.5 岁)体重正常(BMI<25kg/m²)且血压偏高(NH 组)和 40 名男性(年龄 42.0±8.4 岁)超重(BMI≥25kg/m²)且血压偏高(OH 组)接受了 5 次一对一的强化咨询,内容包括营养均衡饮食、低盐饮食、如何了解热量需求以及实施规律运动以调节血压的策略,共持续 12 周。为了提高对钠教育的认识,进行了未调味汤的盐感测试。在第 0 周和第 12 周时进行人体测量、血压测量、24 小时回顾和血液中脂质、空腹血糖、C 反应蛋白(CRP)、瘦素和脂联素的分析。使用基于餐盘的频率问卷-15 大致估计钠的摄入量。

结果

所有受试者在 12 周后体重、BMI、体脂肪(kg 和%)、腰围、臀围和血压均显著降低(p<0.05)。同样,总胆固醇、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和 CRP 也降低(p<0.05),但仅在肥胖受试者中 LDL-C/HDL-C 显著降低(p<0.01)。在基线时,肥胖受试者的瘦素水平显著高于体重正常的受试者。在肥胖受试者中,瘦素水平与 DBP 变化百分比呈显著负相关(r=-0.338,p<0.05)。12 周后,脂联素水平没有显著变化。

结论

这些结果表明,短期(12 周)生活方式干预对受试者的血压控制和体重减轻有积极影响,但对脂联素水平没有影响。有趣的是,基线时瘦素水平与短期干预后血压的变化呈负相关。

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