Diaz-Zavala R G, Esparza-Romero J, Moya-Camarena S Y, Quihui L, Cisneros-Tapia R, Valencia M E
Arch Latinoam Nutr. 2012 Sep;62(3):258-66.
The aim of this study was to evaluate an intensive lifestyle intervention for weight management among youth in a primary care setting on insulin sensibility, compared to a control group. The study included 42 youths 9-17 years old (n=23 intensive lifestyle intervention, n=19 control group) who completed a randomized trial for weight management in a primary care setting which included an oral glucose tolerance test. The intensive lifestyle intervention included monthly consultations with the primary care physician, nutrition counseling with a registered dietitian (weekly first 3 months and then monthly) and 12 group sessions in a behavioral change protocol. The control group attended monthly consultations with the primary care physician. Insulin sensitivity was estimated by the Insulin Sensitivity Index ISI(0,120) at baseline and 6 months posttreatment. At 6 months, the mean +/- DE, increase in insulin sensitivity was greater in the intensive lifestyle intervention than the control group (+46.8 +/- 56 vs. +5.6 +/- 47, between-group difference 41.2 [CI 95%, 8.5, 73.9], p = 0.01): Sixty five percent of youths on the intensive lifestyle intervention increased insulin sensitivity over 9 units vs. 32% in the control group (p=0.03). This study shows preliminary evidence that an intensive lifestyle intervention program can be an alternative model to improve insulin sensitivity among youths in the primary care setting.
本研究的目的是在初级保健机构中，评估针对青少年体重管理的强化生活方式干预对胰岛素敏感性的影响，并与对照组进行比较。该研究纳入了42名9至17岁的青少年（n = 23为强化生活方式干预组，n = 19为对照组），他们在初级保健机构完成了一项体重管理随机试验，其中包括口服葡萄糖耐量试验。强化生活方式干预包括每月与初级保健医生会诊、由注册营养师进行营养咨询（前3个月每周一次，之后每月一次）以及12次行为改变方案的小组会议。对照组每月与初级保健医生进行会诊。在基线和治疗后6个月，通过胰岛素敏感性指数ISI(0,120)评估胰岛素敏感性。6个月时，强化生活方式干预组胰岛素敏感性的平均增加量（±标准差）大于对照组（+46.8±56 vs. +5.6±47，组间差异41.2 [95%CI，8.5，73.9]，p = 0.01）：强化生活方式干预组65%的青少年胰岛素敏感性增加超过9个单位，而对照组为32%（p = 0.03）。本研究显示了初步证据，表明强化生活方式干预计划可能是改善初级保健机构中青少年胰岛素敏感性的一种替代模式。
