Walden Patrick, Jiang Qingmei, Jackson Elizabeth A, Oral Elif A, Weintraub Martha S, Rubenfire Melvyn
Division of Cardiovascular Medicine, Cardiovascular Medicine at Domino's Farms, University of Michigan Health System, Ann Arbor, MI, USA.
Diabetes Metab Syndr Obes. 2016 Jun 1;9:177-84. doi: 10.2147/DMSO.S94772. eCollection 2016.
Lifestyle interventions targeting the components of the metabolic syndrome (MetSyn) have been demonstrated to be a cost-effective and suitable treatment strategy for reducing one's risk of developing coronary artery disease and diabetes. The optimal duration has not yet been defined. We sought to evaluate the incremental benefit of extending a lifestyle intervention from 3 months to 6 months.
We evaluated 114 participants with at least three criteria for the MetSyn in a physician-referred 6-month lifestyle intervention between August 2008 and December 2012. Baseline and follow-up physiological, biochemical, and anthropometric data were analyzed for mean change and incremental change at each time point.
The mean age at enrollment was 53.0±10.2 years, and 42% of participants were males. The mean body mass index at enrollment was 38.2±0.86 kg/m(2) for males and 38.6±0.93 kg/m(2) for females. Anthropometric measures associated with weight management (body mass index, weight, and body fat percentage) improved significantly with the additional 3-month intervention (P<0.001). Systolic blood pressure (P=0.0001) and diastolic blood pressure (P=0.00006) and triglycerides, fasting blood glucose, and homeostatic model assessment of insulin resistance in diabetic participants (P=0.006, P=0.004, P=0.01, respectively) improved rapidly in the initial 3-month intervention without incremental benefit of the additional 3 months. Improvements in fasting insulin (P=0.01) and homeostatic model assessment of insulin resistance (P=0.02) for nondiabetic participants required the full 6-month intervention before significant reductions were achieved.
A 6-month lifestyle intervention yielded significantly better results for variables related to weight management. Standard physiological measures for the MetSyn respond rapidly in a 3-month lifestyle intervention. The long-term impact of an increased duration lifestyle intervention remains to be seen.
针对代谢综合征（MetSyn）各组成部分的生活方式干预已被证明是一种具有成本效益且合适的治疗策略，可降低患冠状动脉疾病和糖尿病的风险。最佳干预时长尚未确定。我们试图评估将生活方式干预从3个月延长至6个月的额外益处。
在2008年8月至2012年12月期间，我们对114名符合至少三项MetSyn标准的参与者进行了为期6个月的由医生推荐的生活方式干预。分析了基线及随访时的生理、生化和人体测量数据，以获取每个时间点的平均变化和增量变化。
入组时的平均年龄为53.0±10.2岁，42%的参与者为男性。入组时男性的平均体重指数为38.2±0.86kg/m²，女性为38.6±0.93kg/m²。与体重管理相关的人体测量指标（体重指数、体重和体脂百分比）在额外的3个月干预后有显著改善（P<0.001）。收缩压（P=0.0001）、舒张压（P=0.00006）以及糖尿病参与者的甘油三酯、空腹血糖和胰岛素抵抗稳态模型评估值（分别为P=0.006、P=0.004、P=0.01）在最初的3个月干预中迅速改善，额外的3个月并无增量益处。非糖尿病参与者的空腹胰岛素（P=0.01）和胰岛素抵抗稳态模型评估值（P=0.02）在进行完整的6个月干预后才实现显著降低。
为期6个月的生活方式干预在与体重管理相关的变量方面产生了显著更好的结果。MetSyn的标准生理指标在为期3个月的生活方式干预中反应迅速。延长生活方式干预时长的长期影响仍有待观察。
