Wang Zhen, Qian Li, Shen Jian-Tong, Wang Bing, Shen Xu-Hui, Shi Guo-Ping
School of Medicine and School of Nursing, Huzhou University, Huzhou, Zhejiang, China.
Huzhou Key Laboratory of Precise Prevention and Control of Major Chronic Diseases, Huzhou University, Huzhou, Zhejiang, China.
Front Endocrinol (Lausanne). 2025 Mar 28;16:1413206. doi: 10.3389/fendo.2025.1413206. eCollection 2025.
Prediabetes indicates an increased risk of developing diabetes mellitus. We hypothesized that structured anti-inflammatory and antioxidant dietary and exercise interventions (SAIDEs) can reduce the onset of diabetes in prediabetic patients.
This study included 542 prediabetic patients who met at least one of the three common criteria for prediabetes: fasting blood glucose (FBG), 2-h oral glucose tolerance (2h OGTT), or hemoglobin A1c (HbA1C). Patients were randomly assigned to one of four groups using the block randomization method: routine community intervention, dietary intervention, exercise intervention, or SAIDEs for 6 months. Follow-up assessments were conducted at 6 months and 7.5 years, monitoring diabetes-related outcomes, inflammatory markers, and diabetes progression.
At baseline, most tested variables, including age, gender, body weight, blood lipids, blood sugar, β-cell function, blood inflammatory and immunological markers, and energy intake, did not differ among the groups. After 6 months of short-term interventions (diet, exercise, and SAIDEs) and 6 months of follow-up, all intervention groups exhibited reduced total energy intake, body weight, blood pressure, blood cholesterol, and glucose levels, along with improved β-cell functions (all < 0.001). Regardless of time considerations, intervention consistently increased total physical activity ( < 0.001). Short-term interventions also reduced blood IgE, high-sensitivity C-reactive protein, IL-6, and TNF-α, while increasing blood IL-4 and IL-10 (all < 0.001). The prevalence of abnormal blood glucose markers-FBG, 2h OGTT, and HbA1C-significantly decreased within each intervention group after short-term intervention and 6 months of follow-up. The time-dependent Cox regression test did not indicate a significant effect of dietary or exercise intervention on diabetes incidence over the 8-year follow-up period. However, the log-rank test revealed significant differences in "survival" distribution among the four intervention groups ( = 15.63, = 0.001). The mean survival time before diabetes onset was significantly longer in prediabetic patients who received SAIDEs than in those in other groups.
Short-term intervention with SAIDEs exhibited significant anti-inflammatory activity and reduced the prevalence of abnormal blood glucose markers. These benefits persisted even after 6 months of follow-up. However, over the 8-year follow-up period, intensive SAIDEs did not reduce diabetes incidence among prediabetic patients but did delay its onset.
https://www.chictr.org.cn/searchproj.html, identifier ChiCTR-IOR-16008445.
糖尿病前期表明患糖尿病的风险增加。我们假设结构化的抗炎和抗氧化饮食及运动干预（SAIDEs）可以降低糖尿病前期患者患糖尿病的几率。
本研究纳入了542名糖尿病前期患者，他们至少符合糖尿病前期的三项常见标准之一：空腹血糖（FBG）、口服葡萄糖耐量试验2小时血糖（2h OGTT）或糖化血红蛋白（HbA1C）。采用区组随机化方法将患者随机分为四组之一：常规社区干预、饮食干预、运动干预或SAIDEs，为期6个月。在6个月和7.5年时进行随访评估，监测与糖尿病相关的结果、炎症标志物和糖尿病进展情况。
在基线时，大多数测试变量，包括年龄、性别、体重、血脂、血糖、β细胞功能、血液炎症和免疫标志物以及能量摄入，在各组之间没有差异。经过6个月的短期干预（饮食、运动和SAIDEs）以及6个月的随访后，所有干预组的总能量摄入、体重、血压、血胆固醇和血糖水平均降低，同时β细胞功能得到改善（均P<0.001）。无论时间因素如何，干预均持续增加了总身体活动量（P<0.001）。短期干预还降低了血液中的免疫球蛋白E（IgE）、高敏C反应蛋白、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α），同时增加了血液中的白细胞介素-4（IL-4）和白细胞介素-10（均P<0.001）。经过短期干预和6个月的随访后，每个干预组中血糖异常标志物——FBG、2h OGTT和HbA1C——的患病率均显著降低。时间依赖性Cox回归检验表明，在8年的随访期内，饮食或运动干预对糖尿病发病率没有显著影响。然而，对数秩检验显示四个干预组之间的“生存”分布存在显著差异（χ² = 15.63，P = 0.001）。接受SAIDEs的糖尿病前期患者在糖尿病发病前的平均生存时间明显长于其他组。
SAIDEs的短期干预表现出显著的抗炎活性，并降低了血糖异常标志物的患病率。即使在随访6个月后，这些益处仍然存在。然而，在8年的随访期内，强化的SAIDEs并没有降低糖尿病前期患者的糖尿病发病率，但确实延迟了其发病。
https://www.chictr.org.cn/searchproj.html，标识符ChiCTR-IOR-16008445。
