个体生活方式和血液检测计划对急救人员心血管风险因素的降低作用：一项随机对照试验。
Cardiovascular Risk Factor Reduction in First Responders Resulting From an Individualized Lifestyle and Blood Test Program: A Randomized Controlled Trial.
机构信息
Boston Heart Diagnostics, Framingham, Massachusetts (Dr Gill, Ms Jones, Ms Ghosh, Mr Gleason, Dr Dansinger); Cholesterol, Genetics, and Heart Disease Institute, Carmel, California (Dr Superko); Heart Fit for Duty, Gilbert, Arizona (Ms McCarthy, Ms Jack); Mesa Fire Services, Mesa, Arizona (Mr Richards); Children's Hospital of Oakland, Oakland (Dr Williams), California; Tufts Medical Center, Boston, Massachusetts (Dr Dansinger).
出版信息
J Occup Environ Med. 2019 Mar;61(3):183-189. doi: 10.1097/JOM.0000000000001490.
OBJECTIVE
We tested the hypothesis that a lifestyle program would improve risk factors linked to cardiovascular disease (CVD) in first responders.
METHODS
A 1-year cluster-randomized controlled clinical trial in 10 cities. Participants were 175 first responders, with increased waist circumference and/or low levels of large (α1) high-density lipoprotein (HDL) particles. The intervention group received personalized online tools and access to telephonic coaching sessions.
RESULTS
At 1 year the intervention significantly reduced body weight (P = 0.004) and waist circumference (P = 0.002), increased α1 HDL (P = 0.01), and decreased triglyceride (P = 0.005) and insulin concentrations (P = 0.03). Program adherence was associated with weight loss (P = 0.0005) and increases in α1 HDL (P = 0.03).
CONCLUSIONS
In first responders, a personalized lifestyle intervention significantly improved CVD risk factors in proportion to program adherence. Changes in large HDL particles were more sensitive indicators of lifestyle changes than HDL-cholesterol measurement.
CLINICAL TRIAL REGISTRATION NUMBER
ClinicalTrials.gov: NCT03322046.
目的
我们检验了这样一个假设，即生活方式干预计划将改善与心血管疾病（CVD）相关的风险因素在急救人员。
方法
这是一项为期 1 年、在 10 个城市进行的集群随机对照临床试验。参与者为 175 名急救人员，他们的腰围增加和/或大（α1）高密度脂蛋白（HDL）颗粒水平较低。干预组接受个性化在线工具和电话辅导课程。
结果
在 1 年内，干预组显著降低体重（P=0.004）和腰围（P=0.002），增加α1 HDL（P=0.01），降低甘油三酯（P=0.005）和胰岛素浓度（P=0.03）。计划依从性与体重减轻（P=0.0005）和α1 HDL 增加（P=0.03）相关。
结论
在急救人员中，个性化的生活方式干预计划与计划依从性成正比，显著改善 CVD 风险因素。大 HDL 颗粒的变化比 HDL-胆固醇测量更能敏感地反映生活方式的改变。
临床试验注册号
ClinicalTrials.gov：NCT03322046。
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