脊髓损伤患者糖尿病预防计划生活方式干预的调整：降低主要心血管代谢风险、增强体能及改善健康相关生活质量的效果
Modification of the Diabetes Prevention Program Lifestyle Intervention in Persons with Spinal Cord Injury: Efficacy for Reducing Major Cardiometabolic Risks, Increased Fitness, and Improved Health-Related Quality of Life.
作者信息
Bigford Gregory E, Lehmann Doug A, Betancourt Luisa F, Maher Jennifer L, Mendez Armando J, Nash Mark S
机构信息
Department of Neurological Surgery, University of Miami Herbert Business School, Miami USA.
The Miami Project to Cure Paralysis, University of Miami Herbert Business School, Miami USA.
出版信息
J Spine Res Surg. 2024;6(1). doi: 10.26502/fjsrs0070.
UNLABELLED
Individuals with chronic spinal cord injury (SCI) face elevated risks of cardiometabolic diseases, including cardiovascular disease and type 2 diabetes, due to factors like physical inactivity, neurogenic obesity, and disrupted glucose and insulin regulation. We conducted a prospective intervention cohort study involving 20 individuals with SCI (aged 28-60) with neurologic injuries at levels C4-T10 and ASIA scale grades A-D, lasting over a year. Our study assessed the impact of a therapeutic lifestyle intervention (TLI) based on the Diabetes Prevention Program (DPP) and its maintenance phase. The TLI comprised circuit resistance training, a Mediterranean-style calorie-restricted diet, and tailored behavioral support. Key outcomes measured included cardiometabolic risks (plasma analytes and disease biomarkers), anthropometrics (body mass, BMI, tissue composition), global metabolism, fitness (aerobic capacity, peak strength), and health-related quality of life (SF36). Results demonstrated a significant reduction in body mass and BMI by 7.5%, a 7% decrease in total fat mass, and substantial improvements in glucose regulation and insulin sensitivity. Lipid profiles improved, with reduced total cholesterol, triglycerides, and LDL-C, and increased HDL-C. Resting energy expenditure and fat oxidation increased by 27.4% and 58.5%, respectively. Aerobic capacity and dynamic strength also improved significantly. The Physical and Mental Composite Scores of the SF36 improved by 22.8% and 30.5%, respectively. Following the maintenance phase, several positive outcomes persisted, indicating a reduction in risk for cardiovascular disease and comorbid disorders. Our findings support the effectiveness of TLI in reducing cardiometabolic risks, enhancing fitness, and improving health-related quality of life in individuals with chronic SCI.
TRIAL REGISTRATION
ClinicalTrials.gov, ID: NCT02853149 Registered August 2, 2016.
未标注
由于缺乏身体活动、神经源性肥胖以及葡萄糖和胰岛素调节紊乱等因素，慢性脊髓损伤（SCI）患者面临患心血管代谢疾病（包括心血管疾病和2型糖尿病）的风险升高。我们进行了一项前瞻性干预队列研究，涉及20名SCI患者（年龄28 - 60岁），其神经损伤位于C4 - T10水平，美国脊髓损伤协会（ASIA）损伤分级为A - D级，研究持续了一年多。我们的研究评估了基于糖尿病预防计划（DPP）及其维持阶段的治疗性生活方式干预（TLI）的影响。TLI包括循环抗阻训练、地中海式热量限制饮食以及量身定制 的行为支持。测量的主要结果包括心血管代谢风险（血浆分析物和疾病生物标志物）、人体测量学指标（体重、体重指数、身体成分）、整体代谢、体能（有氧能力、峰值力量）以及健康相关生活质量（SF36）。结果显示体重和体重指数显著降低7.5%，总脂肪量减少7%，葡萄糖调节和胰岛素敏感性有显著改善。血脂谱得到改善，总胆固醇、甘油三酯和低密度脂蛋白胆固醇降低，高密度脂蛋白胆固醇升高。静息能量消耗和脂肪氧化分别增加27.4%和58.5%。有氧能力和动态力量也有显著改善。SF36的身体和心理综合评分分别提高了22.8%和30.5%。在维持阶段之后，一些积极结果持续存在，表明心血管疾病和合并症的风险降低。我们的研究结果支持TLI在降低慢性SCI患者心血管代谢风险、增强体能以及改善健康相关生活质量方面的有效性。
试验注册
ClinicalTrials.gov，标识符：NCT02853149，于2016年8月2日注册。
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