Rautio Nina, Jokelainen Jari, Pölönen Auli, Oksa Heikki, Peltonen Markku, Vanhala Mauno, Puolijoki Hannu, Moilanen Leena, Tuomilehto Jaakko, Uusitupa Matti, Keinänen-Kiukaanniemi Sirkka, Saaristo Timo
Pirkanmaa Hospital District, Finland
Institute of Health Sciences, University of Oulu, Finland Unit of General Practice, Oulu University Hospital, Finland.
Eur J Cardiovasc Nurs. 2015 Apr;14(2):145-52. doi: 10.1177/1474515114521713. Epub 2014 Jan 22.
The purpose of this study was to assess whether changes in self-rated physical activity and diet during a type 2 diabetes (T2D) prevention program were associated with changes in estimated 10-year risk for cardiovascular disease (CVD) events and mortality in people at high risk for T2D.
Individuals were identified and offered lifestyle counseling as part of the Finnish diabetes prevention program. Ten-year risk for estimated CVD events and mortality were calculated with Framingham Risk Score (FRS) and Systematic Coronary Risk Evaluation (SCORE) formula. FRS was available for 774 men and 1474 women and SCORE for 961 men and 1766 women.
During the one-year follow-up, 9.6% of the men reported both an increase in physical activity and improved dietary pattern, 4.1% an increase in physical activity, 39.3% an increase in improved dietary pattern, while 47.0% reported no lifestyle changes. Corresponding numbers for women were 14.2%, 3.8%, 39.2% and 42.7%. Estimated 10-year risk for CVD events decreased 3.5% in men and 1.5% in women reporting an increase in physical activity and improvement in diet, compared to an increase of 0.15% in men (p<0.001, between groups) and decrease of 0.43% (p=0.027, between groups) in women with no lifestyle changes after adjustment for age and baseline FRS. Numbers needed to treat to prevent one CVD event by lifestyle changes were 25 for men and 59 for women. Lifestyle changes had no effect on estimated CVD mortality risk.
Lifestyle counseling offered in primary health care for one year results in favorable changes in lifestyle, and lowered the estimated 10-year risk for CVD events.
本研究旨在评估在2型糖尿病(T2D)预防项目中,自我报告的身体活动和饮食变化是否与T2D高危人群心血管疾病(CVD)事件和死亡的估计10年风险变化相关。
作为芬兰糖尿病预防项目的一部分,识别个体并为其提供生活方式咨询。使用弗雷明汉风险评分(FRS)和系统性冠状动脉风险评估(SCORE)公式计算CVD事件和死亡的估计10年风险。774名男性和1474名女性可获得FRS,961名男性和1766名女性可获得SCORE。
在一年的随访期间,9.6%的男性报告身体活动增加且饮食模式改善,4.1%的男性报告身体活动增加,39.3%的男性报告饮食模式改善,而47.0%的男性报告生活方式无变化。女性的相应比例分别为14.2%、3.8%、39.2%和42.7%。与未改变生活方式的男性(年龄和基线FRS调整后,组间p<0.001)增加0.15%以及女性减少0.43%(组间p=0.027)相比,报告身体活动增加且饮食改善的男性CVD事件估计10年风险降低3.5%,女性降低1.5%。通过生活方式改变预防一例CVD事件所需治疗人数男性为25人,女性为59人。生活方式改变对CVD死亡风险估计无影响。
初级卫生保健中提供的一年生活方式咨询导致生活方式出现有利变化,并降低了CVD事件的估计10年风险。