Institute of Cardiovascular Research and Sport Medicine, Department of Preventive and Rehabilitative Sport Medicine, German Sport University Cologne, Cologne, Germany.
Department of Fitness and Health, IST University of Applied Sciences, Düsseldorf, Germany.
Front Endocrinol (Lausanne). 2023 Feb 23;14:1106334. doi: 10.3389/fendo.2023.1106334. eCollection 2023.
To evaluate the effects of a multimodal intervention (including exercise training, psychosocial interventions, nutrition coaching, smoking cessation program, medical care) on the health and long-term cardiovascular disease (CVD) mortality risk of company employees with pre-diabetes or diabetes mellitus (DM) at high CVD risk.
In the PreFord study, German company employees (n=4196) participated in a free-of-charge CVD mortality risk screening at their workplace. Based on their European Society of Cardiology - Systematic Coronary Risk Evaluation score (ESC-SCORE), they were subdivided into three risk groups. High-risk patients (ESC-SCORE≥5%) were randomly assigned to a 15-week lifestyle intervention or usual care control group. Data from patients with pre-DM/DM were analyzed intention-to-treat (ITT: n=110 versus n=96) and per protocol (PP: n=60 versus n=52).
Body mass index, glycated hemoglobin, total cholesterol, low-density lipoprotein, triglyceride levels as well as systolic and diastolic blood pressure improved through the intervention (ITT, PP: p<0.001). The ESC-SCORE markedly decreased from pre- to post-intervention (ITT, PP: p<0.001). ESC-SCORE changes from baseline differed significantly between the groups, with the intervention group achieving more favorable results in all follow-up visits 6, 12, 24 and 36 months later (at each time point: ITT: p<0.001; PP: p ≤ 0.010).
The study demonstrates the feasibility of attracting employees with pre-DM/DM at high CVD mortality risk to participate in a multimodal lifestyle program following a free CVD mortality risk screening at their workplace. The lifestyle intervention used in the PreFord study shows high potential for improving health of company employees with pre-DM/DM in the long term. ISRCTN23536103.
评估多模式干预（包括运动训练、心理社会干预、营养指导、戒烟计划、医疗保健）对患有糖尿病前期或糖尿病（DM）且心血管疾病（CVD）风险较高的公司员工的健康和长期 CVD 死亡率风险的影响。
在 PreFord 研究中，德国公司员工（n=4196）在工作场所参加了免费的 CVD 死亡率风险筛查。根据他们的欧洲心脏病学会-系统性冠状动脉风险评估评分（ESC-SCORE），他们被分为三个风险组。高危患者（ESC-SCORE≥5%）被随机分配到 15 周的生活方式干预或常规护理对照组。对患有糖尿病前期/糖尿病的患者进行意向治疗（ITT：n=110 与 n=96）和方案治疗（PP：n=60 与 n=52）分析。
通过干预，体重指数、糖化血红蛋白、总胆固醇、低密度脂蛋白、甘油三酯水平以及收缩压和舒张压均得到改善（ITT、PP：p<0.001）。ESC-SCORE 从干预前到干预后明显降低（ITT、PP：p<0.001）。从基线开始，ESC-SCORE 变化在两组之间存在显著差异，干预组在所有后续随访 6、12、24 和 36 个月后（在每个时间点：ITT：p<0.001；PP：p≤0.010）均取得了更有利的结果。
该研究表明，在工作场所进行免费 CVD 死亡率风险筛查后，吸引患有高 CVD 死亡率风险的糖尿病前期/糖尿病患者参加多模式生活方式计划是可行的。PreFord 研究中使用的生活方式干预具有很大的潜力，可以长期改善患有糖尿病前期/糖尿病的公司员工的健康状况。ISRCTN23536103。
