Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA.
Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
J Phys Act Health. 2023 Oct 27;21(1):40-50. doi: 10.1123/jpah.2023-0145. Print 2024 Jan 1.
Women with abnormal glucose tolerance during pregnancy are at risk for cardiovascular disease (CVD), with higher rates among Hispanics. However, studies on the impact of lifestyle interventions on postpartum CVD profiles are sparse.
This is a secondary analysis of a controlled trial among a subsample of Hispanic women with abnormal glucose tolerance participating in Estudió PARTO (Project Aiming to Reduce Type twO diabetes; mean age = 28.2 y, SD: 5.8) who were randomized to a culturally modified Lifestyle intervention (n = 45) or a comparison Health and Wellness intervention (n = 55). Primary endpoints were biomarkers of cardiovascular risk (lipids, C-reactive protein, fetuin-A, and albumin-to-creatinine ratio) and insulin resistance (fasting insulin, glucose, HbA1c, homeostasis model assessment, leptin, tumor necrosis factor-alpha, and adiponectin) measured at baseline (6-wk postpartum) and 6 and 12 months.
In intent-to-treat analyses, there were no significant differences in changes in biomarkers of CVD risk or insulin resistance over the postpartum year. In prespecified sensitivity analyses, women adherent with the Lifestyle Intervention had more favorable improvements in insulin (intervention effect = -4.87, SE: 1.93, P = .01) and HOMA-IR (intervention effect = -1.15, SE: 0.53, P = .03) compared with the Health and Wellness arm. In pooled analyses, regardless of intervention arm, women with higher postpartum sports/exercise had greater increase in HDL-cholesterol (intervention effect = 6.99, SE: 1.72, P = .0001).
In this randomized controlled trial among Hispanic women with abnormal glucose tolerance, we did not observe a significant effect on postpartum biomarkers of CVD risk or insulin resistance. Women adherent to the intervention had more favorable changes in insulin and HOMA-IR.
患有妊娠期糖耐量异常的女性罹患心血管疾病（CVD）的风险较高，其中西班牙裔人群的发病率更高。然而，关于生活方式干预对产后 CVD 特征影响的研究较少。
这是一项针对参与 Estudió PARTO（旨在减少 2 型糖尿病项目；平均年龄=28.2 岁，SD：5.8）的糖耐量异常的西班牙裔女性亚组的对照试验的二次分析，这些女性被随机分配到文化改良生活方式干预组（n=45）或对照健康与健康干预组（n=55）。主要终点是心血管风险的生物标志物（脂质、C 反应蛋白、胎球蛋白 A 和白蛋白与肌酐比）和胰岛素抵抗（空腹胰岛素、血糖、HbA1c、稳态模型评估、瘦素、肿瘤坏死因子-α和脂联素），在基线（产后 6 周）和 6 个月和 12 个月时进行测量。
在意向治疗分析中，产后一年内 CVD 风险或胰岛素抵抗的生物标志物变化没有显著差异。在预先指定的敏感性分析中，与健康与健康干预组相比，坚持生活方式干预的女性胰岛素（干预效果=-4.87，SE：1.93，P=.01）和 HOMA-IR（干预效果=-1.15，SE：0.53，P=.03）的改善更为有利。在汇总分析中，无论干预组如何，产后运动/锻炼较多的女性 HDL-胆固醇增加幅度更大（干预效果=6.99，SE：1.72，P=.0001）。
在这项针对糖耐量异常的西班牙裔女性的随机对照试验中，我们没有观察到产后 CVD 风险或胰岛素抵抗的生物标志物有显著影响。坚持干预的女性胰岛素和 HOMA-IR 的变化更为有利。
